How to increase testosterone during puberty

Testosterone is a male sex hormone responsible for male sex characteristics, sperm cell development, and fertility. The hormone plays an important role in the development of young adults during puberty, the period when children become young adults through emotional and physical changes.

“In males assigned at birth, the hormone is produced in the testicles and has several developmental functions,” says Victoria M. Smith, a registered dietitian nutritionist at Top Nutrition Coaching. “This includes growing facial and body hair, deepening vocal tones, aiding in fat storage and distribution, and playing a vital role in muscle strength and bone health.”

Some young men may develop more slowly than peers, which may cause concern. Low testosterone, also known as “low T” or male hypogonadism, is the cause of delayed puberty in males. The deficiency can be caused by a genetic disorder of testosterone production by the testes, damage after birth to the testes, or a pituitary gland disorder since the gland produces hormones that stimulate testosterone production by the testes. These conditions can be permanent. A temporary low testosterone level may also result from an underlying inflammatory disease or poor nutrition since the body lacks the energy and resources to support pubertal development. 

Here’s a look at the factors associated with low testosterone levels during puberty and how teens can increase their levels.

Normal testosterone levels during puberty

Understanding the normal range of total testosterone for young men can make it easier to detect male hypogonadism and help teens achieve higher testosterone levels. Teen boys typically begin puberty between ages 9 and 14, and young girls between ages 8 and 13. Teen girls can also produce testosterone during puberty, but in smaller amounts.

Average testosterone levels for females ages 9 to 14 can range from 7–75 nanograms per deciliter (ng/dl). For males, it ranges from 7–1,200 ng/dl. “It’s important to note that there can be considerable individual variation,” says Justin Houman, MD, a board-certified urologist and men’s health specialist at Tower Urology at Cedars-Sinai Medical Center. 

Low testosterone during puberty

Low testosterone levels during puberty “can impact growth, development, and overall well-being,” Dr. Houman says. For adolescents assigned male at birth, the effects of low testosterone before or during puberty include:

• Slowed growth in height with disproportionate arm and leg growth 
• Reduced development of pubic hair, penis, and testicles
• Less deepening of the voice
• Low strength and endurance

Because hypogonadism is often associated with older adults, it’s not uncommon for teens dealing with low testosterone production to be misdiagnosed. In fact, it’s estimated that around 70% of children with hypogonadism will be misdiagnosed if based on measurement of pituitary hormones alone.

“If parents suspect that their teenager may have irregular hormone production or health concerns, a consultation with their healthcare provider is always advisable,” Smith says. “Oversight from a healthcare provider can help determine hormone levels and functioning and, in turn, the best course of treatment.” 

Natural ways to increase testosterone

Although there’s limited research on how to increase testosterone without medicine in adolescents during puberty, there is research that suggests that certain lifestyle changes can boost testosterone levels in adult males. The following measures will not resolve adolescent testosterone deficiency due to congenital abnormal testicular or pituitary function, but they may help an individual with slow pubertal progression:

• Maintaining a healthy weight: Research shows a relationship between obesity and low testosterone. Maintaining a healthy weight throughout childhood and adolescence may help with producing age-appropriate testosterone levels. 
• Engaging in regular exercise: Research shows that exercise has significant health benefits that can cause an increase in testosterone levels in adult men. The Centers for Disease Control and Prevention (CDC) recommends that adolescents engage in 60 minutes or more of moderate-to-vigorous physical activity each day. Do not overdo it, though, because excessive exercise can actually contribute to delayed puberty.
• Getting enough sleep: A lack of sleep can affect testosterone levels, according to a study of the effect of sleep restriction on testosterone levels in young, healthy men. Once they hit puberty, adolescents need around nine hours of sleep each night for optimal health.

Supplements to increase testosterone

Parents are sometimes curious about whether supplements can help to increase testosterone. According to research, vitamin D may boost testosterone levels. Magnesium has also been used to increase testosterone—especially among athletes.

While it seems that dietary supplements may be beneficial in increasing low testosterone, “it’s generally not recommended for teenagers to take supplements to increase testosterone without medical supervision,” Dr. Houman says. “Unregulated supplements can be risky and may have unpredictable effects on hormonal balance and overall health.”

Teens and their parents or guardians should be weary of testosterone-boosting supplements, known as “T-boosters, ” sold at retailers like Amazon. These supplements have few human studies to prove their effectiveness.

“It’s always advisable to consult with a healthcare professional before using any supplements,” Dr. Houman adds.

Medications for low testosterone during puberty

If necessary, a teen’s healthcare provider may recommend testosterone replacement therapy (TRT) medications to treat adolescent low testosterone so pubertal changes can proceed. Medications can be one of the most effective ways to boost testosterone.

“The age at which TRT can be initiated depends on the individual’s specific circumstances and should be determined by a specialist,” Dr. Houman says. It’s advisable to consult the expertise of an endocrinologist—a doctor specializing in treating health conditions caused by problems with the body’s hormones. 

There are two types of hypogonadism prescription medications approved for pediatric use in the United States: synthetic testosterone injections and implantable pellets.

Synthetic testosterone injection 

This testosterone therapy is used to stimulate delayed puberty in male teens who don’t naturally produce enough testosterone. Brand names include Aveed (testosterone undecanoate), Depo-Testosterone (testosterone cypionate), and Xyosted (testosterone enanthate). Some injections are administered to children as young as 12.

Potential side effects of testosterone injections include:

• Acne
• Breast enlargement or pain
• Hoarseness
• Voice deepening
• Pain, redness, bruising, bleeding, or hardness at the injection site
• Tiredness
• Mood swings
• Weight gain
• Pain in the joints and back
• Headache

Implantable pellets

Sold as Testopel, implantable pellets are inserted underneath the skin near the buttocks and slowly release testosterone through a teen’s body. They dissolve within two to six months and are typically replaced every three months to sustain high testosterone levels. 

Additional adverse skin reactions to these pellets may include:

• Acne
• Alopecia (hair loss)
• Hirsutism (abnormal hair growth)
• Bleeding
• Bruising
• Fibrosis (skin thickening or hardening)
• Infections
• Displacement of pellets
• Scarring
• Subcutaneous nodules

Bottom line: See a healthcare provider if you suspect low testosterone

Although healthy lifestyle and dietary changes are worthwhile to support puberty, they aren’t a solution to most cases of low testosterone in adolescents. If you suspect low testosterone in your adolescent, see a healthcare provider who can make a proper diagnosis and prescribe treatment if necessary. Your pediatrician may order a blood test to measure your child’s testosterone levels if puberty starts earlier or later than expected. Results can reveal whether there’s been damage or disease of the testes, adrenal glands, or pituitary gland.