Sex differences in testosterone and obesity

Androgens, particularly testosterone, play a central role in the regulation of energy metabolism and adipose tissue distribution; however, their physiological effects exhibit marked sexual dimorphism. In males, testosterone, primarily secreted by the testes, has been reported to inhibit adipogenesis and limit the accumulation of visceral fat. Conversely, obesity itself may suppress testosterone production, creating a deleterious feedback loop between the two. In females, testosterone is derived from the ovaries, adrenal glands, and peripheral conversion of androgen precursors, and obesity may be associated with relative androgen excess. Excess androgen signaling is implicated in the promotion of further fat accumulation and is a characteristic feature of metabolic disorders such as polyendocrine metabolic ovarian syndrome (PMOS, formerly known as PCOS). This review summarizes the bidirectional relationship between testosterone and obesity in both sexes and discusses future research directions.