Low testosterone in men

low testosterone in men

What Is Low Testosterone? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Testosterone is the primary sex hormone in men, and it is responsible for the development of many of the physical characteristics that are considered typically male, such as deep voice, hair growth, increased bone density, and many others.

Testosterone, part of a hormone class known as androgens, is produced by the testicles after stimulation from the pituitary gland, which is located near the base of the brain and sends signals to a male’s testicles that spark feelings of sexual desire, notes MedlinePlus.

While testosterone may be used to treat women, low levels of testosterone (also known as low T or hypogonadism) is considered a male problem, according to a 2019 review.

Signs and Symptoms of Low Testosterone

Depending on the cause and age when low T first appears, symptoms can differ. Younger males should watch out for:

  • Fatigue
  • Depression
  • Sleep problems
  • Low sex drive
  • Inability to get or maintain an erection
  • Low sperm count
  • Enlarged or tender breasts
  • Loss of muscle and bone
  • Fertility issues
  • Loss of body hair

Men can have low T but have no symptoms. Also, some symptoms, such as fatigue, sleep problems, and depression, can be caused by many underlying conditions that have nothing to do with testosterone.

What Are The Functions of Testosterone After Puberty?

Explore the importance of testosterone in men’s health and its role in regulating various bodily functions post-puberty.

Causes and Risk Factors of Low Testosterone

Men’s testosterone levels start a natural decline starting around age 30, and then drop about 1 percent per year after that for the rest of their lives.

A variety of other medical conditions can cause significantly lower-than-normal testosterone levels in boys and men. These include:

  • Autoimmune diseases
  • Chronic liver or kidney disease
  • Chronic obstructive lung disease
  • Genetic causes
  • Heart failure
  • HIV or AIDS
  • Infections (such as mumps)
  • Injury to the testicles
  • Metabolic disorders
  • Obesity
  • Prolactinoma (prolactin-secreting tumor) or other tumors in the pituitary gland
  • Testicular cancer or treatment for testicular cancer
  • Type 2 diabetes

Some drugs are also associated with low testosterone levels, including:

Sometimes the cause of low testosterone in a man is unknown, and many men have several different causes.

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How Is Low Testosterone Diagnosed?

  • Total Testosterone Level
  • Luteinizing Hormone (LH) Abnormal levels may mean a pituitary gland problem, which can cause low T.
  • Blood Prolactin Level High levels can also signal pituitary problems or tumors.
  • Blood Hemoglobin (Hgb)
  • Follicle Stimulating Hormone (FSH) This may be checked for sperm-making function.
  • Estradiol Hormone Test This is performed if the patient has enlarged breasts.
  • Glycosylated Hemoglobin (HgbA1C) Blood Test This test looks for diabetes by checking the level of hemoglobin attached to glucose.
  • Thyroid Hormone Levels Assessing other hormonal abnormalities can contribute to diagnosis.
  • Cortisol Level This is another potential hormonal abnormality.
  • Magnetic Resonance Imaging (MRI) An MRI scan of the pituitary gland may be performed.
  • Bone Density Tests Low T can promote bone loss.
  • Karyotype (Chromosome Tests)

Prognosis of Low T

The long-term outlook is good, if diagnosed and treated early. Treatment can reverse symptoms, and reduce risk of muscle and bone loss, notes Urology Austin.

Duration of Low Testosterone

During and after treatment, you will need to be checked routinely to ensure that your levels stay normal. If you are responding appropriately to testosterone treatment, your levels should be checked every 6 to 12 months, depending on your physician’s recommendation.

Your doctor will also monitor you for any possible adverse side effects, such as an increased risk of blood clots and prostate cancer.

Treatment and Medication Options for Low Testosterone

Medication and Nonsurgical Treatment Options

In the past, low T was typically treated with testosterone replacement therapy (TRT). Recently, however, thinking has changed on this. The American College of Physicians updated its clinical practice guidelines in 2020 to counsel that TRT should only be prescribed to men for sexual dysfunction.

Possible Side Effects of TRT

Possible long-term effects of TRT have not yet been established, but per the Mayo Clinic, there is scientific evidence to suggest it may cause:

  • Sleep apnea
  • Acne and other skin irritations
  • Growth of existing prostate cancer or benign prostate growths
  • Enlarged breasts
  • Shrinking testicles and reduced sperm production
  • Overabundance of red cell production, which can cause blood clots
  • Possible cardiovascular complications, including events such as stroke or heart attack

If you do take testosterone for sexual dysfunction (and even if you’re not taking testosterone), you should seek immediate medical attention if you experience any symptoms of a heart attack or stroke, such as:

Alternative and Complementary Therapies

  • Lose weight. Losing the pounds often causes testosterone levels to come up, especially if you are obese or have an underlying medical condition such as diabetes that can contribute to low T.
  • Limit alcohol consumption. Consuming alcohol can convert testosterone to estrogen.
  • Calm yourself. The stress hormone cortisol can compromise testosterone’s effects.
  • Get a full night’s sleep. Sleep deprivation shoots up cortisol levels.
  • Work out. Interval exercise can build muscle mass, which in turn releases testosterone from protein.
  • Avoid BPA. Drinking out of plastic cups made with the chemical bisphenol A (BPA) can lower testosterone levels.
  • Get your zinc. Found in shellfish and pork, this mineral can support testosterone levels naturally. If you take a supplement, take 12 to 15 milligrams daily.
  • Eat healthy fats. Add fats to your diet such as those found in nuts, avocado, and olive oil.
  • Avoid sugar. This can decrease testosterone.

Prevention of Low Testosterone

As described above, diet, stress management, and several other nonmedical approaches may be effective in staving off low testosterone issues.