"After age 30, most men begin to experience a gradual decline in testosterone," states David Samadi, MD, chairman of the urology department at Lenox Hill Hospital in New York City.
Though testosterone levels never reach zero (as estrogen levels do in women during menopause), low testosterone levels men to experience symptoms such as fatigue, low libido, and loss of muscle mass.
While reduced testosterone is more prevalent in older men, it can occur in younger guys also. Fortunately, all the causes of low testosterone in young men are treatable, so if you experience these symptoms at any age, there is no reason to dismiss it.
For younger guys, a drop in testosterone levels may be brought on by some illnesses, including type 2 diabetes, diabetes, chronic liver or liver disease, COPD or other lung disease, or adrenal gland problems, according to Dr. Samadi.
Genetic causes of low testosterone in men include the diseases Klinefelter syndrome, Kallmann syndrome, Prader-Willi syndrome, and Myotonic dystrophy. Another disorder which could result in low testosterone is hemochromatosis, which makes the body store too much iron.
"Low testosterone can also result when something happens, like trauma or steroid use, that prevents the testes from making the hormone," states Bruce Gilbert, MD, PhD, an adjunct clinical professor of urology and reproductive medicine at Weill Cornell Medical College and director of reproductive and reproductive medicine at the Smith Institute for Urology of the North Shore-LIJ Health System.
Additional causes of low testosterone in men younger than 50 include pituitary gland tumors, HIV disease, and radiation treatment or chemotherapy for cancer.
Doctors categorize causes of low testosterone as secondary or primary.
"Primary hypogonadism stems from a problem in the testicles," Samadi says. "This could be from a developmental issue, injury to the testicles, or radiation or chemotherapy treatment.
Is It Low Testosterone?
Irrespective of the reason, low testosterone symptoms are the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity, and moodiness," Dr. Gilbert states.
If you suspect low testosterone, the first step is to see your primary care physician.
If your blood test reveals low testosterone (usually defined as a level lower than 300 ng/dL), the doctor may treat you or refer you to a specialist, such as an urologist or endocrinologist.
"When it comes to treating low testosterone in younger guys, we usually reserve treatment for people who have symptoms, such as fatigue and reduced libido," Gilbert says.
In men who don't make the hormone in their testes because of a condition such as Klinefelter syndrome, or those who have lost their testes because of cancer, the only option is testosterone replacement therapy.
In these circumstances,"therapies are often used just in the brief term, and if a doctor has close observation and understanding of the patient," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You don't want to give supplemental testosterone to guys who are interested in being fertile because it can turn off sperm production," Gilbert says.
Once a young man goes off testosterone supplementation, there's a chance his sperm count will never return to what it was before he started. "Therefore, men of reproductive age should think about alternatives which may improve their testosterone as well as preserve their semen production," he states. 1 such choice is a class of drugs known as selective estrogen receptor modulators (SERMs).
Other remedies for low testosterone include weight loss and other lifestyle changes, such as eating healthy and raising exercise.
The bottom line, however, is that if you have low testosterone symptoms, then it is very important to see your doctor. Then, your doctor can rule out more significant causes of your symptoms, including hypertension or a thyroid problem, and offer treatment that could enhance your power and quality of life.