"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 reduction of muscle mass.
While low testosterone is more prevalent in older men, it can occur in younger guys as well. Luckily, every one the causes of low testosterone in young men are curable, so if you experience such symptoms at any given age, there's no reason to dismiss it.
For younger men, a fall in testosterone levels can be caused by some ailments, such as type 2 diabetes, chronic liver or liver disease, COPD or other lung disease, or adrenal gland issues, according to Dr. Samadi.
Genetic causes of low testosterone in males include the ailments Klinefelter syndrome, Kallmann syndrome, Prader-Willi syndrome, and Myotonic dystrophy. Another disorder which could cause 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," says 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 in the Smith Institute for Urology of the North Shore-LIJ Health System.
Other causes of low testosterone in men younger than 50 contain adrenal gland tumors, HIV infection, 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 states. In secondary hypogonadism, the testicles are normal but function improperly because of a problem with the hypothalamus or pituitary gland."
Is It Low Testosterone?
Irrespective of the cause, low testosterone symptoms are the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity and moodiness," Dr. Gilbert states.
Your doctor can diagnose low testosterone with a blood test.
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.
Not everyone with low testosterone needs treatment. "When it comes to treating low testosterone in younger men, we generally reserve treatment for people who have symptoms, such as tiredness 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. Such testosterone supplements come in the form of gel, injections, patches, long-acting pellets, or oral inserts.
In these circumstances,"treatments are usually used only in the short term, and when a doctor has close observation and knowledge of the individual," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You don't wish to offer supplemental testosterone to guys who are interested in being fertile since 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. "Hence, men of reproductive age should think about alternatives which may improve their testosterone in addition to maintain their semen production," he states. 1 such choice is a class of drugs called selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle modifications, like eating healthy and increasing exercise.
The bottom line, though, is that in the event that you've got low testosterone symptoms, then it's important to see your doctor. Then, your doctor can rule out more serious causes of your symptoms, such as high blood pressure or a thyroid problem, and offer treatment that could enhance your energy and quality of life.