"After age 30, most men begin to experience a gradual decline in testosterone," says David Samadi, MD, chairman of the urology department at Lenox Hill Hospital in nyc.
Although testosterone levels never reach zero (as estrogen levels do in women during menopause), low testosterone levels men to experience symptoms like fatigue, low libido, and loss of muscle mass.
While low testosterone is more common in older men, it can occur in younger guys also. Luckily, every one of the causes of low testosterone in young guys are curable, so if you encounter such symptoms at any age, there's no reason to ignore it.
For younger guys, a fall in testosterone levels can be brought on by some ailments, such as type 2 diabetes, diabetes, chronic liver or kidney disease, COPD or other lung disease, or pituitary 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 that could result in low testosterone is hemochromatosis, making 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 sexual medicine at the Smith Institute for Urology of their North Shore-LIJ Health System.
Additional causes of low testosterone in men younger than 50 contain adrenal gland tumors, HIV infection, and radiation therapy 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. In secondary hypogonadism, the testicles are normal but function improperly because of a problem with the hypothalamus or pituitary gland."
Can It Be Low Testosterone?
Regardless of the cause, low testosterone symptoms would be the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity, and moodiness," Dr. Gilbert says.
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.
Treatments for Low Testosterone in Younger Men
Not everyone with low testosterone needs treatment. "When it comes to treating low testosterone in younger guys, we generally reserve treatment for those who have symptoms, such as fatigue and low libido," Gilbert says.
Such testosterone supplements come in the form of a gel, injections, patches, long-acting pellets, or oral inserts.
In these circumstances,"treatments are often used just in the brief term, and if a physician has close monitoring and knowledge of the patient," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You don't wish to offer supplemental testosterone to men who want to be 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. "Therefore, men of reproductive age should consider alternatives that might improve their testosterone as well as maintain their semen production," he states. One such choice is a class of drugs known as selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle modifications, such as eating healthier and raising exercise.
The main point, though, is that if you have low testosterone symptoms, it's 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 give treatment that can improve your power and high quality of life.