"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 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 may occur in younger men also. Fortunately, every one of the causes of low testosterone in young guys are treatable, so in the event that you experience these symptoms at any given age, there's no reason to dismiss it.
For younger guys, a fall in testosterone levels can be brought on by some illnesses, including type 2 diabetes, diabetes, chronic liver or kidney disease, COPD or other lung disease, or adrenal gland problems, based on Dr. Samadi.
Genetic causes of low testosterone in males include the diseases Klinefelter syndrome, Kallmann syndrome, Prader-Willi syndrome, and Myotonic dystrophy. Another disease which can 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," 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 their 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 primary or secondary.
"Primary hypogonadism stems from a problem in the testicles," Samadi states. "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."
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.
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 a urologist or endocrinologist.
"When it comes to treating low testosterone in younger men, we usually reserve treatment for those 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.
In these circumstances,"treatments are often used just in the brief term, and if a physician has close monitoring and understanding of the individual," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You do not wish to offer supplemental testosterone to guys who want to be 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 consider alternatives that might increase their testosterone as well as preserve their sperm production," he says. One such choice is a category of drugs known as selective estrogen receptor modulators (SERMs).
Other remedies for low testosterone include weight loss and other lifestyle modifications, like eating healthy and raising exercise.
The main point, however, is that if you have low testosterone symptoms, it's important to see your doctor. Then, your doctor can rule out potentially more significant causes of your symptoms, including hypertension or a thyroid problem, and give treatment that could enhance your energy and quality of life.