"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.
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 common in older men, it may occur in younger guys as well. Luckily, all the causes of low testosterone in young men are curable, so if you encounter these symptoms at any age, there is no reason to ignore it.
For younger men, a fall in testosterone levels can be caused by some ailments, such as type 2 diabetes, chronic liver or kidney disease, COPD or other lung disorder, or pituitary 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 disorder which could cause low testosterone is hemochromatosis, which makes the body shop 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 in the Smith Institute for Urology of their North Shore-LIJ Health System.
Additional causes of low testosterone in males younger than 50 include pituitary gland tumors, HIV disease, and radiation therapy or chemotherapy for cancer.
Doctors categorize causes of low testosterone as primary or secondary.
"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.
Can It Be Low Testosterone?
Irrespective of the reason, low testosterone symptoms would be the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity, and moodiness," Dr. Gilbert says.
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.
Treatments for Low Testosterone in Younger Men
Not everyone with low testosterone needs treatment. "When it comes to treating low testosterone in older guys, 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.
In these circumstances,"treatments are usually used only in the short 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 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 that might increase their testosterone as well as preserve their semen production," he states. 1 such choice is a category of drugs called selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle changes, such as eating healthy and raising exercise.
The main point, though, is that if you have low testosterone symptoms, then it is very important to see your doctor. Then, your doctor can rule out potentially more serious causes of your symptoms, including hypertension or a thyroid problem, and give treatment that can improve your power and high quality of life.