"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.
Although testosterone levels never reach zero (as estrogen levels do in women during menopause), low testosterone levels men to experience symptoms like fatigue, low sex drive, and reduction 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 guys are treatable, so in the event that you experience such symptoms at any given age, there is no reason to dismiss it.
For younger men, a fall in testosterone levels can be brought on 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 men include the diseases Klinefelter syndrome, Kallmann syndrome, Prader-Willi syndrome, and Myotonic dystrophy. Another disease which could result in low testosterone is hemochromatosis, making 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 at the Smith Institute for Urology of the North Shore-LIJ Health System.
Additional causes of low testosterone in males younger than 50 contain adrenal 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 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?
Regardless of the cause, low testosterone symptoms are the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity, and moodiness," Dr. Gilbert says.
"Younger men with low testosterone usually come to me and say, ‘I can't work out like I used to, and I've lost interest in sex.’ â€
Your doctor can diagnose low testosterone with a blood test.
Not everyone with low testosterone needs treatment. "When it comes to treating low testosterone in younger men, we generally reserve treatment for those who have symptoms, such as tiredness and reduced 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 usually used only in the short term, and when a doctor has close monitoring and knowledge of the individual," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You don't want to give supplemental testosterone to men 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. "Hence, men of reproductive age should think about alternatives that might increase their testosterone as well as maintain their sperm production," he says. One such alternative is a category of drugs known as selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle changes, like eating healthier and increasing exercise.
The bottom line, however, is that if you've got low testosterone symptoms, 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 offer treatment that could enhance your power and quality of life.