Overview

Testosterone is a hormone produced mainly by men’s testicles. It causes the growth of muscle mass, a deep voice, and other male sexual traits like facial hair. Low testosterone levels can result in various symptoms, including reduced sex drive, erectile dysfunction, decreased energy and strength, depression, and osteoporosis.

Several factors, including aging, injury or disease of the testicles, and certain medications, can cause low testosterone. In some cases, the cause of low testosterone is unknown. The diagnosis is through a simple blood test. Treatment can be with testosterone replacement therapy, other medications, and lifestyle changes such as exercise and diet.

What is Low Testosterone?

Low testosterone, also known as hypogonadism, is a condition in which a man has a lower-than-normal testosterone level in his bloodstream. Adults with testosterone levels less than 300 ng/dL are considered to have low levels.

Importance of Testosterone

The primary male sex hormone, testosterone, is in charge of developing male sexual traits like a deeper voice, more muscle, and body hair. 

Both positive and negative outcomes might arise in males when testosterone levels are high.

High testosterone has several advantages, including.

• Increased muscle mass and strength
• Improved libido and sexual function
• Increased energy levels and stamina
• Improved mood and sense of well-being

However, high testosterone levels can also lead to adverse effects, such as

• Aggression and irritability
• Enlarged prostate
• Decreased sperm count and fertility
• Acne and oily skin
• Hair loss
• Sleep apnea

It’s important to note that having high testosterone levels does not automatically mean that a man will experience adverse side effects. Some men with high testosterone levels do not experience any adverse effects, while others may experience a combination of positive and negative effects. Additionally, high testosterone levels can result from various factors, including medical conditions such as testicular tumours and certain medications.

What Causes Low Testosterone in Young Males?

There are several causes of low testosterone in young males, including

1. Klinefelter’s syndrome: A genetic disorder that results in an extra X chromosome in male cells, which can lead to low testosterone production.

2. Testicular injury or damage: Trauma to the testicles, such as from an injury or surgery, can decrease testosterone production.

3. Infections: Certain infections, such as mumps, can cause inflammation of the testicles and decrease testosterone production.

4. Tumours: Tumours in the pituitary gland or hypothalamus can affect testosterone production.

5. Drugs and medications: Certain medications, such as steroids, can suppress testosterone production.

6. Obesity: Excess weight can cause an increase in estrogen levels, which can lead to decreased testosterone production.

7. Chronic illness: Chronic illnesses like liver or kidney disease can affect testosterone production.

It’s important to understand that low testosterone is not always a cause for alarm in young males and may also be a normal component of ageing. 

Symptoms of Low Testosterone in Women

Low testosterone levels in women can cause various symptoms, although they may be less noticeable than in men. Some common symptoms of low testosterone in women include

1. Decreased sex drive: Low testosterone levels can reduce interest in sexual activity.

2. Decreased energy and strength: Women with low testosterone levels may experience decreased physical energy and strength.

3. Depression:  Low testosterone levels can contribute to depression and low mood.

4. Osteoporosis: A condition known as osteoporosis, characterized by brittle bones and a higher risk of fractures, can be made more likely by low testosterone levels.

5. Decreased muscle mass: Low testosterone levels can result in a drop in muscle mass and an expansion in body fat.

6. Hot flashes: Women with low testosterone levels may experience a sudden feeling of intense heat that can cause sweating and flushing.

It’s important to note that other factors can also cause these symptoms, and it’s essential to speak with your healthcare provider to determine if low testosterone is the underlying cause and the best course of treatment.

What does testosterone do?

Testosterone is crucial for developing and maintaining male sexual characteristics and reproductive function. It is produced primarily by the testicles in men and, to a lesser extent, by the ovaries in women. Some of the critical functions of testosterone include

1. Development of male sexual characteristics: Testosterone is responsible for developing masculine sexual characteristics such as a deep voice, facial hair, and muscle mass.

2. Sperm production: Testosterone is essential for sperm production and male fertility.

3. Sex drive: Testosterone is essential for maintaining a healthy sex drive and libido.

4. Bone density: Testosterone helps to maintain strong bones by increasing bone density.

5. Muscle mass and strength: Testosterone is vital for building and maintaining muscle mass and strength.

6. Red blood cell production: Testosterone helps to increase the red blood cell production, which have oxygen to the body’s tissues.

In women, testosterone regulates bone density, sexual function, and mood, among other functions. However, testosterone levels in women are generally much lower than in men.

Symptoms of Low Testosterone

Low testosterone, also known as hypogonadism, can cause several physical symptoms in men. Low testosterone levels can result in various symptoms, including reduced sex drive, erectile dysfunction, decreased energy and strength, depression, and osteoporosis.

Physical Symptoms

Here are some common physical symptoms of low testosterone:

1. Decreased muscle mass and strength: A reduction in overall strength and a loss of muscle mass can result from low testosterone levels.
2. Fatigue and decreased energy: Men with low testosterone may feel more tired and have less energy than they used to.
3. Decreased sex drive: Low testosterone levels can reduce a man’s libido and sexual desire.
4. Decreased bone density: Low testosterone levels can cause a decrease in bone density, putting men at risk for osteoporosis.
5. Increased body fat: Low testosterone levels can cause an increase in body fat, particularly in the abdominal area.
6. Decreased beard and body hair growth: Men with low testosterone may have reduced beard and body hair growth.

It’s significant to remember that these signs and symptoms are not solely related to low testosterone levels. 

Psychological Symptoms

In addition to physical symptoms, low testosterone levels can cause various psychological symptoms in men. Here are some common psychological symptoms of low testosterone:

1. Depression: Low testosterone levels can lead to sadness, hopelessness, and decreased motivation.
2. Anxiety: Men with low testosterone may experience increased levels of stress and nervousness.
3. Decreased self-confidence: Low testosterone levels can lead to a decrease in self-confidence and self-esteem.
4. Difficulty concentrating and decreased memory: Men with low testosterone may have trouble concentrating and retaining information.
5. Irritability and mood swings: Low testosterone levels can cause increased irritability and mood swings.
6. Insomnia: Men with low testosterone may experience difficulty falling or staying asleep.

It’s crucial to remember that these signs might be brought on by more than just low testosterone levels. While effective in treating low testosterone levels, it is also worth noting that testosterone therapy may not necessarily alleviate all of these psychological symptoms. 

Sexual Symptoms

Low testosterone levels can cause several sexual symptoms in men, significantly impacting their sexual health and well-being. Here are some common sexual symptoms of low testosterone:

1. Decreased sex drive: Low testosterone levels can reduce a man’s libido and sexual desire.
2. Erectile dysfunction: Men with low testosterone may have trouble getting or maintaining an erection.
3. Decreased sperm count and infertility: Low testosterone levels can reduce a man’s sperm count and fertility.
4. Decreased ejaculate volume: Men with low testosterone may have reduced ejaculate volume.
5. Decreased morning erections: Low testosterone levels can cause a decrease in the frequency of morning erections.

Testosterone therapy can effectively treat low testosterone levels and the associated sexual symptoms. However, it’s essential to work closely with a doctor to ensure that testosterone therapy is appropriate for you and to monitor any potential side effects.

Diagnosis of Low Testosterone

Low testosterone can be identified using a combination of testosterone tests, a study of the patient’s medical history, and a physical examination.

Testosterone Test

Diagnosing low testosterone typically involves a combination of medical investigations, including.

1. Testosterone testing: A blood test is usually performed to measure testosterone levels in the body. This test is generally performed in the morning when testosterone levels are highest.
2. Hormonal tests: Your doctor may also order tests to check the levels of additional hormones, such as luteinizing hormone (LH) and follicle-stimulating hormone (FSH), in addition to testosterone, to see if any hormonal abnormalities might be impacting testosterone levels.
3. Imaging tests: To assess the shape of testicles and rule out any underlying medical disorders that might lead to low testosterone levels, the doctor may occasionally request imaging tests like a CT scan or MRI.
4. Pelvic ultrasound: This test can evaluate the size and structure of the testicles and rule out any underlying medical conditions that could affect testosterone levels.
5. Biopsy of the testicles: In rare cases, your doctor may perform a biopsy of the testicles to obtain a sample of testicular tissue for analysis. This test can help determine if there is a problem with the testicles affecting testosterone production.
6. Genetic testing: A history of low testosterone in your family, your doctor may order genetic testing to determine if the condition is inherited and to determine the specific gene that is responsible for the low testosterone levels.
7. Semen Analysis: A semen analysis can be used as a tool to help diagnose low testosterone levels in some cases. Low testosterone levels reduce sperm production and quality, and a semen analysis can give important information about the quantity and quality of a man’s sperm.

Based on these medical investigations, your doctor can diagnose low testosterone and determine your best treatment. 

Medical History

During a medical history review for low testosterone, your doctor will ask about various aspects of your health to determine if any factors could contribute to low testosterone levels. Here are some of the things your doctor may ask about during a medical history review for low testosterone:

1. Symptoms: Your doctor may ask about any symptoms you may be experiencing, such as decreased sex drive, erectile dysfunction, or fatigue, to determine if they are consistent with low testosterone levels.
2. Medical conditions: Your doctor may ask about any medical conditions you have, such as diabetes, obesity, or heart disease, as these conditions can affect testosterone levels.
3. Medications: Your doctor may also ask about any medications you are taking, as certain medications, such as opioids or corticosteroids, can lower testosterone levels.
4. Alcohol and substance use: Your doctor may ask about your alcohol and substance use, as alcohol and certain substances can harm testosterone levels.
5. Testosterone therapy: If you have previously received testosterone therapy, your doctor may ask about your experience with the hypogonadism treatment and any side effects you may have experienced.
6. Family history: Your doctor may also ask about your family history, as low testosterone can be an inherited condition.

This medical history review and the results of a testosterone test and physical examination will help your doctor diagnose low testosterone and determine the best course of treatment for you.

Physical Exam

During a physical examination for low testosterone, your doctor will look for signs and symptoms commonly associated with low testosterone levels. Here are some of the things your doctor may assess during a physical examination for low testosterone:

1. Body composition: Your doctor may assess your body composition, including your muscle mass and body fat, to see if there is a decrease muscle mass and an increase in body fat content, which are common physical symptoms of low testosterone.
2. Testicular size: Your doctor may also examine your testicles to check for any signs of shrinkage, which is considered as a sign of low testosterone levels.
3. Genital examination: Your doctor may perform a genital exam to check for any signs of sexual dysfunction, such as reduced ejaculate volume or difficulty achieving or maintaining an erection.
4. Gynecomastia: Your doctor may also check for signs of gynecomastia or the development of breast tissue in men, which can be a sign of low testosterone levels.
5. Other physical symptoms: Your doctor may also assess any other physical symptoms you may be experiencing, such as fatigue or decreased energy levels, to see if they are consistent with low testosterone levels.

This physical examination, along with the results of a testosterone test and medical history review, will help your doctor diagnose low testosterone and determine the best course of treatment for you.

How do I know if my Testosterone is Low?

Various signs of low testosterone levels might impact a man’s physical and mental health. 

A few typical signs of low testosterone are

1. Decreased sex drive
2. Erectile dysfunction
3. Fatigue and decreased energy
4. Reduced muscle mass and increased body fat
5. Decreased bone density
6. Mood changes, such as depression or irritability
7. Decreased body hair
8. Decreased testicular size

Treatment Options for Low Testosterone

The treatment options for low testosterone will depend on the cause of the low levels and the severity of the symptoms. Some standard treatment options for low testosterone include:

Lifestyle Changes

In addition to medical treatments, several lifestyle modifications can help improve testosterone levels, including:

1. Exercise: Regular physical activity, especially weightlifting and resistance training, can help increase testosterone levels. Exercise can also help maintain a healthy weight and reduce stress, which can impact testosterone levels.
2. Healthy diet: A diet rich in protein, healthy fats, and vitamins and minerals can help support testosterone production and improve overall health. Avoiding processed and junk foods, and limiting sugar and unhealthy fats, can also help improve testosterone levels.
3. Getting enough sleep: Adequate sleep is essential for overall health and testosterone production. Aim for 7-9 hours of quality sleep each night.
4. Stress management: Chronic stress can affect testosterone levels, so it’s crucial to find ways to manage stress, such as through exercise, mindfulness, or therapy.
5. Avoiding harmful substances: Substance abuse, including alcohol and tobacco, can harm testosterone production. Avoiding these substances or limiting their use can help improve testosterone levels.

It’s important to note that these lifestyle modifications may not be effective for all cases of low testosterone, and some men may require medical treatment to restore normal testosterone levels. It’s also essential to speak with a doctor before making any changes to your lifestyle, as some modifications may interact with medical treatments.

Hormonal Therapy

Hormonal therapy is a treatment option for low testosterone that involves supplementing the body with testosterone to restore normal levels. It is also known as testosterone replacement therapy (TRT).

There are a variety of forms of testosterone replacement therapy, including.

1. Topical gels: Testosterone gels are applied to the skin daily, and the testosterone is absorbed into the bloodstream.
2. Injections: Testosterone injections in a muscle, typically every 2-4 weeks.
3. Pellets: Testosterone pellets are small, rice-sized pellets inserted under the skin every 3-6 months.
4. Patches: Testosterone patches are applied to the skin daily, and the testosterone is absorbed into the bloodstream.
5. Mouth patches: Testosterone mouth patches are placed inside the mouth and dissolve, releasing testosterone into the bloodstream.

Depending on your unique requirements, state of health, and preferences, you can choose the type of testosterone replacement therapy best for you. 

Your doctor can decide the optimal type of testosterone replacement therapy for you.

It’s important to note that testosterone replacement therapy can have potential side effects, such as acne, breast enlargement, and an increased risk of blood clots. It’s also essential to have regular monitoring and follow-up with your doctor to ensure that your testosterone levels are within a healthy range and to monitor for any potential side effects.

Medications

There are currently no medications specifically approved by the FDA for low testosterone treatment. The primary treatment for low testosterone is testosterone replacement therapy (TRT), which involves supplementing the body with testosterone to restore normal levels.

In some cases, TRT may use medications to address specific symptoms or health conditions related to low testosterone. For example, if low testosterone is causing erectile dysfunction, a phosphodiesterase type 5 (PDE5) inhibitor, such as sildenafil (Viagra) or vardenafil (Levitra), tadalafil (Cialis), may be prescribed.

It’s essential to speak with a doctor to determine the best treatment options for your needs and weigh any medications’ potential benefits and risks. Your doctor can also help monitor your testosterone levels and overall health and adjust your treatment as needed.

Surgical Intervention

Surgical intervention for low testosterone may be considered if the cause of the condition is due to a structural issue in the testes, such as testicular injury or tumour. Surgical removal of the affected testicle or testicular tissue may be necessary to restore average testosterone production.

It’s important to note that surgery should only be considered as a last resort after other non-surgical treatments have failed and only under the guidance of a qualified medical professional.

 Want to get treated for low testosterone levels? Discuss the risks, benefits, and alternatives with one of our doctors online.

Risks and Complications of Low Testosterone

Some potential risks and complications associated with low testosterone levels are below.

Increased Risk of Chronic Diseases:

 Low testosterone levels have been shown to cause an increased risk of several chronic diseases, such as

1. Type 2 Diabetes: Low testosterone levels may increase the risk of type 2 diabetes by interfering with insulin sensitivity and glucose metabolism.
2. Osteoporosis: Low testosterone levels may increase the risk of osteoporosis, a condition where bones become fragile and more likely to break, by reducing bone density.
3. Metabolic Syndrome: Low testosterone levels have been linked to an increased risk of metabolic syndrome, a group of risk factors that increase the risk of cardiac disease, type 2 diabetes and stroke.

Worsening of Cardiovascular Health: 

Low testosterone level has been linked to an increased risk of cardiovascular disease, including

1. Heart Attacks: Low testosterone levels may increase the risk of heart attacks by promoting plaque buildup in the arteries and contributing to cardiovascular disease.
2. Stroke: Low testosterone levels have been associated with an increased risk of stroke by contributing to cardiovascular disease.
3. Atherosclerosis: Low testosterone levels may also increase the risk of atherosclerosis, a condition where the arteries become narrow and hard, by promoting plaque buildup in the arteries.

Decreased Cognitive Function:

 Low levels have also shown a decline in cognitive function and an increased risk of dementia in older men. Low testosterone levels are associated with reduced brain volume, which may contribute to cognitive decline and increased risk of dementia.

It’s important to note that these risks and complications may be prevented or managed with proper treatment, such as hormone replacement therapy. However, the potential risks and benefits of testosterone replacement therapy should be discussed with a healthcare provider before starting treatment.

Additionally, other factors may contribute to these health risks, such as unhealthy lifestyle choices, so it is essential to maintain a healthy lifestyle in addition to any treatment for low testosterone.

Prevention and Management of Low Testosterone

Some ways to prevent and manage low testosterone levels.

Healthy Lifestyle Habits:

 Low testosterone levels can be avoided by leading a healthy lifestyle that includes eating a portion of balanced food, exercising frequently, and abstaining from unhealthy behaviours like smoking and binge drinking.

Regular Medical Check-ups:

Regular medical check-ups can help to detect low testosterone levels early and ensure prompt treatment. This may involve routine testosterone level tests, especially if you have symptoms of low testosterone.

Managing Stress: 

It’s crucial to handle stress with relaxation techniques like yoga and meditation, as well as by asking for help from friends and family. Chronic stress can cause a drop in testosterone levels, so doing both is vital.

In addition to these preventive measures, if low testosterone levels have been diagnosed, hormone replacement therapy (HRT) may be used to restore normal testosterone levels and relieve symptoms.

How to Get more Testosterone?

There are several ways to increase testosterone levels naturally:

1. Exercise regularly: Regular physical activity, especially weightlifting and high-intensity interval training, has boosted testosterone levels.
2. Balanced diet: A diet rich in protein, healthy fats, vitamins, and minerals can help to support healthy testosterone levels.
3. Get enough sleep: Getting enough quality sleep is essential for overall health and can help support healthy testosterone levels.
4. Reduce stress: Chronic stress can lead to a decline in testosterone levels, so it’s essential to manage psychological stress through relaxation techniques, such as yoga and meditation, and by seeking support from friends and family.
5. Avoid unhealthy habits: Habits such as smoking, excessive alcohol consumption, and drug use can negatively impact testosterone levels, so it’s essential to avoid these habits.

Discuss dietary and lifestyle modifications to help with your low testosterone levels with one of our doctors online.

Conclusion:

Low testosterone levels can significantly impact physical and mental health and well-being. Some common symptoms of low testosterone include decreased energy levels, muscle mass, and bone density, as well as sexual dysfunction and mood changes.

Low testosterone levels have also been linked to the risk of chronic diseases, such as cognitive decline and heart disease, and a reduction in overall quality of life.

To prevent and manage low testosterone levels, it’s essential to maintain a healthy lifestyle, such as eating a balanced diet, engaging in regular physical activity, and getting enough quality sleep. Regular medical check-ups and stress management techniques can also help to prevent low testosterone levels.

Testosterone replacement therapy may sometimes be necessary to restore normal testosterone levels and relieve symptoms associated with low testosterone. However, the potential risks and benefits of testosterone replacement therapy should be discussed with a healthcare provider before starting treatment.

Importance of Early Diagnosis and Treatment

Early diagnosis and treatment of low testosterone are essential for several reasons:

1. Improved symptoms: Low testosterone levels can cause a range of symptoms, including decreased energy levels, muscle mass, and bone density, as well as sexual dysfunction and mood changes. Early diagnosis and treatment of low testosterone can help to relieve these symptoms and improve the overall quality of life.
2. Reduced risk of chronic diseases: Low testosterone has been shown to cause an increased risk of chronic conditions, such as cardiovascular disease and cognitive decline. Early diagnosis and treatment of low testosterone can help to reduce the risk of these chronic diseases and improve overall health.
3. Better management of comorbidities: Low testosterone levels can interact with other health conditions, making them more challenging to manage. Early diagnosis and treatment of low testosterone can help manage comorbidities and improve overall health outcomes.
4. Better long-term outcomes: Early diagnosis and treatment of low testosterone can help prevent long-term health problems and improve overall health outcomes in the long term.

Therefore, it is essential to seek medical attention if you have symptoms of low testosterone, such as decreased energy levels, reduced muscle mass, or sexual dysfunction, and to have regular testosterone level tests if you are at risk of low testosterone. Prompt treatment of low testosterone can help to relieve symptoms, reduce the risk of chronic diseases, and improve overall health outcomes.

When to Consult a Doctor?

If you have symptoms of low testosterone, such as decreased energy levels, muscle mass, or sexual dysfunction, it is essential to consult a doctor. Some other signs and symptoms that may indicate low testosterone levels include

1. Fatigue
2. Decreased sex drive
3. Erectile dysfunction
4. Falling body and facial hair
5. Depression or mood changes
6. Decreased bone density
7. Reduced muscle mass and strength

It is also essential to consult a doctor if you are at risk of low testosterone, such as if you have a family history of low testosterone or if you have an underlying medical condition that may cause low testosterone levels, such as obesity, type 2 diabetes, or certain pituitary or hypothalamic disorders.

FAQs about Low Testosterone Answered by Your Doctors Online Team