"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 such as fatigue, low libido, and loss of muscle mass.
While reduced testosterone is more prevalent in older men, it can occur in younger men also. Luckily, all of the causes of low testosterone in young guys are curable, so if you experience these symptoms at any given age, there's no reason to dismiss it.
For younger men, a fall in testosterone levels may be brought on by some illnesses, including type 2 diabetes, chronic liver or liver disease, COPD or other lung disorder, or adrenal gland problems, 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 disease which 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 the North Shore-LIJ Health System.
Other causes of low testosterone in men 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 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 would be the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity and moodiness," Dr. Gilbert states.
"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€
If you suspect low testosterone, the first step is to see your primary care physician. 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.
Not everyone with low testosterone needs treatment. "When it comes to treating low testosterone in younger guys, we usually reserve treatment for those who have symptoms, such as tiredness 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,"therapies are usually used just in the brief term, and when a physician has close observation and understanding of the patient," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You do not wish to give 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 consider alternatives which may improve their testosterone in addition to preserve their semen production," he states. One such alternative is a category of drugs known as selective estrogen receptor modulators (SERMs).
Other remedies for low testosterone include weight loss and other lifestyle modifications, such as eating healthier and increasing exercise.
The main point, though, is that if you've got low testosterone symptoms, then it is very important to see your physician. 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 energy and quality of life.