"After age 30, most men begin to experience a gradual decline in testosterone," states 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 reduction of muscle mass.
While low testosterone is more common in older men, it may occur in younger guys also. Fortunately, every one of 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 guys, a drop in testosterone levels can be brought on by some illnesses, including type 2 diabetes, chronic liver or liver disease, COPD or other lung disease, or pituitary gland issues, 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 can cause 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 in the Smith Institute for Urology of their North Shore-LIJ Health System.
Other causes of low testosterone in men 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 says. "This could be from a developmental issue, injury to the testicles, or radiation or chemotherapy treatment.
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 says.
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 usually reserve treatment for those who have symptoms, such as fatigue and low libido," Gilbert says.
In these circumstances,"therapies are often used just in the short term, and when a doctor has close observation and understanding of the individual," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You do not wish to give supplemental testosterone to men who want to be 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 maintain their semen production," he says. One such alternative is a class of drugs known as selective estrogen receptor modulators (SERMs).
Other remedies for low testosterone include weight loss and other lifestyle changes, such as eating healthy and raising exercise.
The main point, however, is that if you have low testosterone symptoms, then it is important to see your doctor. Then, your doctor can rule out more serious causes of your symptoms, including high blood pressure or a thyroid problem, and offer treatment that could enhance your energy and high quality of life.