"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.
Although testosterone levels never reach zero (as estrogen levels do in women during menopause), low testosterone levels men to experience symptoms like fatigue, low libido, and loss of muscle mass.
While low testosterone is more prevalent in older men, it can occur in younger guys also. Fortunately, all the causes of low testosterone in young guys are treatable, so if you encounter such symptoms at any given age, there's no reason to dismiss it.
For younger men, a fall in testosterone levels can be caused by some ailments, such as type 2 diabetes, diabetes, chronic liver or liver disease, COPD or other lung disease, or adrenal 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 can cause 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," states 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 treatment or chemotherapy for cancer.
Doctors categorize causes of low testosterone as secondary or primary.
"Primary hypogonadism stems from a problem in the testicles," Samadi states.
Is It Low Testosterone?
Irrespective 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.
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.
"When it comes to treating low testosterone in older guys, we usually reserve treatment for those who have symptoms, such as fatigue 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,"treatments are usually used only in the brief term, and if a physician has close monitoring and knowledge of the patient," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You don't wish to offer supplemental testosterone to guys 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 which may improve their testosterone in addition to preserve their sperm production," he states. 1 such choice is a class of drugs called selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle modifications, like eating healthier and increasing exercise.
The main point, though, is that if you have low testosterone symptoms, then it's important to see your physician. Then, your doctor can rule out more significant causes of your symptoms, such as hypertension or a thyroid problem, and give treatment that can improve your power and high quality of life.