"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 such as fatigue, low libido, and loss of muscle mass.
While reduced 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 guys are treatable, so if you encounter these symptoms at any given age, there is no reason to ignore it.
For younger men, a drop in testosterone levels can be brought on by some illnesses, including type 2 diabetes, 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 diseases Klinefelter syndrome, Kallmann syndrome, Prader-Willi syndrome, and Myotonic dystrophy. Another disorder 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," says Bruce Gilbert, MD, PhD, an adjunct clinical professor of urology and reproductive medicine at Weill Cornell Medical College and director of reproductive and reproductive medicine at the Smith Institute for Urology of their North Shore-LIJ Health System.
Additional 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 reason, low testosterone symptoms are 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 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 older men, we generally reserve treatment for people who have symptoms, such as fatigue and low libido," Gilbert says.
In these circumstances,"therapies are often used just in the brief term, and when a doctor has close monitoring and understanding of the patient," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You don't wish to give supplemental testosterone to men 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 think about alternatives that might increase their testosterone as well as maintain their sperm production," he says. One such alternative is a class of drugs called 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, though, is that in the event that you have low testosterone symptoms, it's important to see your physician. Then, your doctor can rule out more significant causes of your symptoms, including hypertension or a thyroid problem, and give treatment that can enhance your energy and high quality of life.