"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 nyc.
Although testosterone levels never reach zero (as estrogen levels do in women during menopause), low testosterone levels men to experience symptoms like fatigue, low sex drive, and loss of muscle mass.
While reduced testosterone is more common in older men, it may occur in younger men as well. Fortunately, all of the causes of low testosterone in young men are curable, so in the event that you encounter such symptoms at any given age, there is no reason to dismiss it.
Causes of Low Testosterone in Younger Men
For younger men, a fall in testosterone levels can be brought on by some illnesses, including type 2 diabetes, chronic liver or kidney disease, COPD or other lung disorder, or adrenal gland problems, based on Dr. Samadi.
Genetic causes of low testosterone in men 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 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," states 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.
Other causes of low testosterone in males younger than 50 contain adrenal gland tumors, HIV infection, and radiation treatment 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.
Can It Be Low Testosterone?
Irrespective of the cause, low testosterone symptoms are the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity and moodiness," Dr. Gilbert states.
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 an urologist or endocrinologist.
Treatments for Low Testosterone in Younger Men
Not everyone with low testosterone needs treatment. "When it comes to treating low testosterone in younger men, we generally reserve treatment for people who have symptoms, such as fatigue and low libido," Gilbert says.
In these circumstances,"treatments are often used only in the short 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 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. "Therefore, men of reproductive age should consider alternatives that might increase their testosterone as well as maintain their semen production," he states. 1 such choice is a category of drugs known as selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle changes, such as eating healthier and increasing exercise.
The bottom line, however, is that if you have low testosterone symptoms, it's important to see your doctor. Then, your doctor can rule out potentially more serious causes of your symptoms, including high blood pressure or a thyroid problem, and give treatment that could improve your energy and high quality of life.