"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 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 men also. Luckily, all the causes of low testosterone in young guys are curable, so if you encounter such symptoms at any given age, there's no reason to dismiss it.
For younger guys, a drop in testosterone levels can be brought on by some illnesses, including type 2 diabetes, diabetes, chronic liver or kidney disease, COPD or other lung disorder, or pituitary gland problems, according to 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 can result in low testosterone is hemochromatosis, which makes 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 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.
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.
"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.
Treatments for Low Testosterone in Younger Men
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 reduced libido," Gilbert says.
Such testosterone supplements come in the form of gel, injections, patches, long-acting pellets, or oral inserts.
In these circumstances,"treatments are often used only in the brief term, and if 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 want to offer supplemental testosterone to men 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 consider alternatives which may increase their testosterone in addition to preserve their semen production," he says. 1 such choice is a class of drugs known as selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle modifications, such as eating healthier and raising exercise.
The bottom line, however, is that if you have low testosterone symptoms, then 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 offer treatment that could improve your power and high quality of life.