"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 such as fatigue, low sex drive, and reduction of muscle mass.
While low testosterone is more common in older men, it can occur in younger guys also. Fortunately, all of the causes of low testosterone in young guys are curable, so if you encounter these symptoms at any age, there's no reason to ignore it.
Causes of Low Testosterone in Younger Men
For younger guys, a fall in testosterone levels can be brought on by some ailments, such as type 2 diabetes, chronic liver or kidney disease, COPD or other lung disorder, or pituitary gland problems, based on Dr. Samadi.
Genetic causes of low testosterone in males include the diseases Klinefelter syndrome, Kallmann syndrome, Prader-Willi syndrome, and Myotonic dystrophy. Another disease that could cause 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 sexual medicine at the Smith Institute for Urology of the North Shore-LIJ Health System.
Additional causes of low testosterone in males younger than 50 include pituitary gland tumors, HIV disease, and radiation therapy 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. "This could be from a developmental issue, injury to the testicles, or radiation or chemotherapy treatment.
Is It Low Testosterone?
Regardless 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 you suspect low testosterone, the first step is to see your primary care physician.
"When it comes to treating low testosterone in older men, we usually reserve treatment for those who have symptoms, such as fatigue and reduced libido," Gilbert says.
In these circumstances,"treatments are usually used just in the brief term, and when a doctor has close observation and knowledge of the individual," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You do not want to offer supplemental testosterone to guys who want to be 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 that might 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, such as eating healthy and increasing exercise.
The bottom line, however, is that if you've got low testosterone symptoms, then it is important to see your physician. 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 improve your power and quality of life.