"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 reduction of muscle mass.
While low testosterone is more common in older men, it may occur in younger guys also. Luckily, all of the causes of low testosterone in young men are treatable, so in the event that you encounter such symptoms at any given age, there's no reason to ignore it.
For younger men, a fall in testosterone levels may be brought on by some ailments, such as type 2 diabetes, chronic liver or kidney disease, COPD or other lung disease, or adrenal gland issues, 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," 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 at the Smith Institute for Urology of their North Shore-LIJ Health System.
Other causes of low testosterone in men younger than 50 include pituitary gland tumors, HIV infection, 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.
Is It 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 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
"When it comes to treating low testosterone in younger men, we usually 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 brief term, and if a physician has close observation and knowledge of the patient," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You do not wish 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. "Therefore, men of reproductive age should think about alternatives which may improve their testosterone as well as preserve their semen production," he states. 1 such alternative is a class of drugs called selective estrogen receptor modulators (SERMs).
Other remedies for low testosterone include weight loss and other lifestyle modifications, such as eating healthier and raising exercise.
The main point, however, is that if you have low testosterone symptoms, then it is important to see your doctor. Then, your doctor can rule out potentially more significant causes of your symptoms, such as hypertension or a thyroid problem, and give treatment that could improve your energy and quality of life.