"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 nyc.
Though 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 reduction of muscle mass.
While reduced testosterone is more common in older men, it may occur in younger guys as well. Luckily, all the causes of low testosterone in young men are curable, so if you encounter such symptoms at any given age, there is no reason to ignore it.
For younger men, a drop in testosterone levels may be brought on by some illnesses, including type 2 diabetes, chronic liver or liver disease, COPD or other lung disease, or adrenal gland problems, according to Dr. Samadi.
Genetic causes of low testosterone in men 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 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," 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 males younger than 50 contain adrenal 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 reason, low testosterone symptoms are the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity, and moodiness," Dr. Gilbert states.
Not everyone with low testosterone needs treatment. "When it comes to treating low testosterone in older guys, we usually reserve treatment for those who have symptoms, such as fatigue and reduced libido," Gilbert says.
In men who don't make the hormone in their testes because of a condition such as Klinefelter syndrome, or those who have lost their testes because of cancer, the only option is testosterone replacement therapy.
In these circumstances,"therapies are usually used only in the short term, and if a doctor has close monitoring 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 want to be 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 consider alternatives which may increase their testosterone as well as maintain their sperm production," he states. One such choice is a category of drugs called selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle changes, such as eating healthier and raising exercise.
The main point, though, is that if you have low testosterone symptoms, it is important to see your doctor. Then, your doctor can rule out more significant causes of your symptoms, including high blood pressure or a thyroid problem, and offer treatment that could enhance your power and quality of life.