Visual Guide to Low Testosterone

Low Testosterone: Causes, Symptoms, and Treatment

An experienced urologist can help identify if Low T is the cause of your symptoms and provide effective treatment options, including testosterone replacement therapy (TRT). Low testosterone, otherwise known as ‘Low T,’ is a common condition that affects nearly 40 percent of men over the age of 45. Testosterone is the hormone that helps men maintain and develop muscle mass, red blood cell levels, bone density, sexual and reproductive function and a general sense of well-being. While levels start dropping at around age 30, when they get too low, men can start to notice some unpleasant symptoms.

Fatigue, low energy, insomnia, depressed mood, and irritability may interfere with daily life and work performance. In addition, fertility issues are also common with low testosterone. Those trying to grow their family through intercourse may experience challenges such as reduced sex drive, decreased sperm production, and/or difficulty maintaining an erection. A variety of treatment options called “testosterone replacement therapy” are available to supplement the body’s testosterone levels. TRT may be taken as an injection, implant or via a gel or patch. Short acting, T nasal gel (Natesto®) is an exogenous T that may not decrease spermatogenesis.

For example, trouble with erections can be a sign of diabetes or heart disease. Low sex drive could be linked to depression or be a side effect of medication. For these reasons, it’s a good idea to call your doctor if you have any of these symptoms so you can have a thorough medical exam. In males, production of this hormone starts to fall after age 30 and continues to decline (about 1% per year) throughout their life.

Men’s testosterone levels decline gradually, while women’s estrogen levels fall more quickly over time. As a urologist who specializes in male sexual and reproductive medicine, I often treat men who are experiencing a decrease in their testosterone levels. These lower testosterone levels can be a normal, natural part of aging, and a simple blood test is all it takes to detect this. The HPGA is of paramount importance in the processes related to the development, maturation, and sustainability of male hormonal balance. The pulsatile secretion of gonadotropin-releasing hormone (GnRH) by the hypothalamus stimulates LH and follicle-stimulating hormone (FSH) production and secretion by the anterior pituitary gland.

Experts don’t suggest that low testosterone causes these conditions. That is, men with medical problems or who are in poor general health might then develop low testosterone. Researchers are unlocking the mysteries of how low testosterone is related to men’s overall health. Along the way, they’re uncovering connections between low testosterone blood test name for male and other health conditions. Channa N Jayasena received an honorarium for debating the safety of testosterone therapy at a meeting organised by the Society of Endocrinology sponsored by Besins Healthcare. Richard Quinton has received honoraria and hospitality from Bayer UK.

As boys exit puberty and enter adulthood, testosterone maintains muscle strength and mass, hair growth, bone density, sexual functions, energy and mood levels. Generally, testosterone levels are highest in the morning and lowest in the evening but fluctuation does occur with age. Be open with your doctor about your medical history, all prescription and nonprescription drugs you are now taking, sexual problems, and any major changes in your life. Your doctor will take a thorough history of your symptoms and then complete a physical exam, including your body hair, breast tissue, and the size and consistency of the testes and scrotum. Your doctor will also use blood tests to see if your total testosterone level is low. To get a diagnosis of hypogonadism, you need at least two early morning (7–10 AM) blood tests that reveal low testosterone in addition to signs and symptoms typical of low testosterone. The cause of hypogonadism can be investigated further by your doctor.

Testosterone replacement also affects metabolic parameters, with effects on cholesterol occurring in 4 weeks, peaking at 6–12 months, and blood sugar levels improving after 3–12 months. On average, it takes about 3 weeks to see an improvement in sexual desire (libido), energy, and mood. Men are increasingly seeking testosterone measurement for a variety of reasons and GPs are thus faced with a burgeoning number of ‘low testosterone’ results needing to be actioned. As the diagnosis of hypogonadism is not always straightforward, careful clinical and biochemical assessment is essential prior to prescribing. A doctor can check your testosterone level with a simple blood test.

It is possible to have low levels and not experience symptoms. But if you do not have any key symptoms, especially fatigue and sexual dysfunction, which are the most common, it is not recommended you go on the therapy given the uncertainty about long-term safety. Testosterone replacement therapy may cause the prostate to grow. If a man has early prostate cancer, a concern is that testosterone may stimulate cancer growth. Therefore, it is important for all men considering testosterone replacement therapy to undergo prostate screening before starting treatment. Men who are found to have prostate cancer should not undergo testosterone replacement therapy.