"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 sex drive, and loss of muscle mass.
While low testosterone is more common in older men, it can occur in younger guys also. Luckily, every one the causes of low testosterone in young men are treatable, so if you experience these symptoms at any given age, there is no reason to dismiss it.
Causes of Low Testosterone in Younger Men
For younger guys, a fall in testosterone levels can be caused by some illnesses, including type 2 diabetes, chronic liver or kidney disease, COPD or other lung disease, or pituitary gland issues, 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 disorder that could result in 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," 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 their North Shore-LIJ Health System.
Additional 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. In secondary hypogonadism, the testicles are normal but function improperly because of a problem with the hypothalamus or pituitary gland."
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.
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.
"When it comes to treating low testosterone in older men, we usually reserve treatment for people who have symptoms, such as tiredness and reduced libido," Gilbert says.
In these circumstances,"treatments are often used only in the brief term, and when 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 improve 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 remedies for low testosterone include weight loss and other lifestyle changes, like eating healthier and increasing exercise.
The main point, though, is that in the event that you've got low testosterone symptoms, it is important to see your doctor. Then, your doctor can rule out more significant causes of your symptoms, such as high blood pressure or a thyroid problem, and give treatment that can improve your power and quality of life.