"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 libido, and reduction of muscle mass.
While low testosterone is more common in older men, it can occur in younger men as well. Fortunately, all the causes of low testosterone in young guys are curable, so if you experience these symptoms at any age, there is no reason to ignore it.
For younger men, a fall in testosterone levels can be brought on by some illnesses, including type 2 diabetes, diabetes, chronic liver or kidney disease, COPD or other lung disease, or adrenal gland problems, based on 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 result in 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," states 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 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 primary or secondary.
"Primary hypogonadism stems from a problem in the testicles," Samadi says. "This could be from a developmental issue, injury to the testicles, or radiation or chemotherapy treatment. In secondary hypogonadism, the testicles are normal but function improperly because of a problem with the hypothalamus or pituitary gland."
Can It Be 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 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 those who have symptoms, such as fatigue and low libido," Gilbert says.
In these circumstances,"treatments are usually used only in the short term, and when a physician has close monitoring and understanding of the individual," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You do not wish to give supplemental testosterone to men 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 consider alternatives which may improve their testosterone in addition to preserve their sperm production," he says. One such alternative is a category of drugs known as selective estrogen receptor modulators (SERMs).
Other remedies for low testosterone include weight loss and other lifestyle changes, such as eating healthier and increasing exercise.
The main point, however, is that if you have low testosterone symptoms, it's very important to see your physician. Then, your doctor can rule out potentially more serious causes of your symptoms, such as hypertension or a thyroid problem, and give treatment that can improve your power and high quality of life.