"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 such as fatigue, low sex drive, and reduction of muscle mass.
While low testosterone is more prevalent in older men, it can occur in younger men as well. Fortunately, all the causes of low testosterone in young men are curable, so in the event that you encounter such symptoms at any age, there is no reason to dismiss it.
Causes of Low Testosterone in Younger Men
For younger guys, a drop in testosterone levels can be caused by some ailments, such as type 2 diabetes, diabetes, chronic liver or liver disease, COPD or other lung disorder, or pituitary 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 disorder that can cause 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 in 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 treatment 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.
Is It Low Testosterone?
Regardless of the reason, low testosterone symptoms would be 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.
Not everyone with low testosterone needs treatment. "When it comes to treating low testosterone in younger guys, we generally 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. Such testosterone supplements come in the form of gel, injections, patches, long-acting pellets, or oral inserts.
In these circumstances,"treatments are often used just in the short term, and when a physician has close observation and knowledge of the individual," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You don't 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 improve their testosterone as well as maintain their sperm production," he states. 1 such alternative is a category of drugs called selective estrogen receptor modulators (SERMs).
Other remedies for low testosterone include weight loss and other lifestyle modifications, such as eating healthy 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 physician. Then, your doctor can rule out potentially more significant causes of your symptoms, such as hypertension or a thyroid problem, and offer treatment that could improve your power and quality of life.