"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.
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 libido, and reduction of muscle mass.
While reduced testosterone is more prevalent in older men, it can occur in younger men also. Fortunately, every one of the causes of low testosterone in young guys are treatable, so in the event that you experience these symptoms at any given age, there is no reason to dismiss it.
For younger men, a fall in testosterone levels may be caused by some illnesses, including type 2 diabetes, chronic liver or kidney disease, COPD or other lung disorder, or pituitary gland problems, according to Dr. Samadi.
Genetic causes of low testosterone in males include the ailments Klinefelter syndrome, Kallmann syndrome, Prader-Willi syndrome, and Myotonic dystrophy. Another disease that can 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 their North Shore-LIJ Health System.
Other 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."
Can It Be 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.
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 guys, we generally reserve treatment for people who have symptoms, such as tiredness and low libido," Gilbert says.
In these circumstances,"treatments are usually used only in the brief 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 don't want to offer supplemental testosterone to guys who are interested in being 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 think about alternatives which may improve their testosterone in addition to maintain their sperm production," he says. One such choice is a class 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 raising exercise.
The main point, however, is that if you have low testosterone symptoms, then it is important to see your doctor. Then, your doctor can rule out more significant causes of your symptoms, such as hypertension or a thyroid problem, and give treatment that can enhance your power and high quality of life.