"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 nyc.
Although 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 loss of muscle mass.
While low testosterone is more prevalent in older men, it can occur in younger guys also. Luckily, all the causes of low testosterone in young guys are curable, so if you encounter these symptoms at any age, there is no reason to ignore it.
For younger men, a drop in testosterone levels can be brought on by some illnesses, including type 2 diabetes, diabetes, chronic liver or liver disease, COPD or other lung disease, 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 disorder which could cause low testosterone is hemochromatosis, which makes the body shop 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 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 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. "This could be from a developmental issue, injury to the testicles, or radiation or chemotherapy treatment.
Can It Be Low Testosterone?
Regardless of the cause, low testosterone symptoms are the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity and moodiness," Dr. Gilbert says.
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 a urologist or endocrinologist.
Treatments for Low Testosterone in Younger Men
"When it comes to treating low testosterone in older guys, we usually reserve treatment for those who have symptoms, such as fatigue and low 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.
In these circumstances,"treatments are usually used just in the short term, and if a doctor has close monitoring 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 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 increase their testosterone as well as maintain their sperm production," he says. One such alternative is a class of drugs called selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle modifications, such as eating healthy and increasing exercise.
The bottom line, however, is that if you've got low testosterone symptoms, it's important to see your doctor. Then, your doctor can rule out more serious causes of your symptoms, such as hypertension or a thyroid problem, and offer treatment that could enhance your energy and high quality of life.