"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.
Though 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 loss of muscle mass.
While reduced testosterone is more common in older men, it may occur in younger guys as well. Luckily, all the causes of low testosterone in young men are treatable, so if you experience such symptoms at any given age, there is no reason to ignore it.
For younger men, a fall in testosterone levels may be caused by some illnesses, including type 2 diabetes, diabetes, chronic liver or liver disease, COPD or other lung disorder, 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 disease which can 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.
Other 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. "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."
Is It Low Testosterone?
Irrespective of the cause, low testosterone symptoms would be the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity, and moodiness," Dr. Gilbert says.
"Younger men with low testosterone usually come to me and say, ‘I can't work out like I used to, and I've lost interest in sex.' â€
"When it comes to treating low testosterone in older men, we usually reserve treatment for those who have symptoms, such as tiredness and low libido," Gilbert says.
Such testosterone supplements come in the form of a gel, injections, patches, long-acting pellets, or oral inserts.
In these circumstances,"treatments are usually used just in the short term, and when a doctor has close monitoring and knowledge of the patient," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You do not want to give supplemental testosterone to guys 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. "Hence, men of reproductive age should consider alternatives that might increase their testosterone in addition to maintain their semen production," he states. 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 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 physician. Then, your doctor can rule out potentially more serious causes of your symptoms, such as hypertension or a thyroid problem, and offer treatment that can enhance your energy and high quality of life.