"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 like fatigue, low libido, and reduction of muscle mass.
While reduced testosterone is more common in older men, it may occur in younger guys also. Luckily, every one of the causes of low testosterone in young guys are treatable, so in the event that you encounter these symptoms at any age, there is no reason to dismiss it.
Causes of Low Testosterone in Younger Men
For younger men, a drop in testosterone levels may be brought on by some ailments, such as type 2 diabetes, diabetes, chronic liver or kidney disease, COPD or other lung disorder, or adrenal gland problems, 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 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," says Bruce Gilbert, MD, PhD, an adjunct clinical professor of urology and reproductive medicine at Weill Cornell Medical College and director of reproductive and sexual medicine in the Smith Institute for Urology of their North Shore-LIJ Health System.
Additional causes of low testosterone in males younger than 50 contain adrenal gland tumors, HIV infection, 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.
Is It 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 you suspect low testosterone, the first step is to see your primary care physician. Your doctor can diagnose low testosterone with a blood test.
Treatments for Low Testosterone in Younger Men
"When it comes to treating low testosterone in younger men, we generally reserve treatment for people 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,"therapies are usually used only in the short term, and when a physician has close observation and knowledge of the patient," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You do not wish to give 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 increase their testosterone in addition to preserve their sperm production," he says. One such alternative is a class of drugs known as selective estrogen receptor modulators (SERMs).
Other remedies for low testosterone include weight loss and other lifestyle modifications, like eating healthy and increasing exercise.
The main point, however, is that in the event that you've got low testosterone symptoms, it's important to see your physician. Then, your doctor can rule out potentially more serious causes of your symptoms, including hypertension or a thyroid problem, and give treatment that can enhance your energy and quality of life.