When you think of testosterone deficiency, you probably think of your father or grandfather. But most men don’t realize that testosterone deficiency can happen at a much younger age than they think.
Older men are indeed more likely to have low testosterone. That’s why low testosterone affects more than 60% of men over 65. But low testosterone also affects about a quarter of men over 30 and nearly 40% of men over 45.
Because testosterone affects so many things, you may have signs and not even know it.
What is Testosterone?
Testosterone is a type of hormone produced primarily in the gonads. It is an androgen, which encourages the growth of male traits and characteristics. Testosterone is essential for reproduction and keeping bones and muscles strong.
This hormone also tells the body to produce new blood cells and increases libido in both men and women, making them more sexually active. Testosterone is linked to numerous puberty-related changes in boys, including:
- body and pubic hair growth
- increase in height
- a bigger penis, testicles, and prostate gland
- changes in sexual and aggressive behavior
This sex hormone often reaches its peak during adolescence or early adulthood. Around age 40, men’s ability to make testosterone begins to wane, causing testosterone levels to decline by 1 to 3 percent yearly.
Testosterone is much more common in men than in women. It starts the development of a man’s external and internal reproductive organs when he is still in the womb, and it is necessary for the production of sperm when he is an adult.
What Happens if I Have Testosterone Deficiency?
Low testosterone, also called hypogonadism, is when the amount of testosterone in the blood is lower than it should be. Hypogonadism is when your sex glands don’t make enough or any sex hormones. However, most cases of this disease get better with proper medical care.
If there isn’t enough testosterone when a baby is still in the womb, male traits might not fully form. If a boy doesn’t have enough testosterone during puberty, his growth may slow down, and he won’t have a growth spurt.
The child’s pubic hair, penis, and testes may not grow as much, and their voice may not change as much. Boys who don’t have enough testosterone may not be as strong or as durable as other boys their age, and their limbs may continue to grow out of proportion to the rest of their bodies.
Low testosterone levels in adult men can cause their muscles to get smaller, their body hair to fall out, and their skin to look wrinkly and “like parchment.” As men age, their testosterone levels naturally go down. This is sometimes called “male menopause” or andropause. Low testosterone levels can lead to:
- mood swings
- more body fat
- less muscle tone
- weak erections
- poor sexual performance
- trouble focusing
- memory loss
- trouble sleeping
Current research shows that this effect only happens in about 2% of men as they age. But there is a lot of research going on right now to learn more about how testosterone affects older men and if using testosterone replacement therapy would be helpful.
What are the Causes of Low Testosterone?
Testosterone levels naturally go down as men age, but other conditions or situations can also cause low testosterone. Some of these are:
- injuries to the testicle
- chemotherapy or radiation
- Klinefelter syndrome
- pituitary gland conditions
- using certain medications
- autoimmune disease
- metabolic syndrome
- alcohol use disorder
Most of the time, there is no apparent reason why a person has low testosterone. In this case, testosterone replacement therapy is a common and successful treatment.
What are the Symptoms of Testosterone Deficiency?
When a man’s testosterone level drops too low, he might have a number of symptoms. Unfortunately, many of these signs and symptoms are subtle, making them difficult to detect unless one knows what to look for.
- Low Sex Drive
Testosterone is a very important part of sex drive or libido. When your testosterone level goes down, so does your desire to have sex. As people age, their testosterone levels naturally go down. But a sudden drop in testosterone can cause a drop in libido.
Some people’s sex drive goes down as they get older, but those with low testosterone are more likely to notice a significant change.
Researchers have found that the amount of testosterone in your body can affect your sexual fantasies and even your daydreams. If you don’t have enough testosterone, you might not be able to come up with sexual fantasies or desire to masturbate.
Since low testosterone can happen at any age and for a number of reasons, it’s best to talk to your doctor if you notice a change in your sexual desires. There are many ways to get testosterone levels back to normal, but you should always talk to your doctor first.
- Problems with Erections
When testosterone levels are low, it can be hard to get or keep an erection. Testosterone has two kinds of effects on erections in your body. The first is in your brain and spinal cord, or central nervous system. Testosterone causes your CNS to release neurotransmitters, which are chemical messages from your brain that help you get an erection.
These neurotransmitters include dopamine, nitric oxide, and oxytocin. They are essential molecules that speed up the chemical reaction that causes an erection.
The second step is to trigger your spinal nerves so that your blood vessels change in ways that help you get and keep an erection.
When a man has low testosterone, this chemical reaction slows down. As a result, this makes it harder for him to get an erection.
- Reduced Muscle Mass
Testosterone helps build muscle mass, and if you don’t have enough of it, you can lose a lot of muscle tissue and tone. Testosterone helps your muscle cells keep their strength and keep your muscle fibers together.
When your androgen receptors don’t get enough testosterone, your muscle cells can’t keep your muscle fibers in good shape, and your muscle fibers start to break down. Your muscles get weaker and weaker over time. So, even if you go to the gym every day, having low testosterone will make it harder for you to reach your goals.
- Low Bone Mass
Testosterone helps make bone tissue and keep the volume of bones. Low testosterone can cause this volume to shrink, which can make the bones more likely to break. Additionally, studies show that testosterone makes osteoporosis worse. Osteoporosis is when bones lose their strength and density.
As people age, their bones naturally start to break down. Testosterone helps build new bones and keep the mass you already have. If the body lacks testosterone, new bone growth can’t keep up with the bone loss. The result is fragile bones that are likely to break when you trip or bump into something. Yes, bones do get weaker over time. Still, a lack of testosterone is directly linked to how weak men are and how quickly they age.
- Hair Loss
Even though male pattern baldness happens naturally to many men, a drop in testosterone can also be a big reason men lose their hair. Persons with low testosterone may lose hair all over their bodies and not just on their heads. This could be a sign that their testosterone levels are too low.
- Low Energy Levels
Hormones that are in balance do many important things, including ensuring you have enough energy throughout the day. If you don’t have enough testosterone, you might feel tired even after a good night’s sleep. This drop in energy can make you feel tired and worn out.
Low testosterone often leads to fatigue. You may feel like you don’t have as much energy as usual despite having plenty of sleep. You may also find it harder to get motivated to do anything or to exercise.
- Lower Sperm Count
If your sex drive hasn’t changed much, but you’re making less sperm than usual, it could be because your testosterone level is low. Testosterone is a key part of how your body makes sperm, and if you have less of it, your sperm production will go down over time.
Studies have shown that a low testosterone level is directly linked to a low number of sperm and problems with male fertility. Additionally, men’s sperm counts have dropped by more than half in the last 40 years, which is a worrying trend.
Who is at Risk?
Hypogonadism can affect men of all ages, from birth to adulthood. Low testosterone is more prevalent among men who:
- are older
- have poorly controlled Type 2 diabetes.
- have obesity
- have obstructive sleep apnea
- chronic medical issues, such as kidney disease or liver cirrhosis
- have HIV/AIDS
How to Test Testosterone?
A testosterone test looks at how much testosterone is in your blood. If a doctor wants to check the levels of hormones in your blood, they will tell you what time of day to take the test. Since hormone levels peak in the morning, this test is often done between 7 and 10 in the morning. Your doctor may do more than one test to see your levels.
Before your test, your doctor may tell you to stop taking some drugs that could affect your testosterone levels. You should also tell your physician about all the medicines you are taking. Include both prescription and over-the-counter medicines.
Can Low Testosterone Levels be Avoided?
Healthcare professionals and medical researchers do not know how to avoid low testosterone caused by genetic disorders or testicular, hypothalamic, or pituitary gland injury. However, there are various ways to boost testosterone levels naturally. Some of them are:
- Eating a healthy diet
- Regular exercise
- Proper weight management
- Avoiding too much use of drugs and alcohol
- Getting enough sleep
- Minimizing stress
Treatments for Low Testosterone
When a specific reason is found for testosterone deficiency, treatment can be centered on that reason. For example, when the pituitary gland makes too many hormones, medicine or surgical procedures may be used to fix the problem.
When there is no clear cause, Testosterone Replacement Therapy (TRT) is the most common way to treat the problem. Through regular injections of testosterone, TRT raises the amount of testosterone in the body. This therapy can be done in different ways:
- Testosterone patches give a set amount of testosterone every day, but they need to be changed every day.
- Testosterone gels work a lot like testosterone patches and must be put on daily.
- Intramuscular testosterone supplementation is a shot that is given every one to four weeks.
- Testosterone pellets are placed under the skin, making the level of testosterone stays stable for 4-6 months.
Using testosterone therapy to treat normal aging is not a good idea. Suppose you don’t have a medical condition that could be causing your testosterone levels to drop. In that case, your doctor might recommend natural ways to boost testosterone, like losing weight and building muscle mass through exercise.
What are the Risks of Testosterone Therapy?
Before starting TRT, patients should know they will have to do it for the rest of their lives. When you take testosterone supplements, the amount of testosterone your body makes on its own goes down.
A hematocrit test can show that testosterone replacement therapy can also increase a patient’s red blood cell mass. Because of this, it is crucial to keep a close eye on hematocrit levels. Other risks of TRT include:
- Worsening sleep apnea
- Acne or other skin reactions
- Growth of the prostate
- Shrinkage of the testicles
- Limited sperm production
- Enlarging breasts
If you have any of the symptoms of low testosterone, you should talk to a doctor first. Many of these indications are common and could be signs of other problems. A medical diagnosis is needed to ensure you get the right care. Your doctor can check for testosterone imbalances and help you fix them so that these signs and symptoms go away.
If your doctor says you have low testosterone, you should consider getting treatment. Never treat low testosterone on your own with medicines your doctor hasn’t approved. It’s too dangerous. Instead, talk to your doctor about different ways to treat your illness so you can find one that works for you.