"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.
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 reduction of muscle mass.
While reduced testosterone is more prevalent in older men, it may occur in younger guys as well. Fortunately, every one the causes of low testosterone in young guys are treatable, so if you experience such symptoms at any given age, there's no reason to dismiss it.
For younger guys, a fall in testosterone levels can be brought on by some ailments, such as type 2 diabetes, chronic liver or kidney disease, COPD or other lung disorder, or adrenal gland problems, according to Dr. Samadi.
Genetic causes of low testosterone in men 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 sexual medicine at the Smith Institute for Urology of their North Shore-LIJ Health System.
Other causes of low testosterone in men younger than 50 contain adrenal 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.
Is It Low Testosterone?
Regardless of the reason, low testosterone symptoms are the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity, and moodiness," Dr. Gilbert states.
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 older guys, we usually reserve treatment for people who have symptoms, such as fatigue and reduced 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 often used just in the short term, and if a physician has close observation and knowledge of the individual," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You do not wish 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 that might improve their testosterone as well as maintain their semen production," he says. 1 such choice 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 raising exercise.
The main point, however, is that if you've got low testosterone symptoms, it is very 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 improve your energy and quality of life.