"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 sex drive, and reduction of muscle mass.
While reduced testosterone is more prevalent in older men, it can occur in younger men as well. Fortunately, all of the causes of low testosterone in young men are curable, so if you experience such symptoms at any age, there's no reason to ignore 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, 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 ailments Klinefelter syndrome, Kallmann syndrome, Prader-Willi syndrome, and Myotonic dystrophy. Another disorder which could cause low testosterone is hemochromatosis, making 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," states 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.
Additional causes of low testosterone in males 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 states.
Can It Be 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 says.
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.
"When it comes to treating low testosterone in younger guys, we generally reserve treatment for those who have symptoms, such as fatigue and reduced libido," Gilbert says.
Such testosterone supplements come in the form of gel, injections, patches, long-acting pellets, or oral inserts.
In these circumstances,"treatments are often used just in the short term, and if a doctor has close observation and knowledge of the patient," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You don't want to give 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 think about alternatives that might increase their testosterone as well as maintain their semen production," he states. 1 such alternative is a category of drugs known as selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle changes, like eating healthier and raising exercise.
The bottom line, however, is that if you've got low testosterone symptoms, then it is important to see your doctor. Then, your doctor can rule out potentially more serious causes of your symptoms, including hypertension or a thyroid problem, and give treatment that could enhance your power and high quality of life.