"After age 30, most men begin to experience a gradual decline in testosterone," says 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 common in older men, it can occur in younger guys as well. Luckily, all the causes of low testosterone in young guys are curable, so if you encounter such symptoms at any age, there is no reason to ignore it.
Causes of Low Testosterone in Younger Men
For younger guys, a fall in testosterone levels can be brought on by some ailments, such as type 2 diabetes, chronic liver or liver disease, COPD or other lung disorder, or pituitary gland problems, according to Dr. Samadi.
Genetic causes of low testosterone in males include the ailments 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," 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 in the Smith Institute for Urology of the North Shore-LIJ Health System.
Other causes of low testosterone in men younger than 50 contain adrenal gland tumors, HIV disease, 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 states. 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 reason, low testosterone symptoms would be the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity, and moodiness," Dr. Gilbert says.
Not everyone with low testosterone needs treatment. "When it comes to treating low testosterone in older guys, we generally reserve treatment for those who have symptoms, such as tiredness and low libido," Gilbert says.
In these circumstances,"treatments are usually used just in the short term, and when a physician has close observation and understanding of the individual," 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 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 improve their testosterone in addition to maintain their sperm production," he says. One such choice is a class of drugs known as selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle modifications, like eating healthier and raising exercise.
The main point, however, is that in the event that you have low testosterone symptoms, then it's important to see your physician. Then, your doctor can rule out more significant causes of your symptoms, including hypertension or a thyroid problem, and give treatment that can improve your energy and quality of life.