What is low testosterone?

Low testosterone, also called testosterone deficiency or hypogonadism, is a medical condition in which the testes (testicles, the male reproductive glands) do not produce enough testosterone (the male sex hormone).2-5 While it is common for testosterone levels to progressively decline in men as they get older,6 low testosterone can occur even in young men, especially if they have developed a belly or have an excess amount of total body fat.7 Other possible causes for low testosterone in younger men is life/work stress8,9 and use of medications, such as opioids,10 selective serotonin reuptake inhibitors (SSRIs)11 and statins.12 Therefore, low testosterone is not just an “old man’s problem”. Less common causes of low testosterone in young men include testicular trauma, concussion and congenital (present at birth) disease caused by chromosomal abnormalities or gene mutations.13

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What are the signs & symptoms of low testosterone?

Signs & symptoms

Common symptoms and signs of hypogonadism (low testosterone) in men.2,4,5,18,19

Metabolic symptoms / signs

  • Obesity (BMI 30 or higher)
  • Abdominal (belly) obesity (waist circumference 102cm or higher)
  • Metabolic syndrome
  • Insulin resistance, prediabetes or type 2 diabetes

Sexual symptoms

  • Decreased sexual desire and activity
  • Decreased frequency of sexual thoughts
  • Erectile dysfunction
  • Delayed ejaculation
  • Decreased volume of ejaculate
  • Decreased frequency or absent morning or night-time erections
  • Small testes
  • Infertility
Marek on his own

Psychological symptoms

  • Depressed mood
  • Loss of energy
  • Reduced motivation
  • Poor concentration
  • Decreased well-being and/or poor self-rated health
  • Irritability
  • Sadness
  • Impaired memory
  • Decreased cognitive function (including impaired concentration, verbal memory, and spatial performance)

Physical symptoms

  • Decreased muscle mass and strength
  • Reduced physical performance
  • Hot flushes or sweats
  • Sleep disturbances
  • Fatigue
  • Reduced bone mineral density, osteoporosis,
    low trauma fractures
  • Decreased body hair
  • Gynaecomastia (enlarged breasts)

What causes low testosterone?

Although many people think that the main cause of low testosterone is ageing, observational studies consistently show a strong association of obesity with low circulating testosterone levels in men.6,23,24

This means that by living a healthy lifestyle with regular exercise and healthy food habits, you improve your chances of maintaining your testosterone in the healthy range even as you get older. In other words, low testosterone – while common - is not inevitable in men as they get older, as menopause is in women.

Other possible factors for low testosterone the metabolic syndrome25-27 and type 2 diabetes.28-31 Chronic diseases, such as high blood pressure, heart disease, liver disease, kidney disease, arthritis, stroke, emphysema, rheumatoid arthritis and depression may also be risk factors for low testosterone.1,29,32

Which men are most at risk of TD?

Men with...

Up to 80% of men with a BMI ≥ 50 have low testosterone.33,34 Medical guidelines state that all men with BMI > 30 kg/m2, or waist circumference > 102 cm should be checked for low testosterone by having testosterone levels measured.35

Men with...
Erectile dysfunction

Among men with erectile dysfunction, over one third (36%) have low testosterone levels.9 Low testosterone can cause erectile dysfunction and/or non-responsiveness to treatment with PDE5i (phosphodiesterase 5 inhibitors) such as Viagra. Therefore, according to medical guidelines is it mandatory that men with erectile dysfunction have testosterone levels measured.39,40 This is particularly important if your erectile dysfunction treatment doesn’t appear to be working well.

Men who...
Take medications

Certain medications, especially opioids,10 selective serotonin reuptake inhibitors (SSRIs)11 and statins,12 may reduce your testosterone level.

Men with...
Type 2 diabetes

Nearly half of men with type 2 diabetes have low testosterone.36 Obesity is common among men with type 2 diabetes,37 but even non-obese men with type 2 diabetes commonly have low testosterone.36 The frequent occurrence of low testosterone in men with type 2 diabetes prompted medical guidelines to recommend that testosterone levels are measured in men with type 2 diabetes who have symptoms.4

Men with...
High life/work stress

Among men with sexual dysfunction, half who report a high degree of life/work stress have been found to have low testosterone.

Low testosterone?

Think you’ve got low testosterone?

Regardless of age, if you’re rarely in the mood for sex and perhaps have difficulties getting an erection, often feel tired/lethargic and have a depressed mood, you may be experiencing symptoms of low testosterone.

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