Low Testosterone

Low testosterone at a glance

• Production of testosterone, a hormone affecting emotion and appearance, ramps up during puberty and starts to gradually decline as men age.
• A lower than normal level of testosterone, however, can cause a variety of symptoms including a lower sex drive, sleep loss, hair loss, mood changes and an increase in body fat.
• A urologist can conduct a blood test to determine if/when testosterone falls below the normal levels circulating in the body.
• If low testosterone is diagnosed, a doctor may recommend testosterone replacement therapy to boost the levels of testosterone.
• Treatment may relieve symptoms and help keep bones and muscles strong; however, there is no cure for low testosterone.
• Men should not take testosterone if not recommend and directed by a physician.

What is low testosterone?

Testosterone (T) is a hormone naturally produced in the body that affects appearance (like hair growth and muscle mass), emotion and a man’s sex drive.

Testosterone production ramps up during puberty and typically decreases gradually with age, starting around age 30. The older the man, the more likely he is to experience below-normal testosterone levels.

According to the American Urological Association, about 2 out of 5 men over age 45 and 3 out of 10 men older than 70 have low testosterone.

Low testosterone (low T) occurs when levels fall below 300 nanograms per deciliter (ng/dL). A normal range for men is typically 300–1,000 ng/dL, according to the U.S. Food and Drug Administration. Low testosterone is often called hypogonadism, although this refers to low or no production of hormones by the gonads, which are the ovaries in women and the testicles in men.

Low testosterone symptoms and risk factors

Signs of low T are often subtle, and some men may not exhibit symptoms at all. Other men may have a range of symptoms including:

• Lower sex drive
• Difficulty with erections
• Low semen volume
• Hair loss
• Fatigue
• Loss of muscle mass
• Increase in body fat
• Decrease in bone mass
• Depression and other mood changes.

While each of the symptoms above may result from lowered testosterone levels, they may also be normal side effects of aging.

Risk factors for low T

Outside of aging, certain health issues can also contribute to the risk of low testosterone including:

• High blood pressure (about 40 percent of men also have low testosterone)
• High cholesterol (about 40 percent also have low testosterone)
• Diabetes (about 50 percent also have low testosterone)
• Obesity (about 50 percent also have low testosterone)
• HIV (about 30 percent have low testosterone)
• AIDS (about 50 percent also have low testosterone)
• Long-term opioid use (almost 75 percent also have low testosterone).

Diagnosing low testosterone

A blood test called a serum testosterone test is used to determine the level of circulating testosterone in a body. The test is usually performed in the morning, when T levels are highest. In general, a diagnosis of low testosterone is made if the hormone’s level is below 300 ng/dL.

Other tests may be required. A urologist may also conduct a PSA (prostate-specific antigen) blood test to check for signs of prostate cancer. He/she may also measure the red blood cells in the body (hematocrit) to keep a baseline record of red blood cell counts, because they can go up after taking testosterone.

These tests administered and interpreted by a urologist, can help reveal whether any underlying conditions, health issues or lifestyle choices are affecting testosterone production and whether treatment is needed.

Testosterone replacement therapy (TRT)

A variety of treatment options called “testosterone replacement therapy” are available to supplement the body’s testosterone levels. TRT may be taken as an injection, implant or via a gel or patch.

Treatment may relieve symptoms and help keep bones and muscles strong, however, there is no cure for low T.