"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.
Although testosterone levels never reach zero (as estrogen levels do in women during menopause), low testosterone levels men to experience symptoms like fatigue, low libido, and reduction of muscle mass.
While low testosterone is more common in older men, it may occur in younger guys also. Luckily, all the causes of low testosterone in young guys are treatable, so if you encounter such symptoms at any age, there is no reason to dismiss it.
For younger men, a drop in testosterone levels can be caused by some ailments, such as type 2 diabetes, diabetes, chronic liver or kidney disease, COPD or other lung disorder, or pituitary gland issues, 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 that can cause low testosterone is hemochromatosis, making 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 reproductive medicine at the Smith Institute for Urology of the North Shore-LIJ Health System.
Additional causes of low testosterone in men younger than 50 contain adrenal gland tumors, HIV disease, 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. In secondary hypogonadism, the testicles are normal but function improperly because of a problem with the hypothalamus or pituitary gland."
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 says.
"Younger men with low testosterone usually come to me and say, 'I can't work out like I used to, and I've lost interest in sex.’ â€
Treatments for Low Testosterone in Younger Men
"When it comes to treating low testosterone in younger men, we usually reserve treatment for people who have symptoms, such as tiredness and low 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 only 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 don't wish to give supplemental testosterone to men 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. "Therefore, men of reproductive age should think about alternatives that might improve their testosterone as well as preserve their sperm production," he states. One such alternative is a class of drugs called selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle changes, such as eating healthier and raising exercise.
The main point, however, is that if you have low testosterone symptoms, it is important to see your doctor. Then, your doctor can rule out potentially more serious causes of your symptoms, such as high blood pressure or a thyroid problem, and offer treatment that could improve your energy and quality of life.