"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 nyc.
Although testosterone levels never reach zero (as estrogen levels do in women during menopause), low testosterone levels men to experience symptoms like fatigue, low sex drive, and reduction of muscle mass.
While low testosterone is more prevalent in older men, it can occur in younger guys as well. Luckily, all of the causes of low testosterone in young guys are treatable, so in the event that you experience these symptoms at any given age, there's no reason to dismiss it.
Causes of Low Testosterone in Younger Men
For younger guys, a drop in testosterone levels may be caused by some ailments, such as type 2 diabetes, diabetes, chronic liver or kidney disease, COPD or other lung disorder, or pituitary gland problems, based on 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 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 at the Smith Institute for Urology of their North Shore-LIJ Health System.
Other 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 secondary or primary.
"Primary hypogonadism stems from a problem in the testicles," Samadi states. "This could be from a developmental issue, injury to the testicles, or radiation or chemotherapy treatment. In secondary hypogonadism, the testicles are normal but function improperly because of a problem with the hypothalamus or pituitary gland."
Can It Be Low Testosterone?
Regardless of the cause, low testosterone symptoms are the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity and moodiness," Dr. Gilbert states.
If your blood test reveals low testosterone (usually defined as a level lower than 300 ng/dL), the doctor may treat you or refer you to a specialist, such as an urologist or endocrinologist.
Treatments for Low Testosterone in Younger Men
"When it comes to treating low testosterone in younger guys, we generally reserve treatment for those who have symptoms, such as fatigue and low libido," Gilbert says.
In these circumstances,"therapies are often used just in the brief term, and if a physician has close monitoring 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 want to be fertile because 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 consider alternatives which may improve their testosterone in addition to maintain their semen production," he says. One such alternative is a category of drugs known as selective estrogen receptor modulators (SERMs).
Other remedies for low testosterone include weight loss and other lifestyle modifications, such as eating healthier and increasing exercise.
The main point, however, is that in the event that you have low testosterone symptoms, it is very important to see your physician. Then, your doctor can rule out potentially more serious causes of your symptoms, including hypertension or a thyroid problem, and give treatment that can improve your power and high quality of life.