"After age 30, most men begin to experience a gradual decline in testosterone," states 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 sex drive, and reduction of muscle mass.
While reduced testosterone is more common in older men, it can occur in younger guys as well. Fortunately, all of the causes of low testosterone in young men are curable, so in the event that you encounter these symptoms at any age, there's no reason to ignore it.
For younger guys, a drop in testosterone levels may be brought on by some ailments, such as type 2 diabetes, diabetes, chronic liver or liver disease, COPD or other lung disease, or adrenal gland issues, based on Dr. Samadi.
Genetic causes of low testosterone in males include the ailments Klinefelter syndrome, Kallmann syndrome, Prader-Willi syndrome, and Myotonic dystrophy. Another disorder that could result in low testosterone is hemochromatosis, making the body shop too much iron.
"Low testosterone can also result when something happens, like trauma or steroid use, that prevents the testes from making the hormone," says 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 their North Shore-LIJ Health System.
Other causes of low testosterone in males 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 says. "This could be from a developmental issue, injury to the testicles, or radiation or chemotherapy treatment.
Can It Be 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 states.
"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
Not everyone with low testosterone needs treatment. "When it comes to treating low testosterone in older men, we generally reserve treatment for people who have symptoms, such as tiredness and reduced libido," Gilbert says.
Such testosterone supplements come in the form of gel, injections, patches, long-acting pellets, or oral inserts.
In these circumstances,"therapies are often used just in the short term, and when a doctor has close observation and knowledge of the patient," 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 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 think about alternatives which may improve their testosterone in addition to maintain their sperm production," he says. One such choice is a category of drugs known as 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, though, is that if you have low testosterone symptoms, it is very important to see your doctor. Then, your doctor can rule out potentially more significant causes of your symptoms, including hypertension or a thyroid problem, and offer treatment that can enhance your power and quality of life.