What Causes Low Testosterone?
When a male gets past the age of 40, his "equipment" might not work like it once did. Erections are not as reliable, and even sex drive has waned. He may not feel as energetic as before.
These are all signs of low testosterone, also known as testosterone deficiency or hypogonadism.
That prompts some men to explore low testosterone or "Low-T" therapy – believing it will make them sexier, more muscular and energetic. It is a somewhat controversial topic, as many men have viewed testosterone therapy as a fountain of youth.
Fact is, there are serious risks to getting testosterone therapy if you do not need it. Higher chance of heart attack is just one. On the other hand, men who could benefit – people with diabetes and HIV/AIDs patients – often aren't tested for Low T and don't get the treatment they need.
Also, other health problems can cause low libido and symptoms of Low-T. If there's another cause, with depression or stress, testosterone therapy will not help. In some cases, lifestyle changes can make all the difference in improving symptoms. In others, testosterone therapy may be warranted.
Let's look at what low testosterone is, what causes it, and what you can do about it.
What Is Low Testosterone?
Low testosterone is a condition in which the testicles do not produce enough testosterone, which is a male sex hormone.
This hormone allows men to produce sperm and to develop and keep common physical male traits. Testosterone also affects sex drive (libido), sexual function, muscle mass, red blood cells levels and overall well-being.
What Are the Symptoms of Low Testosterone?
The symptoms of low testosterone may appear gradually. As a man ages, his testosterone level will naturally decline. Certain medical conditions can also lead to low testosterone levels.
Symptoms may include:
- Low sex drive
- Erectile dysfunction
- Fatigue
- Depression and/or anxiety
- Trouble concentrating
- Moodiness and irritability
- Loss of muscle strength
Other signs may include:
- Mild anemia
- Loss of facial and body hair
- Bone thinning
- Increased body fat
- Male breast development (called gynecomastia)
What Causes Low Testosterone?
Testosterone levels naturally decrease as a man ages.
Low testosterone affects nearly 40 percent of men over age 45. Testosterone levels vary during the day. Various factors affect testosterone level including diet, alcohol consumption and illness.
Other causes may include:
- Obesity
- Certain medications
- Obstructive sleep apnea
- Kidney or liver disease
- Hypothyroidism
- Injury to the testicles, surgery or radiation treatment
How Can I Know If I Have Low Testosterone?
A blood test can determine a man’s testosterone level. Because levels vary during the day, you may need several measurements to determine low testosterone. Doctors prefer to test in the early morning when testosterone levels are at their highest.
Spinal stenosis (or narrowing) is a condition that affects older adults, causing pain, numbness and other problems within bones of your spine.
If your doctor believes another medical problem could cause low testosterone, you may need additional tests. You may benefit from treating that medical problem - in addition to testosterone therapy.
Symptoms can occur even if you have normal levels of total testosterone. Your doctor will then measure levels of the two types of testosterone - "free" and "bioavailable." These levels can offer helpful clues about your body's ability to make testosterone.
Can Women Experience Low-T Too?
Androgen deficiency is the medical term that is associated with low levels of testosterone in women. Androgens are hormones that are produced by both men and women that contribute to the reproductive cycle. However, androgen production tends to slow as the woman ages.
The two main types of androgens are testosterone and androstenedione. Although men have much higher levels, they are still important in women as well as they have over two hundred functions.
The androgens are also converted into estrogens, which are known as the female hormones. Since androgens help prevent bone loss and regulate organ functions, a deficiency can have negative consequences on a woman’s overall health.
How Is Low Testosterone Treated?
Doctors typically look first at a patient's lifestyle. Very few prescribe testosterone alone without discussing healthy lifestyle changes.
That includes:
- Sufficient sleep. Sleep affects many hormones and natural chemicals and can lower testosterone level. Get a good night's sleep – 7 or 8 hours – regularly. Put your electronic devices away earlier, and switch off the TV, too. Adequate sleep must be a priority.
- Healthy weight. If you are overweight or obese, that is enough to tank your testosterone level. Losing the weight will help bring it up to a normal level. If you are underweight, weight gain will improve testosterone level.
- Increased activity. Even a little regular physical activity will boost testosterone level. Walk briskly up to 20 minutes daily. Use elastic bands or hand weights to build strength. We are not talking about high-intensity workouts – just enough to be "active." When you are physically active, your brain sends a signal for more testosterone.
- Stress control. When you are under stress, your body creates the stress hormone cortisol – which short-circuits your testosterone level. Make de-stressing a priority.
- Cut back on long workdays. Do something enjoyable and relaxing instead. Listen to music. Read a good book.
Your doctor should also review your medications, to make sure they are not the cause of low testosterone – including prednisone and other glucocorticoid drugs, opioid drugs and anabolic steroids.
What Is Involved in Testosterone Replacement Therapy?
Testosterone can give in several ways:
- Injections (into a muscle) every 10 to 14 days.
- Patches are worn every day on buttocks, arms, back, and abdomen.
- Gels applied every day to upper back and arms.
- Pellets that are implanted under the skin every two months.
- Oral testosterone (not yet approved for use in the US)
What are the side effects of testosterone therapy?
- Acne or oily skin
- Skin irritation
- Mild fluid retention in ankles
- Difficulty urinating
- Worsening of sleep apnea
- Breast enlargement or tenderness
What Can I Expect From Testosterone Therapy?
With testosterone therapy, you will see improvements in all aspects of life – mood, sexual function, mental sharpness and physical performance. You will lose fat, gain muscle as well as bone strength.
With all those benefits, it is no wonder that Low-T therapy is a popular option. However, if an unhealthy lifestyle is a cause, you have got to attack that first. You can help keep testosterone level normal with a healthy way of life – and offset your risk of multiple health problems.
