"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 such as fatigue, low sex drive, and loss of muscle mass.
While low testosterone is more common in older men, it can occur in younger men as well. Fortunately, all the causes of low testosterone in young men are treatable, so if you experience such symptoms at any age, there's no reason to ignore it.
Causes of Low Testosterone in Younger Men
For younger men, a drop in testosterone levels can be caused by some illnesses, including type 2 diabetes, chronic liver or liver disease, COPD or other lung disorder, or adrenal 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 disorder which could 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 reproductive medicine in the Smith Institute for Urology of the North Shore-LIJ Health System.
Other causes of low testosterone in men younger than 50 contain adrenal gland tumors, HIV disease, and radiation therapy 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.
Is It Low Testosterone?
Irrespective of the reason, low testosterone symptoms are the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity and moodiness," Dr. Gilbert states.
"When it comes to treating low testosterone in older men, we usually reserve treatment for people who have symptoms, such as fatigue and reduced libido," Gilbert says.
In these circumstances,"treatments are often used only in the brief term, and when a doctor has close monitoring 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 guys 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 semen production," he says. 1 such choice is a class of drugs known as selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle changes, like eating healthier and raising exercise.
The bottom line, however, is that in the event that you have low testosterone symptoms, then it's important to see your physician. Then, your doctor can rule out potentially more serious causes of your symptoms, including high blood pressure or a thyroid problem, and offer treatment that could improve your energy and high quality of life.