"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 nyc.
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 libido, and reduction of muscle mass.
While low testosterone is more prevalent in older men, it can occur in younger guys as well. Luckily, all the causes of low testosterone in young men are curable, so if you encounter such symptoms at any given age, there is no reason to ignore 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, chronic liver or kidney disease, COPD or other lung disorder, or pituitary gland issues, according to Dr. Samadi.
Genetic causes of low testosterone in males include the ailments Klinefelter syndrome, Kallmann syndrome, Prader-Willi syndrome, and Myotonic dystrophy. Another disease which can cause 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," 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 in 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 says. 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?
Irrespective 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 you suspect low testosterone, the first step is to see your primary care physician.
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 fatigue and reduced 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,"therapies are usually used only in the short term, and when a doctor has close observation and understanding of the individual," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You do not wish to offer supplemental testosterone to guys who are interested in being 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. "Hence, men of reproductive age should think about alternatives which may improve their testosterone in addition to maintain their sperm production," he says. One such alternative is a class of drugs called selective estrogen receptor modulators (SERMs).
Other remedies for low testosterone include weight loss and other lifestyle modifications, like eating healthy and raising exercise.
The main point, however, is that if you have low testosterone symptoms, it is very important to see your physician. Then, your doctor can rule out 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.