"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 like fatigue, low sex drive, and reduction of muscle mass.
While low testosterone is more common in older men, it can occur in younger guys also. Luckily, all of the causes of low testosterone in young guys are curable, so in the event that you experience such symptoms at any given age, there's no reason to ignore it.
For younger guys, a drop in testosterone levels may be caused by some ailments, such as type 2 diabetes, chronic liver or liver disease, COPD or other lung disorder, or pituitary gland problems, 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 disease that could cause low testosterone is hemochromatosis, which makes 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 at the Smith Institute for Urology of the North Shore-LIJ Health System.
Additional causes of low testosterone in males younger than 50 include pituitary gland tumors, HIV disease, and radiation therapy 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.
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.
"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€
"When it comes to treating low testosterone in older guys, we usually reserve treatment for people who have symptoms, such as fatigue and reduced libido," Gilbert says.
In these circumstances,"treatments are usually used only in the brief term, and when a physician has close observation and understanding of the patient," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You do not 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. "Hence, men of reproductive age should think about alternatives which may increase their testosterone as well as preserve their sperm production," he says. One such alternative is a class of drugs called selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle changes, like eating healthy and raising exercise.
The bottom line, however, is that if you have low testosterone symptoms, then it is important to see your physician. Then, your doctor can rule out potentially more serious causes of your symptoms, such as hypertension or a thyroid problem, and offer treatment that can improve your power and high quality of life.