"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 reduced testosterone is more common in older men, it may occur in younger men as well. Fortunately, all the causes of low testosterone in young guys are treatable, so in the event that you encounter such symptoms at any age, there is no reason to dismiss it.
For younger guys, a fall in testosterone levels can be caused by some ailments, such as type 2 diabetes, diabetes, chronic liver or liver disease, COPD or other lung disease, or pituitary gland problems, according to Dr. Samadi.
Genetic causes of low testosterone in men include the ailments Klinefelter syndrome, Kallmann syndrome, Prader-Willi syndrome, and Myotonic dystrophy. Another disease which could cause 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," 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 at the Smith Institute for Urology of the North Shore-LIJ Health System.
Other causes of low testosterone in men younger than 50 include pituitary gland tumors, HIV infection, 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. In secondary hypogonadism, the testicles are normal but function improperly because of a problem with the hypothalamus or pituitary gland."
Is It Low Testosterone?
Regardless of the reason, low testosterone symptoms would be the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity and moodiness," Dr. Gilbert says.
"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 younger guys, we usually reserve treatment for those who have symptoms, such as tiredness 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. Such testosterone supplements come in the form of a gel, injections, patches, long-acting pellets, or oral inserts.
In these circumstances,"therapies are usually used only in the brief term, and when a physician has close observation and understanding of the individual," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You don't want to offer supplemental testosterone to men 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. "Hence, men of reproductive age should consider alternatives which may increase their testosterone as well as maintain their sperm production," he says. One such choice is a category of drugs known as selective estrogen receptor modulators (SERMs).
Other remedies for low testosterone include weight loss and other lifestyle changes, like eating healthy and increasing exercise.
The main point, however, is that if you've got low testosterone symptoms, it is very important to see your doctor. Then, your doctor can rule out potentially more significant causes of your symptoms, such as hypertension or a thyroid problem, and offer treatment that can enhance your power and quality of life.