Low Testosterone: Causes, Symptoms, Diagnosis, and Treatment

Low Testosterone: Causes, Symptoms, Diagnosis, and Treatment

See "Exogenous Androgens/Anabolic Steroids" section for more detailed information. While testosterone is necessary for producing sperm, Dr. Rogers says, external testosterone replacement will lower sperm counts. Low T affects 2 to 4 million men in the U.S., or 60% of men over age 65.

Testosterone levels also play a role in libido, erectile function, and ejaculatory function. Your doctor will help you decide if measuring your testosterone levels is important. Blood tests are the only way to know for certain if testosterone levels are low. The normal range is above 300 nanograms per deciliter (ng/dL). Two blood tests on separate days must show low testosterone levels before a diagnosis is confirmed. Maintaining normal testosterone levels throughout a man’s life can support his sex drive and fertility, and build the strength of his muscles and bones. Always consult with a healthcare professional to determine the most appropriate treatment for your situation.

Testosterone readings below the reference range on at least two different occasions, at least 4 weeks apart, are consistent with hypogonadism, but the underlying cause should then also be ascertained. In rare cases when neither therapy works, we can consider increasing the FSH level as well with injections of the FSH substitute hMG. According to the AUA, 7 in 10 people receiving treatment for low T are using TRT skin gels.

In men, testosterone levels increase from puberty to adulthood and then progressively decline starting by the fourth or fifth decade of life (4). One small study investigated this question by looking at groups of men across different age groups who were in "very good or excellent health" (5). The authors found no statistically significant difference in serum total testosterone levels across the cohorts grouped by decades of age. Their data support the idea that "the decline in serum T with male ageing is a non-specific effect of the common co-morbidities that accumulate during ageing" (5). Because of circadian variations in testosterone levels, serum testosterone measurement should occur in the morning, or within two hours of awakening in shift workers (Figure 19 ).

According to the American Urological Association (AUA), 4 in 10 males ages 45 years and older have low testosterone. The American Urology Association reports that low testosterone affects around 2 in every 100 men. The risk increases with age, though most people naturally lose testosterone as they get older. Rare genetic disorders such as Klinefelter syndrome, where males have an extra X chromosome, may also affect testosterone production. A doctor will typically only prescribe TRT if the person has several symptoms of low testosterone and blood test results that indicate a deficiency. Many people experience hair loss as a natural part of aging, and age-related hair loss can also affect anyone. Testosterone production can slow as a person ages, and many older people experience symptoms of low testosterone.

Men have decreased levels of their sex hormone with less obvious clinical consequences. During puberty, those levels are important for developing features in men like a deeper voice, facial hair, and muscle strength. But too much loss leads to hypogonadism, which is defined as testosterone levels below 300 nanograms per deciliter.

Your doctor may recommend injections, skin patches, topical gels, capsules or implantable pellets. Treatment will depend on your unique situation and individual needs. If you think you may have low T, let your doctor know so you can get tested as soon as possible. Remember, while low testosterone can cause a variety of uncomfortable symptoms, you don’t have to suffer from it forever.

The general target level for testosterone ranges from 350 to 750 ng/dL, which is roughly the range for healthy, androgen-sufficient adult men. Testosterone levels should be monitored 3 to 6 months after initiation of treatment. The different testosterone preparations available include intramuscular formulations, topical gels, solutions, and skin patches. Tablets and implanted subcutaneous pellet formulations are less commonly used options. Each preparation has advantages and disadvantages and should be presented as an option to the patient (Table 1).

Those low levels cause decreased testosterone and sperm production. All men with low testosterone levels are at an increased risk for developing osteoporosis, or weakening of the bones, and should receive counseling on osteoporosis prevention. Though it is not included in the ASA guidelines, I recommend to consider obtaining a DEXA scan (which evaluates bone density) in men with a baseline total testosterone of less than 200 ng/dL. See the "Osteoporosis" section of this website for more information. For example, let’s say a man who has been taking exogenous androgens for low T comes to my office for fertility treatment.

They can a female take testosterone evaluate you and assess if testosterone levels may be responsible. If low testosterone symptoms bother you, speak with a healthcare professional. TRT is a lifelong treatment, so your testosterone levels may drop if you stop treatment. Both testosterone levels and cognitive functions, particularly memory, decline with age. As a result, doctors have theorized that lower testosterone levels may contribute to affected memory.