Low testosterone (male hypogonadism) is when your testicles don’t produce enough testosterone (the male sex hormone). Testicles are the male gonads that produce testosterone through Leydig cells.
Low testosterone causes different symptoms at different ages. As individuals are assigned male at birth (AMAB) age, their testosterone levels tend to decrease naturally. This includes cisgender men, non-binary people AMAB, and transgender women not undergoing feminizing hormone therapy.
Low testosterone and male hypogonadism have several other names, which may include:
- Testosterone deficiency syndrome.
- Testosterone deficiency.
- Primary hypogonadism.
- Secondary hypogonadism.
- Hypergonadotropic hypogonadism.
- Hypogonadotropic hypogonadism.
What does testosterone do?
Testosterone is the primary androgen. Testosterone is essential for the development of male characteristics and sperm production. It is naturally higher in those assigned male at birth than those assigned female at birth.
Testosterone is crucial in maintaining and developing specific physical characteristics in individuals assigned male at birth (AMAB).
- Sex organs and genitalia.
- Muscle mass.
- Adequate levels of red blood cells.
- Bone density.
- Sense of well-being.
- Sexual and reproductive function.
Your body tightly regulates testosterone levels, highest in the morning.
Your hypothalamus and pituitary gland typically control the amount of testosterone your testicles produce and release.
The hypothalamus in your brain releases gonadotropin-releasing hormone (GnRH). This hormone triggers your pituitary gland to release luteinizing hormone (LH), which then travels to your gonads (testicles or ovaries) to stimulate the production and release of testosterone. The pituitary gland also releases follicle-stimulating hormone (FSH) to promote sperm production. Any issues with your testicles, hypothalamus, or pituitary gland can lead to low testosterone levels, known as male hypogonadism.
What is a low testosterone level?
The American Urology Association (AUA) defines low blood testosterone as below 300 ng/dL for adults, but some researchers and healthcare providers consider levels below 250 ng/dL to be low. Providers also consider symptoms when diagnosing low testosterone.
How common is low testosterone?
It can be challenging for researchers to determine the prevalence of low testosterone due to varying definitions used in different studies. Some evidence indicates that low testosterone affects approximately 2% of individuals assigned male at birth (AMAB).”
Meanwhile, other studies report that over 8% of AMAB individuals aged between 50 to 79 years experience low testosterone.
Symptoms and Causes
What are the symptoms of low testosterone?
Symptoms of low testosterone can vary, especially by age. Adults assigned male at birth with symptoms highly suggestive of low testosterone include:
- Reduced sex drive.
- Erectile dysfunction.
- Loss of armpit and pubic hair.
- Shrinking testicles.
- Hot flashes.
- Low or zero sperm count (azoospermia), which causes male infertility.
Other symptoms of low testosterone in adults AMAB include:
- Depressed mood.
- Difficulties with concentration and memory.
- Increased body fat.
- Enlarged male breast tissue (gynecomastia).
- Decrease in muscle strength and mass.
- Decrease in endurance.
Symptoms of low testosterone in children
Low testosterone before or during puberty for children assigned male at birth can result in:
- Slowed growth in height, but their arms and legs may continue to grow out of proportion with the rest of their body.
- Reduced development of pubic hair.
- Reduced growth of their penis and testicles.
- Less voice deepening.
- Lower-than-normal strength and endurance.
What causes low testosterone?
There are several possible causes of low testosterone. The two types of male hypogonadism are:
- Primary hypogonadism (testicular disorder).
- Secondary hypogonadism (pituitary/hypothalamus dysfunction).
Causes of primary and secondary hypogonadism are also divided into either congenital (at birth) or acquired (developed later in childhood or adulthood).
Diagnosis and Tests
How is low testosterone diagnosed?
If you have signs and symptoms of low testosterone, a healthcare provider will perform a physical exam. They’ll also ask questions about your medical history, medications you take or have taken smoking history, and any current symptoms. Blood tests may be ordered.
A provider will consider your specific signs, symptoms, and any blood test results to diagnose.
What tests will be done to diagnose low testosterone?
The confirmation of low testosterone and its probable cause can be determined through the following tests:
- Total testosterone level blood test: This test requires two samples to be collected between 8 a.m. and 10 a.m., as testosterone levels are at their highest during this period. It’s crucial to inform your healthcare provider if you’re sick or have recently been ill as acute illness may lead to a falsely low result.
- Luteinizing hormone (LH) blood test: This test can help determine whether the cause of low testosterone is an issue with your pituitary gland.
- Prolactin blood test: High prolactin levels may indicate pituitary gland issues or tumors.
Prevention
Can low testosterone be prevented?
Healthcare providers and medical researchers don’t know how to prevent low testosterone from genetic conditions or damage to your testicles, hypothalamus, or pituitary gland.
Lifestyle habits that may help keep testosterone levels standard include:
- Eating a healthy diet.
- Exercise.
- Weight management.
- Avoiding excessive use of alcohol and drugs.
What are the side effects of testosterone replacement therapy?
Before undergoing testosterone replacement therapy in Cincinnati, be aware of potential side effects, which may include:
- Acne or oily skin.
- Swelling in your ankles is caused by mild fluid retention.
- Stimulation of the prostate can cause urinary symptoms such as difficulty peeing.
- Breast enlargement or tenderness.
- Worsening of sleep apnea.
- Smaller testicles.
- Skin irritation (if you use topical testosterone replacement).
Laboratory abnormalities that can occur with testosterone replacement therapy include:
- Increase in prostate-specific antigen (PSA).
- Increase in red blood cell count.
- A decrease in sperm count produces infertility (inability to have children), which is especially important in younger people who want biological children.
The bottom line
As we age, we might tend to disregard the symptoms of low testosterone as a natural part of the process. However, addressing the symptoms affecting our quality of life is crucial. If you are experiencing any discomforting signs of low testosterone, For low testosterone treatment cincinnati you should see a healthcare provider and discuss the available treatment options.
