"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 New York City.
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 loss of muscle mass.
While low testosterone is more prevalent in older men, it can occur in younger guys also. Fortunately, every one of the causes of low testosterone in young guys are curable, so in the event that you encounter such symptoms at any age, there is no reason to ignore it.
Causes of Low Testosterone in Younger Men
For younger men, a drop in testosterone levels can be brought on by some illnesses, including type 2 diabetes, diabetes, chronic liver or liver disease, COPD or other lung disease, or adrenal gland issues, 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 result in low testosterone is hemochromatosis, making 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," 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 the North Shore-LIJ Health System.
Additional 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 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. 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?
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 states.
If you suspect low testosterone, the first step is to see your primary care physician. Your doctor can diagnose low testosterone with a blood test.
Treatments for Low Testosterone in Younger Men
"When it comes to treating low testosterone in older guys, we usually reserve treatment for people who have symptoms, such as tiredness and low libido," Gilbert says.
In these circumstances,"treatments are often used only in the short term, and if a physician has close monitoring and knowledge of the individual," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You don't want to give supplemental testosterone to guys who are interested in being 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. "Therefore, men of reproductive age should think about alternatives which may increase their testosterone as well as maintain their semen production," he says. One such choice 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 increasing exercise.
The bottom line, though, is that if you have low testosterone symptoms, then it is very important to see your physician. Then, your doctor can rule out potentially more serious causes of your symptoms, including hypertension or a thyroid problem, and offer treatment that could improve your energy and quality of life.