"After age 30, most men begin to experience a gradual decline in testosterone," says 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 sex drive, and loss of muscle mass.
While reduced testosterone is more prevalent in older men, it can occur in younger men as well. Luckily, every one of the causes of low testosterone in young men are treatable, so in the event that you encounter such symptoms at any age, there is no reason to dismiss it.
Causes of Low Testosterone in Younger Men
For younger guys, a fall in testosterone levels may be caused by some illnesses, including type 2 diabetes, diabetes, chronic liver or liver disease, COPD or other lung disorder, or adrenal 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 result in low testosterone is hemochromatosis, making 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," 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.
Can It Be Low Testosterone?
Irrespective 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.
Treatments for Low Testosterone in Younger Men
"When it comes to treating low testosterone in younger guys, we generally reserve treatment for those who have symptoms, such as fatigue 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 gel, injections, patches, long-acting pellets, or oral inserts.
In these circumstances,"treatments are usually used only in the short term, and if a doctor has close observation and understanding of the patient," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You don't wish 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 that might improve their testosterone in addition to preserve their semen production," he says. 1 such alternative is a class of drugs known as selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle modifications, such as eating healthy and raising exercise.
The bottom line, however, is that if you've got low testosterone symptoms, it is important to see your physician. 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 energy and high quality of life.