low testosterone Systems - Insights

There's a good reason men go girl-crazy in their teens and twenties: Their testosterone levels go now are at their peak. From there, however, testosterone my explanation levels slowly decrease. click for more

"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.

Although 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 reduction of muscle mass.

While reduced testosterone is more common in older men, it may occur in younger men as well. Luckily, all the causes of low testosterone in young guys are curable, so if you encounter these symptoms at any age, there's no reason to dismiss it.


For younger men, a fall in testosterone levels can be caused by some ailments, such as type 2 diabetes, chronic liver or liver disease, COPD or other lung disorder, or pituitary gland problems, based on Dr. Samadi.

Genetic causes of low testosterone in men include the diseases Klinefelter syndrome, Kallmann syndrome, Prader-Willi syndrome, and Myotonic dystrophy. Another disease which can cause 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 their North Shore-LIJ Health System.

Additional causes of low testosterone in men younger than 50 include pituitary gland tumors, HIV disease, 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."

Is It Low Testosterone?

Irrespective of the reason, low testosterone symptoms are the same.

"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity, and moodiness," Dr. Gilbert says.



If your blood test reveals low testosterone (usually defined as a level lower than 300 ng/dL), the doctor may treat you or refer you to a specialist, such as a urologist or endocrinologist.

Treatments for Low Testosterone in Younger Men

Not everyone with low testosterone needs treatment. "When it comes to treating low testosterone in younger men, we usually reserve treatment for people 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.

In these circumstances,"treatments are often used just in the brief term, and if a physician has close monitoring and understanding of the individual," Gilbert says.

An important consideration for younger men before getting treatment is fertility. "You do not wish to give supplemental testosterone to men who want to be 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 consider alternatives which may improve their testosterone in addition to maintain their semen production," he states. One such alternative is a class of drugs called selective estrogen receptor modulators (SERMs).

Other treatments for low testosterone include weight loss and other lifestyle modifications, like eating healthy and raising exercise.

The bottom line, though, is that if you've got low testosterone symptoms, then it is important to see your doctor. Then, your doctor can rule out more serious causes of your symptoms, such as hypertension or a thyroid problem, and give treatment that can improve your power and high quality of life.

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