"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 New York City.
Although 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 low testosterone is more common in older men, it can occur in younger men also. Fortunately, every one the causes of low testosterone in young men are treatable, so if you experience such symptoms at any age, there's no reason to dismiss it.
Causes of Low Testosterone in Younger Men
For younger men, a drop in testosterone levels can be brought on by some ailments, such as type 2 diabetes, chronic liver or liver disease, COPD or other lung disorder, or adrenal gland issues, according to Dr. Samadi.
Genetic causes of low testosterone in males include the diseases Klinefelter syndrome, Kallmann syndrome, Prader-Willi syndrome, and Myotonic dystrophy. Another disorder that 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 in 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 infection, and radiation therapy 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. In secondary hypogonadism, the testicles are normal but function improperly because of a problem with the hypothalamus or pituitary gland."
Is It Low Testosterone?
Regardless of the reason, low testosterone symptoms are the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity, and moodiness," Dr. Gilbert states.
"Younger men with low testosterone usually come to me and say, 'I can't work out like I used to, and I've lost interest in sex.' â€
"When it comes to treating low testosterone in older men, we usually reserve treatment for people who have symptoms, such as fatigue and reduced libido," Gilbert says.
In these circumstances,"therapies are usually used just in the short term, and if a doctor has close monitoring and knowledge of the individual," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You don't wish to offer 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. "Hence, men of reproductive age should consider alternatives which may increase their testosterone in addition to maintain their sperm production," he states. One such choice is a category of drugs called selective estrogen receptor modulators (SERMs).
Other remedies for low testosterone include weight loss and other lifestyle changes, such as eating healthy and increasing exercise.
The bottom line, however, is that if you have low testosterone symptoms, then it's 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 enhance your energy and quality of life.