"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 such as fatigue, low sex drive, and reduction of muscle mass.
While low testosterone is more prevalent in older men, it can occur in younger men also. Luckily, every one of the causes of low testosterone in young guys are treatable, so if you encounter such symptoms at any given age, there is no reason to ignore it.
Causes of Low Testosterone in Younger Men
For younger guys, a fall 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 pituitary gland issues, 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 that can 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 reproductive medicine in the Smith Institute for Urology of the North Shore-LIJ Health System.
Other causes of low testosterone in males younger than 50 contain adrenal gland tumors, HIV infection, and radiation therapy 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. "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?
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.
Your doctor can diagnose low testosterone with a blood test.
Not everyone with low testosterone needs treatment. "When it comes to treating low testosterone in younger men, we usually reserve treatment for those who have symptoms, such as fatigue and low libido," Gilbert says.
In these circumstances,"treatments are usually used just in the brief term, and if a doctor has close observation and knowledge 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 since 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 think about alternatives which may increase their testosterone as well as maintain their semen production," he says. One such choice is a category of drugs called selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle modifications, like eating healthier and increasing exercise.
The main point, though, is that if you've got low testosterone symptoms, it's very important to see your physician. Then, your doctor can rule out potentially more significant causes of your symptoms, including high blood pressure or a thyroid problem, and give treatment that could improve your power and quality of life.