Patient education: Low testosterone in males (The Basics)

What is testosterone? — 

This is the most important "male hormone," or "androgen." It helps with muscle strength and sex drive. Testosterone in males is made by the testicles.

It is normal for testosterone levels to decrease a bit as males get older. This does not usually cause symptoms. But certain health conditions and other problems can also cause low testosterone. When this happens and it causes symptoms, it is called "hypogonadism."

Testosterone level is measured with a blood test. To get the most accurate results, doctors usually do the test between 8 and 10 AM. They repeat the test 2 or more times on different days to confirm the results.

What causes low testosterone in males? — 

It can be caused by:

●Problems with the testicles – The most common cause is a genetic disorder called "Klinefelter syndrome." Other causes include undescended testicles during childhood, injury, and infection.

●Cancer treatments that damage the testicles or block testosterone production - These include chemotherapy, radiation treatments, and hormone therapy for prostate cancer.

●Disorders that affect the pituitary gland – This gland is located at the base of the brain. It makes hormones that tell the testicles to produce testosterone.

●Some serious or long-term illnesses

●Using opioids or anabolic steroids

What are the symptoms of low testosterone? — 

The symptoms are different depending on:

●How low the testosterone level is

●How long it has been low

In adults, early symptoms of low testosterone can include:

●Feeling tired, especially at the end of the day

●Having little or no interest in sex (called "low libido")

●Feeling sad, down, or depressed

After 1 year or more of low testosterone , adult males develop other symptoms or problems. These include:

●Loss of muscle

●Loss of facial or body hair

●Growing breasts (called "gynecomastia")

Should I see a doctor or nurse? — 

Yes. If you have symptoms of low testosterone, see your doctor or nurse. Many things can cause these symptoms. Your doctor or nurse will try to find out the cause. They will do an exam and ask questions about your symptoms.

Blood tests can show whether you have low testosterone and help your doctor or nurse figure out the cause. Depending on your situation, they might do other tests, too.

How is low testosterone in males treated? — 

Low testosterone due to age does not need treatment if it is not causing symptoms.

When treatment is needed, it is called "testosterone replacement." Your doctor might recommend this if several blood tests confirm you have low testosterone and you have symptoms that bother you.

Testosterone comes in different forms (table 1). Most doctors prescribe a shot or gel.

People who have testosterone replacement need regular testing. This includes:

●Tests to measure the level of testosterone in their blood

●Tests to check their red blood cell count

●Regular screening tests for prostate cancer

Testosterone treatment is usually safe when prescribed in the right situations. But it does come with some risks if testosterone levels get too high. This is why doctors should only prescribe testosterone replacement if you have certain symptoms and several blood tests have confirmed your level is low.

Can supplements or other products increase my testosterone level? — 

You might have seen ads for products claiming to increase your testosterone level, give you more energy, or improve your sex life. Most of the time, there is no evidence these products work. The companies and people selling these products do not always provide accurate information.

The best way to know if you need testosterone replacement is to talk to your doctor. They can discuss your options and whether treatment is right for you.

More on this topic

Patient education: Androgen replacement in men (The Basics)
Patient education: Sex problems in males (The Basics)
Patient education: Gynecomastia (male breast development) (The Basics)
Patient education: Hormones to boost sports performance: Risks and side effects (The Basics)
Patient education: Prostate cancer screening (PSA tests) (The Basics)

Patient education: Sexual problems in males (Beyond the Basics)
Patient education: Gynecomastia (breast enlargement in males) (Beyond the Basics)
Patient education: Prostate cancer screening (Beyond the Basics)