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Low Testosterone – Causes, Symptoms and Treatment Options

clapping hands before lifting barbell

Think you may have low testosterone?

Low testosterone (aka, hypogonadism) is more common in older men, but it can happen to younger guys as well.

Produced by the testicles, testosterone is a sex hormone that plays an important role in male sexual development, sexual health and muscle mass development.

If you’ve been exhausted lately and have a decreased sex drive (two common symptoms of low testosterone), you may want to get your testosterone levels checked by your doctor.

Here are three things you should know about low testosterone:

  • Testosterone naturally decreases with age.
  • Low testosterone has been linked to the rise of chronic diseases.
  • Although testosterone replacement therapy is a possible treatment for low-T, it comes with some degree of risk.

Causes of Low Testosterone

Testosterone levels fluctuate throughout our lives.

In early adulthood, testosterone peaks (and cause those annoying acne breakouts you hate so much).

However, these levels begin to decline as we age.

According to a 2016 review published in Therapeutic Advances in Urology, testosterone begins to dip as much as 0.4-2 percent annually after age 30 (see claim: “Testosterone levels also decrease with age as rapidly as 0.4–2% annually after age 30 years…”)

Although this gradual decrease in testosterone is natural, other potential causes of low testosterone may include the following:

  • Injury to the testicles
  • Chemotherapy
  • Dysfunction of the pituitary gland
  • Medications such as opioids, hormones and steroids
  • Alcohol abuse
  • Liver problems
  • Hyperthyroidism
  • HIV
  • Comorbid medical conditions
  • Sleep apnea

Rising rates of obesity have also been blamed for low testosterone levels.

In a 2018 study published in Scientific Reports, researchers found a strong association between testosterone levels and chronic diseases (see claim: “Significant higher prevalences of individual chronic diseases were found between men with testosterone deficiency as compared to men with normal TT (Table 2).”)

man holding head in bed


Low Testosterone Symptoms

Many guys with low testosterone are asymptomatic.

However, others may experience a wide range of low testosterone symptoms, ranging anywhere from thinning hair to depressed mood.

Here are the most commonly reported low testosterone symptoms:

  • Brain fogginess
  • Depression
  • Male-Pattern Baldness
  • Lethargy
  • Stubborn belly fat
  • Decreased sex drive
  • Erectile dysfunction
  • Increased body fat
  • Decreased body hair
  • Mood swings
  • Loss of muscle mass and strength
  • Loss of bone density
  • Male breast development (gynecomastia)
  • Infertility

Diagnosing low testosterone in men can be tricky because many of these symptoms overlap with symptoms of normal aging.

For instance, going bald, losing muscle mass and gaining a few pounds are all commonly associated with old age.

As a result, your doctor will want to rule out other potential causes of your symptoms before chalking them up to low testosterone.

Most doctors will want to take a blood test to determine your testosterone levels.

Since testosterone levels fluctuate throughout the day, it’s best to take the test between 7 a.m. and 11 a.m.

If the levels are on the low side, your doctor will discuss treatment options with you.

Treatment for Low-T

Treatment for low testosterone can vary depending on your age and how much your low testosterone symptoms are affecting your life.

If your symptoms are mild, lifestyle changes in the form of exercise, diet and sleeping habits may be recommended.

If you’re a younger guy who is struggling with low testosterone symptoms, your doctor may suggest testosterone replacement therapy (TRT).

TRT can come in several forms, including skin patches, gels, pills and injections.

testosterone prescription injection

However, most medical professionals consider TRT to be the last resort for treating low testosterone.

The reason being that we simply don’t know enough about the risks and benefits of testosterone replacement therapy.

Testosterone replacement therapy has been heavily marketed to men of all ages, claiming to give them back their youth and vitality.

But in recent years, TRT has come under fire for its potential side effects.

For instance, a 2019 study published in the American Journal of Medicine found that testosterone replacement therapy can increase the risk of cardiovascular disease in men with low-T (see claim: “TRT may increase the risk of cardiovascular events in aging men with low testosterone levels, particularly in the first 2 years of use.”)


Low Testosterone or Lack of Self-Care?

If exhaustion and decreased sex drive are your only two symptoms, it could be something other than low testosterone.

We all feel exhausted on occasion.

Oftentimes, it’s a side effect of not taking good care of our bodies.

Eat a healthy diet, work out regularly and start a simple skin care regimen.

Practice a little self-care for a few weeks and see how it makes you feel.

If your symptoms persist, it’s time to schedule an appointment with your doctor and take charge of your health.


McBride, J Abram et al. “Testosterone deficiency in the aging male.” Therapeutic advances in urology vol. 8,1 (2016): 47-60.

Peterson, M.D., Belakovskiy, A., McGrath, R. et al. Testosterone Deficiency, Weakness, and Multimorbidity in Men. Sci Rep 8, 5897 (2018).

Loo, Simone Y., et al. “Cardiovascular and Cerebrovascular Safety of Testosterone Replacement Therapy Among Aging Men with Low Testosterone Levels: A Cohort Study.” The American Journal of Medicine, vol. 132, no. 9, Elsevier, Sept. 2019, pp. 1069-1077.e4.

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