Low Testosterone: Types, Symptoms, Causes, Diagnosis And Treatment

Written by Dr. Ahmed Zayed
Low Testosterone

Low testosterone or hypogonadism is simply a condition wherein the body (specifically the testicles) doesn’t produce enough of the hormone testosterone. More and more men are suffering from low testosterone today due to several reasons including lifestyle factors. The fact of the matter is that testosterone normally declines as a man grows older. In fact, testosterone production in the body starts to decline when a man is in his early 30s. Of course there are some exceptions like those that are physically active and have a healthy lifestyle.

Low Testosterone Signs and Symptoms

Here are the common signs that a man has low testosterone:

Low Testosterone Signs and Symptoms

Types of Hypogonadism/Low Testosterone

The two main types are:
1. Primary: It is also called primary testicular failure because it is directly caused by any problem in the testicles.

2. Secondary: It indicates that there is a problem in the parts of the brain (hypothalamus and pituitary gland) that signal the production of testosterone.

Low Testosterone Causes and Risk Factors

Low Testosterone Causes is divided into two sections-

Causes of Primary Low Testosterone/Hypogonadism

  • Klinefelter Syndrome: There is a congenital abnormality of the sex chromosomes, so the development of the testicles is abnormal resulting in the low production of testosterone.
  • Undescended Testicles: During birth, one or both testicles may not descend. If not corrected, it causes the malfunction of the testicles.
  • Mumps Orchitis: When it occurs during adolescence or adulthood, testicular damage can occur affecting its function.
  • Hemochromatosis: Too much iron in the blood can lead to testicular failure or dysfunction of the pituitary gland which can affect the production of testosterone.
  • Testicle Injury: Damage to the testicles can cause hypogonadism.
  • Cancer Treatment: Radiation or chemotherapy can affect sperm and testosterone production and can even lead to permanent infertility.
Low Testosterone Causes and Risk Factors

Causes of Secondary Low Testosterone/ Hypogonadism

  • Kallmann Syndrome: This is the abnormal development of the hypothalamus which is important for the secretion of pituitary hormones.
  • Pituitary Disorders: It can impair the release of hormones including testosterone.
  • Inflammatory Disease: When it affects the hypothalamus and pituitary gland, testosterone production can be affected as well.
  • HIV/AIDS: It can also affect the hypothalamus.
  • Medications: Certain drugs can affect hormone production in the body.
  • Obesity: Carrying too much excess weight has been connected to hypogonadism.
  • Normal Aging: Older men typically have lower testosterone compared to when they were younger.
  • Concurrent Illness: Physical stress caused by illness or surgery can cause the temporary shutdown of the reproductive system.

Must Watch – Dr. Siegel Consults On Low Testosterone

Tests and Diagnosis

The doctor makes an initial diagnosis by getting a thorough patient history and asking about the different signs and symptoms. Then, a simple testosterone test will determine if the patient has low testosterone. If it is confirmed that the patient has low testosterone, further testing can be done to determine the cause. The tests may include hormone testing, semen analysis, genetic studies, testicular biopsy and pituitary imaging.

Treatments and Medications

Low Testosterone Treatments

1. Low Testosterone Treatments for Adults
Treating low testosterone depends on the main cause and if the patient is concerned about fertility.

  • Hormone Replacement Therapy: Testosterone replacement therapy (TRT) is used when the problem is caused by testicular failure. It restores sexual function and muscle mass while preventing bone loss. It can relieve the different symptoms of low testosterone. There are different forms of TRT like injection, gels, patches, gum and cheek or the use of implanted pellets.
  • Assisted Reproduction: There is no treatment for restoring the fertility of a man with primary hypogonadism, but this may be helpful. It uses techniques that help couples achieve conception.

2. Low Testosterone Treatment For Boys
TRT can be used to stimulate puberty and pituitary hormones can be used to stimulate the growth of testicles. An initial low dose followed by gradual increases help prevent adverse effects while also closely mimicking the slow increase in testosterone during puberty.

Precautions And Self Care

Low testosterone can cause problems life fatigue, osteoporosis and erectile dysfunction. These specific problems need to be addressed. Osteoporosis risk can be decreased with lifestyle and dietary changes. Studies have shown that regular exercise can help increase bone mass. Also, you need sufficient intake of the bone-building mineral calcium along with vitamin D which is important for calcium absorption. There are also natural ways to boost testosterone production in the body like lifting weights and the use of testosterone boosting supplements. Studies have shown that losing excess weight can also increase natural testosterone production in the body.


Contributor : Dr. Ahmed Zayed ()

This Article Has Been Published on February 23, 2017 and Last Modified on October 19, 2018

Dr. Ahmed Zayed Helmy holds a baccalaureate of Medicine and Surgery. He has completed his degree in 2011 at the University of Alexandria, Egypt. Dr. Ahmed believes in providing knowledgeable information to readers. Other than his passion for writing, currently he is working as a Plastic surgeon and is doing his masters at Ain Shams University. You can connect with him on Linkedin.

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