Photo: Ron Lach

How do I know if my testosterone is low?

What are the symptoms of low testosterone? Reduced sex drive. Erectile dysfunction. Loss of armpit and pubic hair. Shrinking testicles. Hot flashes. Low or zero sperm count (azoospermia), which causes male infertility.

my.clevelandclinic.org - Low Testosterone (Low T): Causes, Symptoms & Treatment

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Overview

Symptoms of low testosterone can vary considerably, particularly by age and how severe it is.

What is low testosterone (male hypogonadism)?

Low testosterone (male hypogonadism) is a condition in which your testicles don’t produce enough testosterone (the male sex hormone). Testicles are the gonads (sex organs) in people assigned male at birth (AMAB). More specifically, the Leydig cells in your testicles make testosterone. Low testosterone causes different symptoms at different ages. Testosterone levels in adults AMAB naturally decline as they age. This includes cisgender men, non-binary people AMAB and transgender women who aren’t undergoing feminizing hormone therapy.

Other names for low testosterone and male hypogonadism include:

Testosterone deficiency syndrome.

Testosterone deficiency.

Primary hypogonadism.

Secondary hypogonadism.

Hypergonadotropic hypogonadism.

Hypogonadotropic hypogonadism.

What does testosterone do?

Testosterone is the main androgen. It stimulates the development of male characteristics and is essential for sperm production (spermatogenesis). Levels of testosterone are naturally much higher in people assigned AMAB than in people assigned female at birth (AFAB).

In people assigned AMAB, testosterone helps maintain and develop:

Sex organs and genitalia.

Muscle mass.

Bone density.

Sense of well-being.

Sexual and reproductive function.

Your body usually tightly controls the levels of testosterone in your blood. Levels are typically highest in the morning and decline through the day. Your hypothalamus and pituitary gland normally control the amount of testosterone your testicles produce and release. Your hypothalamus releases gonadotropin-releasing hormone (GnRH), which triggers your pituitary gland to release luteinizing hormone (LH). LH then travels to your gonads (testicles or ovaries) and stimulates the production and release of testosterone. Your pituitary also releases follicle-stimulating hormone (FSH) to cause sperm production. Any issue with your testicles, hypothalamus or pituitary gland can cause low testosterone (male hypogonadism).

What is a low testosterone level?

The American Urology Association (AUA) considers low blood testosterone to be less than 300 nanograms per deciliter (ng/dL) for adults. However, some researchers and healthcare providers disagree with this and feel that levels below 250 ng/dL are low. Providers also take symptoms into consideration when diagnosing low testosterone.

Who does low testosterone (male hypogonadism) affect?

Male hypogonadism is a medical condition that can affect people with testicles at any age from birth through adulthood.

Low testosterone is more likely to affect people who:

How common is low testosterone?

It’s difficult for researchers to estimate how common low testosterone is since different studies have different definitions for low testosterone. Data suggest that about 2% of people AMAB may have low testosterone. And other studies have estimated that more than 8% of people AMAB aged 50 to 79 years have low testosterone.

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Is TURP still the gold standard?

TURP is considered as the accepted standard of surgical therapy for the management of symptomatic bladder outlet obstruction due to benign prostatic hyperplasia (BPH).

uroweb.org - Re-examining TUR-P: gold standard for benign prostate obstruction?

The role of transurethral prostate resection (TURP) in patients with benign prostate obstruction (BPO) was re-examined during Plenary Session 3 against the backdrop of new technologies such as the use of laser ablation techniques. TURP is considered as the accepted standard of surgical therapy for the management of symptomatic bladder outlet obstruction due to benign prostatic hyperplasia (BPH). But as a major operative procedure, it has been associated with significant perioperative morbidity. In recent years, TURP has been somehow pushed to the sidelines amid the popularity of modern laser ablation techniques. In his state-of-the-art lecture, Prof. Michael Marberger (AT) posed the query on whether TURP retains its role as a standard tool in managing prostate obstruction. “We have today in the market a range of laser devices, perhaps as many as 20 different kinds. Is there a place for TURP or do we consign it to the museum?,” Marberger said, posing the query whether TURP nowadays is still competitive. He mentioned the various issues associated with TURP such as post-operative retention, blood transfusion and mortality, among others. “TURP has low morbidity and is continuously being improved,” Marberger said noting that the procedure provides an effective and durable solution. Moreover, he said that for TURP to be replaced as a ‘gold’ standard, an alternative has to be “…non-inferior to TURP in results at less morbidity.” “The alternative also has to be technically simple with standardized technique or technology (that is cost-effective and equipment that is readily available),” he added. In his closing remarks, Marberger said: “TURP is not a ‘gold standard’ for treating BPO as it has some problems (like bleeding), but it still is the ‘reference standard’ to be met by all alternative treatment options.”

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