What are signs of low testosterone in men?

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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What is a healthy testosterone level by age?

Age-specific middle tertile levels were 409-558 ng/dL for men 20-24 years old, 413-575 ng/dL for 25-29 years old, 359-498 ng/dL for 30-34 years old, 352-478 ng/dL for 35-39 years old, and 350-473 ng/dL for 40-44 years old.

auajournals.org - What Is a Normal Testosterone Level for Young Men? Rethinking the 300 ...

Abstract

Purpose:

There is an age-related decline in male testosterone production. It is therefore surprising that young men are evaluated for testosterone deficiency with the same cutoff of 300 ng/dL that was developed from samples of older men. Our aim is to describe normative total testosterone levels and age-specific cutoffs for low testosterone levels in men 20 to 44 years old.

Materials and Methods:

We analyzed the 2011-2016 National Health and Nutrition Examination Surveys, which survey nationally representative samples of United States residents. Men 20 to 44 years old with testosterone levels were included. Men on hormonal medications, with a history of testicular cancer or orchiectomy, and with afternoon/evening laboratory values were excluded. We separated men into 5-year intervals and evaluated the testosterone levels of each age group, and for all men 20 to 44 years old. We used the American Urological Association definition of a “normal testosterone level” (the “middle tertile”) to calculate age-specific cutoffs for low testosterone levels.

Results:

Our final analytic cohort contained 1,486 men. Age-specific middle tertile levels were 409-558 ng/dL (20-24 years old), 413-575 ng/dL (25-29 years old), 359-498 ng/dL (30-34 years old), 352-478 ng/dL (35-39 years old), and 350-473 ng/dL (40-44 years old). Age-specific cutoffs for low testosterone levels were 409, 413, 359, 352, and 350 ng/dL, respectively.

Conclusions:

Diagnosis of testosterone deficiency has traditionally been performed in an age-indiscriminate manner. However, young men have different testosterone reference ranges than older men. Accordingly, age-specific normative values and cutoffs should be integrated into the evaluation of young men presenting with testosterone deficiency.

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