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What is the main cause of low testosterone?

Causes of low testosterone levels Conditions that may cause hypogonadism include: testicular injury or infection. chemotherapy or radiation cancer treatments. pituitary gland disease or other hormone disorders.

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Testosterone is a sex hormone often associated with males, though females have small amounts. If a male has low testosterone, symptoms can include erectile dysfunction, and males and females may have reduced bone mass and sex drive. The hormone has many important functions, including: the development of the bones and muscles the deepening of the voice, hair growth, and other factors related to appearance the production of sperm Testosterone production can slow as a person ages, and many older people experience symptoms of low testosterone. The American Urology Association defines low testosterone as less than 300 nanograms (ng) of the hormone per deciliter (dl) of blood. The foundation also reports that about 2 in every 100 men have low testosterone. A note about sex and gender Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more. Symptoms of low testosterone Share on Pinterest Bangmaha Art/EyeEm/Getty Images Below are common signs and symptoms of low testosterone. Reduced muscle mass Testosterone plays a role in the development of muscle mass, and reduced levels of the hormone can result in a significant loss of muscle mass. However, as low testosterone causes a decrease in mass, the function and strength of the muscles do not diminish, according to a 2016 review . Reduced bone mass Testosterone helps to produce bone tissue and maintain bone volume. Low testosterone can lead to a reduction in this volume, which can make the bones more susceptible to fractures. Reduced sex drive People with low testosterone often experience a reduction in sex drive. A diminishing sex drive occurs naturally with age, but when the cause is low testosterone, a male will notice a significant decrease in the desire for sex. A decrease in energy levels Low testosterone can lead to reduced levels of energy and fatigue. A person may feel tired, even after adequate rest, or develop a diminished interest in exercise or movement. An increase in body fat A reduction in testosterone can lead to an increase in body fat. In some cases, people with a deficiency of the hormone develop gynecomastia, which causes an enlargement of the breasts. Hair loss Many people experience hair loss as a natural part of aging, and age-related hair loss can also affect anyone. Authors of an older study from 2012 found that testosterone implants supported hair regrowth in some women receiving treatment for symptoms of sex hormone deficiency. Symptoms of low testosterone in females Females may also experience specific low testosterone symptoms, such as the following. Hot flashes While many people associate hot flashes with estrogen levels that fluctuate during menopause, low testosterone levels may also cause this symptom. Irregular menstrual cycles Low testosterone levels can cause a hormonal imbalance that results in menstrual cycles that are shorter or longer than the average of 28 days . Vaginal dryness Vaginal dryness is common during and after menopause, but it can occur at any age. It usually results from low estrogen, but low testosterone can also be a trigger. Anemia Testosterone helps the body produce healthy red blood cells (RBCs). Low testosterone levels could lead to anemia, a blood disorder that may occur due to the decrease of RBCs. The main symptom is fatigue. An older 2006 study found that women over 65 with low testosterone levels tended to have lower hemoglobin levels, putting them at greater risk for anemia.

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Low testosterone does not always present symptoms, and some people only learn about it after a routine physical examination with blood work. However, anyone who experiences one or more of the above symptoms should seek medical attention. To diagnose low testosterone, a doctor will often perform a physical evaluation and review the person’s symptoms. The doctor may also request testing to look for additional signs. For example, a bone density test can show diminished bone mass, one result of low testosterone. Treatment The most common treatment is testosterone replacement therapy (TRT). A doctor will typically only prescribe TRT if the person has several symptoms of low testosterone and blood test results that indicate a deficiency. There are several delivery methods of TRT, including: skin patches

gels

tablets that dissolve in the mouth

injections

surgically implanted pellets that release the hormone Most people will notice relief from symptoms within 4–6 weeks of starting TRT. Frequently asked questions Can low testosterone cause diabetes? Studies show that low testosterone levels in men are a risk factor for type 2 diabetes, the most common form of diabetes. Testosterone helps the body’s cells increase glucose, or blood sugar, in response to insulin, a hormone that regulates glucose. Reduced testosterone can affect insulin resistance. This can cause the body to produce more insulin to keep glucose levels normal. When the cells are full of glucose, the body stores the excess in fat cells, which may lead to conditions such as type 2 diabetes and obesity. Do you consult a urologist or endocrinologist for low testosterone? A primary care physician may refer an individual to a urologist, who specializes in diseases of the male reproductive system, or to an endocrinologist who specializes in hormone-related diseases. According to a 2018 study , urologists seemed to adhere more consistently than other specialists to established guidelines for the screening and treatment of low testosterone in males. Does low testosterone affect fertility? About 15% of men with fertility problems have low testosterone levels. However, low testosterone does not cause infertility. In people with fertility problems, low testosterone may be a symptom of a testicular function issue causing infertility rather than a cause of infertility itself. For example, testicular atrophy can cause infertility and also reduce a person’s testosterone levels. In this instance, the low testosterone levels are a symptom of an underlying condition, not a cause of infertility. Is low testosterone genetic? Genetic variants that affect the Y chromosome and the sex hormone-binding globulin may result in a higher risk for low testosterone. SHBG is a protein that helps deliver testosterone to the body’s tissues. Rare genetic disorders such as Klinefelter syndrome, where males have an extra X chromosome, may also affect testosterone production. A 2021 study identified 141 new genetic markers that may assist in determining the risk for low testosterone.

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