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Symptoms of Low Testosterone

Medically Reviewed by Dr Sravya, MBBS, MS 

Introduction

The primary anabolic steroid and sex hormone in men is testosterone. Both humans and other animals produce can produce it. The testicles are where males primarily create testosterone. Though in much smaller amounts, testosterone is also produced by women’s ovaries. 

symptoms of low testosterone

Additionally, testosterone affects both sexes’ health and wellbeing in a variety of ways. It has a big impact on things like general mood, cognition, social and sexual behaviour, metabolism and energy output, the cardiovascular system, and osteoporosis prevention. Testosterone is produced by the ovaries and testicles. Your physical and mental health may be impacted by producing either too little or too much testosterone.

The production of testosterone starts to considerably increase throughout puberty and then begins to drop around the age of 30. Here, in this article we will see the introduction of testosterone, functions of testosterone, low testosterone, symptoms of low testosterone, causes of low testosterone, diagnosis of low testosterone, management & treatment of low testosterone, prevention of low testosterone.

In This Article

  1. Functions of Testosterone
  2. Low Testosterone
  3. Symptoms of low testosterone
  4. Symptoms of low testosterone in males
  5. Other low testosterone symptoms in men’s include
  6.  Low testosterone symptoms in children
  7. Causes of low testosterone
  8. Causes of Primary Male Hypogonadism
  9. Causes of Secondary Male Hypogonadism
  10. Diagnoses of low testosterone
  11. Management and treatment of low testosterone
  12. Prevention of low testosterone
  13. Conclusion

Functions of Testosterone:

  • Promotes the development and growth of the male reproductive tissues such as the penis, testicles, scrotum, and sexual secretory glands.
  • Stimulates the sperm production (spermatogenesis) in the seminiferous tubules and maintains male fertility.
  • Promoting secondary sexual characteristics of males such as increased muscle and bone mass, beard, and pubic hair growth on the body, increase in height, growth of Adam's apple (larynx) deeper voice, etc.,
  • Increasing libido (sex drive).

Low Testosterone:

Low testosterone, or low T, is defined as the hormone with levels below 300 nanograms per deciliter (ng/dL). The Food and Drug Administration specifies a normal range as 300 to 1,000 ng/dL. You can check your amount of circulating testosterone by having a blood test called a serum testosterone test.

If you have low testosterone (male hypogonadism), your testicles don’t produce enough of it. There are numerous potential causes, such as illnesses or trauma that damage your testicles, pituitary gland, or hypothalamus. With testosterone replacement therapy, it is curable.

Male hypogonadism and low testosterone are also known as: –

  • Testosterone deficiency syndrome
  • Testosterone deficiency
  • Primary hypogonadism
  • Secondary hypogonadism
  • Hypergonadotropic hypogonadism

Your testicles don’t create enough testosterone, the hormone responsible for male sex, if you have low testosterone (male hypogonadism). People who are assigned as male at birth (AMAB) have testicles as their gonads (sex organs). In your testicles, the Leydig cells particularly produce testosterone.

Symptoms of low testosterone:

At different ages, there are various symptoms of low testosterone. As people get older, their levels of testosterone naturally decrease AMAB. This covers transgender people who aren’t receiving feminising hormone therapy, non-binary people, AMAB, and cisgender guys.

Your testicles’ capacity to manufacture and release testosterone is typically regulated by your hypothalamus and pituitary glands. Gonadotropin-releasing hormone (GnRH), which is released by the hypothalamus, causes the pituitary to release luteinizing hormone (LH). The release of testosterone is then stimulated by LH as it travels to your gonads (testicles or ovaries). Follicle-stimulating hormone (FSH), which is also released by the pituitary, promotes the generation of sperm.

Low testosterone, also known as male hypogonadism, can result from any problem with your testicles, brain, or pituitary gland. Men with testicles can develop male hypogonadism, a medical illness that can strike them at any age, from infancy to adulthood.

The following individuals are more susceptible to low testosterone:

  • Have Older
  • Have obesity
  • Have poorly managed Type 2 diabetes.
  • Have obstructive sleep apnea.
  • Have ongoing medical issues, such as liver cirrhosis or kidney disease.
  • Have HIV/AIDs.

According to data, roughly 2% of AMAB individuals may have low testosterone. Additionally, according to other studies, low testosterone affects more than 8% of AMABs between the ages of 50 and 79.

Symptoms of low testosterone in males:

The signs & symptoms of low testosterone might differ greatly depending on age. In adults who were born masculine yet have low testosterone, there are several symptoms that come to mind:

  • Reduce sex drive
  • Erectile dysfunction.
  • Loss of armpit and pubic hair
  • Shrinking testicles
  • Hot Flashes
  • Male infertility is caused by azoospermia, which is a low or nonexistent sperm count.

Other low testosterone symptoms in men's include:

There are following symptoms of low testosterone which includes-

  • Depressed mood
  • Difficulties with concentration and memory.
  • Increased body fat.
  • Enlarged male breast tissue (gynecomastia).
  • Decrease in muscle strength and mass.
  • Decrease in endurance.

Low testosterone level symptoms in children

For children who were given the gender “male” at birth, insufficient testosterone before or throughout puberty can cause following symptoms of low testosterone in children which includes: –

  • Slowed growth in height, yet their arms and legs may continue to grow out of proportion with the rest of their body.
  • Reduced development of pubic hair.
  • Reduced growth of their penis and testicles.
  • Less voice deepening.
  • Lower-than-normal strength and endurance.

Causes of low testosterone

There are several possible causes of low testosterone. In men, there are two forms of hypogonadism:

  • Primary hypogonadism (testicular disorder).
  • Secondary hypogonadism (pituitary/hypothalamus dysfunction).

Both primary and secondary hypogonadism can have congenital (present at birth) and acquired (acquired later in childhood or adulthood) causes.

Causes of Primary Male Hypogonadism:

When there is a problem with your testicles that prevents them from producing normal levels of testosterone, you have primary hypogonadism. The following congenital disorders can cause primary hypogonadism and have an impact on your testicles:

  • Absence of testicles at birth (anorchia).
  • Undescended testicles (cryptorchidism).
  • Your testicles may have Leydig cell hypoplasia, which is an underdevelopment of these cells.
  • When a person has Klinefelter's syndrome, they are born with an extra X chromosome (XXY rather than XY), making them AMAB.
  • Noonan syndrome is an uncommon genetic disorder that can lead to infertility, delayed puberty, or undescended testicles.
  • Muscular dystrophies are a class of hereditary diseases that includes myotonic dystrophy.

The following acquired disorders might harm your testicles and cause primary hypogonadism:

  • Testicle injury or removal.
  • Inflammation of one or both testicles is known as orchitis. This can be caused by viral diseases, such as the mumps, but it most frequently results from bacterial infections, such as a sexually transmitted illness.
  • Chemotherapy or radiation therapy to your testicles.
  • Certain types of tumors.
  • Anabolic steroid use.
Causes of Secondary Male Hypogonadism:

Secondary hypogonadism is brought on by illnesses that alter how your hypothalamus and/or pituitary gland function. Because of the low levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), this condition is known as hypogonadotropic hypogonadism. Because of the low levels, testosterone and sperm production are reduced.

Isolated hypogonadotropic hypogonadism, which results in low levels of gonadotropin-releasing hormone from birth, is a congenital disease that can produce secondary hypogonadism.

A uncommon genetic disorder called Kallmann syndrome prevents the growth of nerve cells in your hypothalamus that make gonadotropin-releasing hormone. It may also result in an absence of smell. Hypothalamus dysfunction may result from the rare genetic multisystem condition Prader-Willi syndrome. 

Secondary hypogonadism can develop from a number of acquired disorders, such as:
  • Hypopituitarism, which can be brought on by adenoma, infiltrative disease, infection, injury, radiation therapy, or surgery that affects your pituitary gland.
  • Hyperprolactinemia.
  • Iron overload (hemochromatosis).
  • Brain or head injury.
  • Cushing’s syndrome.
  • Cirrhosis of the liver.
  • Kidney failure
  • HIV/AIDS
  • Alcohol use disorder.
  • Poorly managed diabetes.
  • Obesity
  • Obstructive sleep apnea.
  • Several treatments, such as estrogens, hallucinogens, metoclopramide, opioids, leuprolide, goserelin, triptorelin, and more recent inhibitors of androgen production for prostate cancer.
Diagnosis of low testosterone:

The tests listed below can be used to confirm low testosterone and identify its etiology.

  • Tests for total testosterone levels: This test typically needs two sample collections between the hours of 8 and 10 in the morning, when testosterone levels should be at their peak. Telling your provider if you're ill or have recently been ill is crucial. A sudden illness could produce an incorrectly low score.
  • Blood test for luteinizing hormone (LH): If your pituitary gland is the source of your low testosterone, this test can assist identify it.
  • Blood test for prolactin: High prolactin levels may indicate tumours or problems with the pituitary gland.
Management and treatment of low testosterone:

Testosterone Replacement Therapy (TRT) used to treat male hypogonadism, or low testosterone, by medical professionals. The testosterone replacement therapy comes in several forms, including:

  • Testosterone skin gels: - Every day, as instructed, apply the gel to clean, dry skin. It's crucial that you avoid making skin-to-skin contact with anyone else to avoid spreading the gel. One of the most popular types of treatment in the United States is testosterone skin gel.
  • Intramuscular testosterone injections: - Every one to two weeks, administer the injections into a muscle. Long-acting testosterone injections can be given by providers every 10 weeks. Additionally, subcutaneous injections are an alternative.
  • Testosterone patches: - As advised, apply these patches to your skin each day. You usually have to alternate their positioning to avoid skin reactions.
  • Testosterone pellets: - Every three to six months, a doctor inserts these pellets under your skin. The pellets deliver steady testosterone dosages over an extended period of time.
  • Buccal testosterone tablets: - Put these adhesive pills on your gums twice a day. Your gums allow the testosterone to quickly enter your bloodstream.
  • Testosterone nasal gel: - A testosterone gel is applied three times each day, one drop into each nostril.
  • Oral testosterone: - For those with low testosterone brought on by certain medical problems such Klinefelter syndrome or tumors that have harmed their pituitary gland, undecanoate, a tablet version of testosterone, is available.
Prevention of low testosterone:

Medical professionals and researchers are unsure of how to stop low testosterone caused by hereditary disorders or harm to your testicles, hypothalamus, or pituitary gland.

Following a healthy lifestyle can help maintain normal testosterone levels:

  • Eating a healthy diet.
  • Exercise.
  • Weight Management
  • Avoiding excessive use of alcohol and drugs.

Conclusion:

According to the American Urological Association, one out of every 100 males suffers from low testosterone. The danger rises with age, despite the fact that most people naturally reduce testosterone as they age. The majority of cases of low testosterone are curable, and being aware of the signs & symptoms can aid in early identification and therapy.