Understanding Low Testosterone: Symptoms, Causes, and Treatment

Low sex drive lately or struggling with erectile issues? Maybe you’ve noticed less hair under your arms or in your pubic area, or even shrinking testicles. If yes, then you may be blaming it all on age? Well, it could be more than just getting older; it may be because of your dropping testosterone levels (less than 300 nanograms per decilitre for adults). 

Yes, it's the same hormone that once gave you energy, muscle growth, and confidence in your younger years. But as time passes or due to many other factors, testosterone levels can decline, leaving you feeling off balance. However, the good news is? You can refuse to accept it; instead, work towards improving the levels. 

Read this blog to learn about factors behind low testosterone, and learn to boost its levels naturally so that you can help yourself regain your vitality and feel like yourself (young) again.

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Causes of Low Testosterone

Low testosterone happens when your testicles (the male reproductive part that makes sperm and hormones) don’t make sufficient primary male hormone called testosterone. This can be due to ageing, injury, infections, certain health conditions, or issues with parts of your brain that control hormone levels. Symptoms differ by age, and testosterone naturally declines as men get older.

Alternative names of low testosterone and male hypogonadism are:

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

The Two Types of Male Hypogonadism, or Low Testosterone, are:

• Primary hypogonadism or testicular disorder
• Secondary hypogonadism or pituitary/hypothalamus dysfunction

Causes of primary and secondary hypogonadism can be subcategorised into congenital (at birth) or acquired (developed later in life).

1. Causes of Primary Male Hypogonadism

It happens when your testicles are insufficient to make enough testosterone, even though your brain sends signals to produce it. This could be because of damage from: 

• Chemotherapy
• Infections like mumps
• Injuries
• Genetic conditions like Klinefelter’s syndrome (an extra X chromosome at the time of male birth) 

Sometimes, testicles may be missing or underdeveloped from birth. Even if testosterone seems normal, high hormone levels can mean your testicles aren’t functioning the way they should. A specialist can guide whether treatment is needed.

2. Causes of Secondary Male Hypogonadism

It happens when the brain’s hypothalamus (which controls important body functions) or pituitary gland (which controls growth and reproduction) doesn’t send the right signals to the testicles, leading to low testosterone. It decreases hormone production even though the testicles may be healthy.

Secondary male hypogonadism can be from:

• Genetic issues like Kallmann syndrome (delays puberty and may affect your sense of smell)
• Brain injuries
• Infections
• Diseases like diabetes, obesity, and liver or kidney issues. 
• Certain medications and ageing can also cause it. 

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What are the Symptoms of Low Testosterone Levels

Symptoms of low testosterone are based on the age you are at. Some of the common indications of low testosterone levels are:

• Lower sex drive
• Erectile dysfunction (inability of the penis to erect properly)
• Shrinking testicles
• Hot flushes
• Low or zero sperm count (azoospermia), leading to male infertility
• Loss of armpit and pubic hair
• Depression-like mood.
• Trouble with concentration and memory.
• Increased body fat

Symptoms of Low Testosterone in Children

Low testosterone before or during the teenage years for boys is:

• Slower growth of their penis and testicles
• Reduced voice deepening
• Lesser strength and endurance
• Slowed growth in height; however, their arms and legs could continue to grow out. It may look out of proportion with the rest of their body
• Lower development of pubic hair

What are the Lab Tests to Diagnose Low Testosterone?

To evaluate for low testosterone, healthcare professionals usually do the following blood tests:

• Total Testosterone Test: Two blood samples between 8 a.m. and 10 a.m. are taken early morning when levels are highest. Two times samples are collected to confirm results.
• Luteinizing Hormone (LH) Test: This test will help understand if the pituitary gland (master gland of all hormones) is telling the testicles to make or not make testosterone.
• Prolactin Test: High prolactin levels may indicate issues with the pituitary gland or tumors.

These tests help your doctor figure out if testosterone is low and help you get proper treatment.

What are the Treatments for Low Testosterone?

Healthcare providers treat low testosterone with testosterone replacement therapy. There are different forms of testosterone replacement therapy, and some of them are:

1. Testosterone Skin Gels

You apply a doctor’s prescribed testosterone gel daily to clean skin. Make sure to avoid skin contact with others.

2. Intramuscular Testosterone Injections

A healthcare professional gives a shot of testosterone into the muscles every 1 to 2 weeks.

3. Testosterone Patches

Apply testosterone patches on your skin daily as per your doctor’s prescription; change the spot to avoid irritation.

4. Testosterone Pellets

Small pellets of testosterone are placed under your skin every few months for steady hormone release.

5. Buccal Testosterone Tablets

Pills of testosterone are prescribed that stick to your gums twice daily to absorb the male hormone.

6. Testosterone Nasal Gel

Testosterone gel is applied inside your nose 3 times a day for quick absorption.

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Conclusion

Other testosterone treatments, like oral undecanoate, are only for certain medical conditions and must be guided by a doctor. Alongside medical care, small lifestyle changes, including maintaining a healthy weight, eating enough protein, managing stress, and getting vitamin D, can help you boost testosterone naturally. It is crucial to not feel embarrassed about your situation because with the right support, you can handle low testosterone comfortably.