Low testosterone levels in males can lead to erectile dysfunction. They can also affect sleep, mood, the size of the testicles, and more. In both males and females, low testosterone can lead to lower bone mass and reduced sex drive.
Testosterone is a sex hormone often associated with males, though females have small amounts.
It 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
The American Urological Association defines low testosterone as less than 300 nanograms (ng) of the hormone per deciliter (dl) of blood. They also report 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.
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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
However, as low testosterone causes a decrease in mass, the function and strength of the muscles do not diminish, according to a
Reduced bone mass
Testosterone helps to produce bone tissue and maintain bone volume. Low testosterone
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
Males may experience specific symptoms of low testosterone levels.
Problems with erections
Low testosterone can make it difficult to achieve or maintain erections. However, low testosterone itself is not always a direct cause of erectile dysfunction. People with high testosterone levels can find it difficult to achieve erections, and people with low levels the opposite.
Testosterone stimulates the penile tissues to
Other factors that can cause erectile dysfunction
- smoking
- thyroid-related issues
- high cholesterol
- stress or anxiety
- alcohol consumption
- diabetes
- high blood pressure
Studies show that testosterone replacement therapy can
Reduction in testicle size
A male with low testosterone may notice a
Reduction in the amount of semen
Semen is the fluid that makes up the majority of male ejaculate. This type of fluid helps the sperm move toward the egg.
Testosterone helps stimulate the production of semen, and reduced semen levels
Difficulty sleeping
People with low testosterone may find it difficult to fall or stay asleep.
Low testosterone levels are common in men who have sleep apnea. This potentially severe disorder causes a person to temporarily stop breathing, which can disrupt sleep.
Changes in mood or mood swings
Some evidence suggests that people with low testosterone levels are likely to experience a lack of focus, irritability, and depression.
One
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Females may also experience specific low testosterone symptoms, such as the following.
Irregular menstrual cycles
Low testosterone levels can cause a hormonal imbalance that
Anemia
Testosterone helps the body produce healthy red blood cells (RBCs). Low testosterone levels
An older 2006
Testosterone production generally begins to decrease after the age of 30 and after menopause. However, younger people may also have low testosterone levels.
In males, hypogonadism, a condition where the testicles produce little or no testosterone, may occur at any age.
Conditions that may cause hypogonadism
- testicular injury, trauma, or infection
- genetic conditions, such as Klinefelter syndrome
- chemotherapy or radiation cancer treatments
- pituitary gland disease or other hormone disorders
- medications, such as
opiate pain relief alcohol and drug misuse
In females, low testosterone levels may result from conditions,
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.
The
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,
- 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 3–60 weeks of starting TRT. This can vary depending on the symptom.
Weight loss and exercise can often increase testosterone levels naturally.
While changes to the lifestyle and diet alone may not raise levels sufficiently, they can often help.
It is important to remember that males typically
Diets high in trans-fats can
Eating a balanced diet rich in nutrient-dense whole foods and low in trans-fats may help boost a person’s testosterone levels.
Below are some commonly asked questions about low testosterone.
What happens when a male’s testosterone is low?
When a male’s testosterone levels are low, it can cause a variety of symptoms. These can include low libido, erectile dysfunction, depression, irritability, and reduced lean muscle mass.
It can also cause a reduction in testicle size, lower amounts of semen, and difficulty sleeping.
If a person notices these symptoms, they should speak with a doctor. A doctor can then come up with a treatment plan to increase their testosterone levels. Treatment often includes testosterone therapy.
Can low testosterone cause diabetes?
Studies show that low testosterone levels in males have an association with 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.
Does a person 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.
Does low testosterone affect fertility?
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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.
The American Urology Association reports that low testosterone affects around 2 in every 100 men. The risk increases with age, though most people naturally lose testosterone as they get older.
Most cases of low testosterone are treatable, and being aware of the symptoms can help a person receive an early diagnosis and treatment.