From the Guidelines
Low testosterone, or hypogonadism, can cause a range of symptoms in men, including decreased sex drive, erectile dysfunction, fatigue, and mood changes, and diagnosis typically involves blood tests to measure testosterone levels, preferably drawn in the morning when levels are highest, as recommended by the most recent guidelines 1.
Symptoms of Low Testosterone
The symptoms of low testosterone in men can vary widely and may include:
- Decreased sex drive (libido)
- Erectile dysfunction
- Fatigue
- Reduced muscle mass
- Increased body fat (especially around the abdomen)
- Decreased bone density
- Hair loss
- Mood changes (irritability, depression)
- Difficulty concentrating
- Reduced semen volume Some men may also experience hot flashes, decreased beard growth, and development of breast tissue (gynecomastia).
Importance of Medical Evaluation
If you're experiencing these symptoms, it's essential to see a healthcare provider for proper testing, as many of these symptoms can also be caused by other conditions. A morning total testosterone level should be measured using an accurate and reliable assay, and in men who have total testosterone levels close to the lower limit, it is reasonable to determine free testosterone concentrations either directly from equilibrium dialysis assays or by calculations that use total testosterone, sex hormone binding globulin, and albumin concentrations, as suggested by recent studies 1.
Treatment Options
Treatment options may include testosterone replacement therapy (TRT) through injections, patches, gels, or pellets, but this should only be pursued under medical supervision due to potential risks and side effects. Testosterone replacement in men with symptomatic hypogonadism may have benefits, including improved sexual function, well-being, muscle mass and strength, and bone density, as noted in recent guidelines 1.
From the Research
Symptoms of Low Testosterone
The symptoms of low testosterone, also known as hypogonadism, can have a significant impact on male sexual function, overall health, and fertility 2. Some common symptoms include:
- Decreased libido
- Erectile dysfunction
- Fatigue or tiredness
- Anxiety
- Osteoporosis
Effects of Low Testosterone on Men's Health
Low testosterone levels can affect various aspects of men's health, including:
- Sexual function: Testosterone plays an essential role in male sexual function, and low levels can lead to decreased libido and erectile dysfunction 3
- Metabolism: Testosterone helps regulate metabolism, and low levels can contribute to weight gain and other metabolic problems 4
- Mood: Low testosterone levels have been linked to depression, anxiety, and other mood disorders 5
- Fertility: Testosterone is necessary for sperm production, and low levels can affect fertility 6
Treatment Options for Low Testosterone
Several treatment options are available for low testosterone, including:
- Testosterone replacement therapy (TRT): This is the conventional treatment for hypogonadism, but it has potential adverse effects and is not suitable for men seeking to conceive 2
- Clomiphene citrate: This drug can stimulate gonadotropin secretion, leading to increased endogenous testosterone production, and has been shown to be effective in improving hypogonadal symptoms 3, 5
- Gonadotropins: These can be used as an alternative to TRT when fertility is desired, but require frequent injections 3
- Human chorionic gonadotropin: This can be used in combination with clomiphene citrate to enhance the effectiveness of treatment 4