Table of ContentsView AllTable of ContentsWhat Is Low Testosterone?CausesSymptomsDiagnosisWhen to See a Healthcare ProviderTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
What Is Low Testosterone?
Causes
Symptoms
Diagnosis
When to See a Healthcare Provider
Treatment
Frequently Asked Questions
Testosterone stimulates the development of sex characteristics associated with males (like body hair and muscle growth) and is essential in the production ofsperm.
Low levels of testosterone can cause a loss of sexual drive, reduced bone and muscle mass, mood disorders, and may exacerbate symptoms of erectile dysfunction. In this article, you will learn more about the symptoms oflow testosterone, how low testosterone is diagnosed, and the treatments available.
Some males havelow testosterone levels. This is referred to ashypogonadism, testosterone deficiency syndrome (TD), low testosterone (Low-T), orandropause.
The American Urology Association (AUA) defines hypogonadism as total testosterone level of less than 300 nanograms per deciliter (ng/dL). The diagnosis is only made after two testosterone lab checks are done and thepatient has symptoms.
Females may also have low testosterone, especially as they age. However, there are no conclusive guidelines on what should be considered “low” testosterone levels in females.
Aging and Testosterone
Testosterone levelsnaturally decline with age. In males, production of this hormone starts to fall after age 30 and continues to decline (about 1% per year) throughout their life.
Low testosterone affects almost 40% of males aged 45 and older.While low testosterone is more common in older males, it can occur in younger males as well.
Causes of Low Testosterone
Some other causes of low testosterone levels in males include:
The 6 Best At-Home Sperm Tests for Reliable Results
Symptoms of Low Testosterone
A range of symptoms can occur if testosterone production drastically drops below normal. Signs of low testosterone are often subtle. Some symptoms that may indicate low testosterone levels may include:
Low Sex Drive
Testosterone plays a key role inlibido(sex drive) in males. Someone with low T may experience a more drastic drop in their desire to have sex.
Sexual Health
Difficulty With Erection
Low Semen Volume
Testosterone plays a role in the production of semen. People with low testosterone may notice a decrease in the volume of their semen during ejaculation.
Body Hair Loss
While there is a genetic component to balding, males with low testosterone may experience a loss of body and facial hair, too.
Fatigue
Males with low T often report extreme fatigue and decrease in energy levels.
Loss of Muscle Mass
Males with low T might notice a decrease in muscle mass. Studies have shown testosterone affects muscle mass, but not necessarily strength or function.
Increased Body Fat
Males with low T sometimes developgynecomastiaor enlarged breast tissue. This effect is believed to occur due to an imbalance between testosterone and estrogen.
Decreased Bone Mass
Testosterone helps produce and strengthen bones. So males with low testosterone, especially those who are older, have lower bone volume and are more susceptible to bone fractures.
Mood Changes
As well as the physical effects of low T, research suggests that men with low testosterone are thought to be more likely to face depression, irritability, or a lack of focus.
Affected Memory
Both testosterone levels and cognitive functions—such as memory—decline with age. As a result, doctors have speculated that lower testosterone levels could contribute to affected memory.
Low Blood Counts
Studies have found that adults with low T levels also had lower hemoglobin levels and were at an increased risk for having or developing anemia. Researchers have suggested that low testosterone may make you more susceptible to anemia.
Low Testosterone in Women
Testosterone is often thought of as a “male” hormone. However, those assigned female at birth also have testosterone in their bodies. Research shows that normal testosterone levels in females are vital to maintaining libido, cognitive function, lean muscle repair and growth, and bone strength. It may also play a role in reducing the risk of certain endocrine cancers.
It’s possible that as with males, female testosterone levels naturally decline with age, and may lead to symptoms, such as low energy and impaired muscle growth. But at this time, research into the effect of low testosterone in females is limited and there are no conclusive guidelines for what should be considered “low” testosterone levels in females.
Testosterone Patch for Female Sex Drive
Are There Tests to Diagnose Low Testosterone?
Adiagnosis of hypogonadismor low T requires two blood tests done on separate days. Your healthcare provider may order other lab tests to look at other sometimes reversible causes of your low testosterone levels.
Free Testosterone Levels
There are two kinds of testosterone found in your blood:
When you have your testosterone levels tested, or test yourself at home, a healthcare provider will look at both your free testosterone levels and your total testosterone levels.Your total testosterone levels include both free and bound testosterone.
If you have symptoms such as reduced sex drive or erection problems, you should see your healthcare provider. They can do a blood test to help determine whether you have low testosterone. Low T is also a known risk factor for cardiovascular disease so its important to get checked to not only help your symptoms but protect your heart.
How to Treat Low Testosterone Symptoms
If your low testosterone levels are the result of an underlying medical condition or lifestyle factor, then at least part of your treatment plan will be treating the original condition.
It may be possible in these cases to have testosterone levels return to normal levels after treatment or lifestyle change. This is not always an option, unfortunately. In these cases, your healthcare provider may recommend treatment such as testosterone replacement therapy (TRT).
Testosterone Replacement Therapy (TRT)
According to the American Urological Society, testosterone replacement therapy (TRT) may result in improvements in low sex drive, anemia, bone mineral density, lean body mass, and/or depressive symptoms. The evidence is inconclusive whether TRT improves cognitive function, measures of diabetes, energy, fatigue, lipid profiles, and quality of life measures.
There are several ways to do TRT. Discuss what option best suits your lifestyle and medical needs with your healthcare provider. TRT options include:
Side Effects of TRTTRT can cause certain side effects, so make sure you are following your provider’s orders. This therapy may cause:Decreased sperm countElevatedred blood cell countAcneSleep apnea(snoring and interruptions in breathing while asleep, a rare side effect)According to the U.S. Food and Drug Administration (FDA), there’s a risk of developingstrokeorheart diseasewith TRT.
Side Effects of TRT
TRT can cause certain side effects, so make sure you are following your provider’s orders. This therapy may cause:Decreased sperm countElevatedred blood cell countAcneSleep apnea(snoring and interruptions in breathing while asleep, a rare side effect)According to the U.S. Food and Drug Administration (FDA), there’s a risk of developingstrokeorheart diseasewith TRT.
TRT can cause certain side effects, so make sure you are following your provider’s orders. This therapy may cause:
According to the U.S. Food and Drug Administration (FDA), there’s a risk of developingstrokeorheart diseasewith TRT.
An Overview of Testosterone Replacement Therapy
Who Should Not Take Testosterone?
Testosterone replacement therapy may cause the prostate to grow. Therefore, if a person has earlyprostate cancer, there is concern that testosterone may stimulate the cancer’s growth.
People who have prostate cancer are advised not take testosterone replacement therapy. It is important for all males considering testosterone replacement therapy to speak to their healthcare providers and undergo prostate screening before starting this therapy.
Should Older Men Take Testosterone Supplements?
Summary
Low testosterone is a common side effect of the aging process in males. Most cases of low testosterone are treatable, and being aware of the symptoms can help a person to receive an early diagnosis and treatment.
A Word From Verywell
If you are experiencing symptoms of low testosterone such as low sex drive, erectile dysfunction, hair loss, and fatigue, speak to your healthcare provider. Most causes of low testosterone are easily treated.
Testosterone is an important hormone in people assigned male at birth. It’s thought to regulate sex drive (libido), bone mass, fat distribution, muscle mass and strength, and the production of red blood cells and sperm. When testosterone is low, it can have physical and mental effects.
Symptoms of low testosterone in males may include:Decreased beard and body hair growthDecreased muscle massDepressionDifficulty with concentrationEnlarged or sensitive breastsErectile dysfunctionFatigueHot flashesLow sex driveReduced strength
Symptoms of low testosterone in males may include:
7–10 years old - 1.80 to 5.68 ng/dl
13–17 years old - 208.08 to 496.58 ng/dl
19 years and older - 265 to 923 ng/dl
Most males with low-T will be treated if they have symptoms of low-T and blood tests showing low-T levels. Whether you seek treatment is your choice.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mulhall JP, Trost LW, Brannigan RE, et al.Evaluation and management of testosterone deficiency: AUA guideline.J Urol. 2018;200(2):423-432. doi:10.1016/j.juro.2018.03.115Wierman ME, Arlt W, Basson R, Davis SR, Miller KK, Murad MH, Rosner W, Santoro N.Androgen therapy in women: a reappraisal: an Endocrine Society clinical practice guideline.J Clin Endocrinol Metab. 2014 Oct;99(10):3489-510. doi:10.1210/jc.2014-2260Rivas AM, Mulkey Z, Lado-Abeal J, Yarbrough S.Diagnosing and managing low serum testosterone.Proc (Bayl Univ Med Cent). 2014;27(4):321-324. doi:10.1080/08998280.2014.11929145Pantalone KM, Faiman C.Male hypogonadism: more than just a low testosterone.Cleve Clin J Med.2012;79(10):717-725. doi:10.3949/ccjm.79a.11174Kataoka T, Kimura K.Testosterone and Erectile Function: A Review of Evidence from Basic Research. IntechOpen; 2017. doi:10.5772/intechopen.72935Huo S, Scialli AR, McGarvey S, et al.Treatment of Men for “Low Testosterone”: A Systematic Review.PLoS One. 2016;11(9):e0162480. Published 2016 Sep 21. doi:10.1371/journal.pone.0162480Tsujimura A.The Relationship between Testosterone Deficiency and Men’s Health.World J Mens Health. 2013;31(2):126-135. doi:10.5534/wjmh.2013.31.2.126Roy CN, Snyder PJ, Stephens-Shields AJ, et al.Association of Testosterone Levels With Anemia in Older Men: A Controlled Clinical Trial.JAMA Intern Med.2017;177(4):480–490. doi:10.1001/jamainternmed.2016.9540Davis SR, Wahlin-Jacobsen S.Testosterone in women–the clinical significance.Lancet Diabetes Endocrinol. 2015;3(12):980-992. doi:10.1016/S2213-8587(15)00284-3MedlinePlus.Testosterone levels test.Endocrine Society.Hypogonadism in men.Osterberg EC, Bernie AM, Ramasamy R.Risks of testosterone replacement therapy in men.Indian J Urol. 2014;30(1):2-7. doi:10.4103/0970-1591.124197Yao Q, Zhou G, Xu M, et al.Blood metal levels and serum testosterone concentrations in male and female children and adolescents: NHANES 2011-2012.PLoS One. 2019;14(11):e0224892. Published 2019 Nov 7. doi:10.1371/journal.pone.0224892
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mulhall JP, Trost LW, Brannigan RE, et al.Evaluation and management of testosterone deficiency: AUA guideline.J Urol. 2018;200(2):423-432. doi:10.1016/j.juro.2018.03.115Wierman ME, Arlt W, Basson R, Davis SR, Miller KK, Murad MH, Rosner W, Santoro N.Androgen therapy in women: a reappraisal: an Endocrine Society clinical practice guideline.J Clin Endocrinol Metab. 2014 Oct;99(10):3489-510. doi:10.1210/jc.2014-2260Rivas AM, Mulkey Z, Lado-Abeal J, Yarbrough S.Diagnosing and managing low serum testosterone.Proc (Bayl Univ Med Cent). 2014;27(4):321-324. doi:10.1080/08998280.2014.11929145Pantalone KM, Faiman C.Male hypogonadism: more than just a low testosterone.Cleve Clin J Med.2012;79(10):717-725. doi:10.3949/ccjm.79a.11174Kataoka T, Kimura K.Testosterone and Erectile Function: A Review of Evidence from Basic Research. IntechOpen; 2017. doi:10.5772/intechopen.72935Huo S, Scialli AR, McGarvey S, et al.Treatment of Men for “Low Testosterone”: A Systematic Review.PLoS One. 2016;11(9):e0162480. Published 2016 Sep 21. doi:10.1371/journal.pone.0162480Tsujimura A.The Relationship between Testosterone Deficiency and Men’s Health.World J Mens Health. 2013;31(2):126-135. doi:10.5534/wjmh.2013.31.2.126Roy CN, Snyder PJ, Stephens-Shields AJ, et al.Association of Testosterone Levels With Anemia in Older Men: A Controlled Clinical Trial.JAMA Intern Med.2017;177(4):480–490. doi:10.1001/jamainternmed.2016.9540Davis SR, Wahlin-Jacobsen S.Testosterone in women–the clinical significance.Lancet Diabetes Endocrinol. 2015;3(12):980-992. doi:10.1016/S2213-8587(15)00284-3MedlinePlus.Testosterone levels test.Endocrine Society.Hypogonadism in men.Osterberg EC, Bernie AM, Ramasamy R.Risks of testosterone replacement therapy in men.Indian J Urol. 2014;30(1):2-7. doi:10.4103/0970-1591.124197Yao Q, Zhou G, Xu M, et al.Blood metal levels and serum testosterone concentrations in male and female children and adolescents: NHANES 2011-2012.PLoS One. 2019;14(11):e0224892. Published 2019 Nov 7. doi:10.1371/journal.pone.0224892
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Mulhall JP, Trost LW, Brannigan RE, et al.Evaluation and management of testosterone deficiency: AUA guideline.J Urol. 2018;200(2):423-432. doi:10.1016/j.juro.2018.03.115Wierman ME, Arlt W, Basson R, Davis SR, Miller KK, Murad MH, Rosner W, Santoro N.Androgen therapy in women: a reappraisal: an Endocrine Society clinical practice guideline.J Clin Endocrinol Metab. 2014 Oct;99(10):3489-510. doi:10.1210/jc.2014-2260Rivas AM, Mulkey Z, Lado-Abeal J, Yarbrough S.Diagnosing and managing low serum testosterone.Proc (Bayl Univ Med Cent). 2014;27(4):321-324. doi:10.1080/08998280.2014.11929145Pantalone KM, Faiman C.Male hypogonadism: more than just a low testosterone.Cleve Clin J Med.2012;79(10):717-725. doi:10.3949/ccjm.79a.11174Kataoka T, Kimura K.Testosterone and Erectile Function: A Review of Evidence from Basic Research. IntechOpen; 2017. doi:10.5772/intechopen.72935Huo S, Scialli AR, McGarvey S, et al.Treatment of Men for “Low Testosterone”: A Systematic Review.PLoS One. 2016;11(9):e0162480. Published 2016 Sep 21. doi:10.1371/journal.pone.0162480Tsujimura A.The Relationship between Testosterone Deficiency and Men’s Health.World J Mens Health. 2013;31(2):126-135. doi:10.5534/wjmh.2013.31.2.126Roy CN, Snyder PJ, Stephens-Shields AJ, et al.Association of Testosterone Levels With Anemia in Older Men: A Controlled Clinical Trial.JAMA Intern Med.2017;177(4):480–490. doi:10.1001/jamainternmed.2016.9540Davis SR, Wahlin-Jacobsen S.Testosterone in women–the clinical significance.Lancet Diabetes Endocrinol. 2015;3(12):980-992. doi:10.1016/S2213-8587(15)00284-3MedlinePlus.Testosterone levels test.Endocrine Society.Hypogonadism in men.Osterberg EC, Bernie AM, Ramasamy R.Risks of testosterone replacement therapy in men.Indian J Urol. 2014;30(1):2-7. doi:10.4103/0970-1591.124197Yao Q, Zhou G, Xu M, et al.Blood metal levels and serum testosterone concentrations in male and female children and adolescents: NHANES 2011-2012.PLoS One. 2019;14(11):e0224892. Published 2019 Nov 7. doi:10.1371/journal.pone.0224892
Mulhall JP, Trost LW, Brannigan RE, et al.Evaluation and management of testosterone deficiency: AUA guideline.J Urol. 2018;200(2):423-432. doi:10.1016/j.juro.2018.03.115
Wierman ME, Arlt W, Basson R, Davis SR, Miller KK, Murad MH, Rosner W, Santoro N.Androgen therapy in women: a reappraisal: an Endocrine Society clinical practice guideline.J Clin Endocrinol Metab. 2014 Oct;99(10):3489-510. doi:10.1210/jc.2014-2260
Rivas AM, Mulkey Z, Lado-Abeal J, Yarbrough S.Diagnosing and managing low serum testosterone.Proc (Bayl Univ Med Cent). 2014;27(4):321-324. doi:10.1080/08998280.2014.11929145
Pantalone KM, Faiman C.Male hypogonadism: more than just a low testosterone.Cleve Clin J Med.2012;79(10):717-725. doi:10.3949/ccjm.79a.11174
Kataoka T, Kimura K.Testosterone and Erectile Function: A Review of Evidence from Basic Research. IntechOpen; 2017. doi:10.5772/intechopen.72935
Huo S, Scialli AR, McGarvey S, et al.Treatment of Men for “Low Testosterone”: A Systematic Review.PLoS One. 2016;11(9):e0162480. Published 2016 Sep 21. doi:10.1371/journal.pone.0162480
Tsujimura A.The Relationship between Testosterone Deficiency and Men’s Health.World J Mens Health. 2013;31(2):126-135. doi:10.5534/wjmh.2013.31.2.126
Roy CN, Snyder PJ, Stephens-Shields AJ, et al.Association of Testosterone Levels With Anemia in Older Men: A Controlled Clinical Trial.JAMA Intern Med.2017;177(4):480–490. doi:10.1001/jamainternmed.2016.9540
Davis SR, Wahlin-Jacobsen S.Testosterone in women–the clinical significance.Lancet Diabetes Endocrinol. 2015;3(12):980-992. doi:10.1016/S2213-8587(15)00284-3
MedlinePlus.Testosterone levels test.
Endocrine Society.Hypogonadism in men.
Osterberg EC, Bernie AM, Ramasamy R.Risks of testosterone replacement therapy in men.Indian J Urol. 2014;30(1):2-7. doi:10.4103/0970-1591.124197
Yao Q, Zhou G, Xu M, et al.Blood metal levels and serum testosterone concentrations in male and female children and adolescents: NHANES 2011-2012.PLoS One. 2019;14(11):e0224892. Published 2019 Nov 7. doi:10.1371/journal.pone.0224892
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