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Low Testosterone (Hypogonadism)

Insufficient testosterone production causing symptoms affecting energy, mood, libido, and physical health.

Medical Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment.

Overview

Low testosterone (hypogonadism) occurs when the body doesn't produce enough testosterone, the primary male sex hormone. While commonly associated with men, testosterone is also important for women's health.

Testosterone naturally declines with age (approximately 1-2% per year after age 30), but pathologically low levels can occur at any age. Causes include testicular problems (primary hypogonadism), pituitary/hypothalamic issues (secondary hypogonadism), obesity, chronic illness, medications, and lifestyle factors.

Symptoms significantly impact quality of life and can mimic other conditions like depression or thyroid disorders. Diagnosis requires both low testosterone levels AND symptoms. Treatment options include testosterone replacement therapy (TRT) when appropriate.

Common Symptoms

  • •Low energy and fatigue
  • •Decreased libido and sexual desire
  • •Erectile dysfunction
  • •Depression and mood changes
  • •Difficulty concentrating
  • •Decreased muscle mass and strength
  • •Increased body fat, especially abdominal
  • •Hair loss
  • •Reduced bone density
  • •Hot flashes
  • •Sleep disturbances
  • •Decreased motivation

Key Blood Markers

Total Testosterone

Low (<300 ng/dL or 10.4 nmol/L)

Primary marker - measures total testosterone including bound and free

Free Testosterone

Low

The unbound, bioavailable hormone - often more relevant for symptoms

Sex Hormone Binding Globulin

May be elevated

Binds testosterone - high SHBG can cause low free T despite normal total T

Luteinizing Hormone

Low (secondary) or high (primary)

Helps determine if low T is primary (testicular) or secondary (pituitary)

Estradiol

May be elevated relative to testosterone

Important for monitoring if considering or on testosterone therapy

Frequently Asked Questions

What testosterone level is considered low?
Generally, total testosterone below 300 ng/dL (10.4 nmol/L) is considered low. However, symptoms matter - some men feel fine at lower levels while others have symptoms at higher levels. Free testosterone should also be evaluated.
Can low testosterone be improved naturally?
Sometimes. Weight loss, exercise (especially resistance training), adequate sleep, stress reduction, and zinc/vitamin D sufficiency can improve testosterone. However, if levels are significantly low, these measures may not be sufficient.
Does TRT affect fertility?
Yes, testosterone replacement suppresses natural production and sperm production. Men wanting to preserve fertility may use alternatives like clomiphene or HCG instead of, or alongside, testosterone.
At what age should testosterone be checked?
There's no set age, but testing is recommended when symptoms are present. Natural decline begins around 30, and many men start testing in their 40s-50s. Younger men with symptoms should also be evaluated.

Quick Facts

  • Key Markers:5
  • Common Symptoms:12

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