"After age 30, most men begin to experience a gradual decline in testosterone," says David Samadi, MD, chairman of the urology department at Lenox Hill Hospital in New York City.
Though testosterone levels never reach zero (as estrogen levels do in women during menopause), low testosterone levels men to experience symptoms like fatigue, low libido, and reduction of muscle mass.
While reduced testosterone is more common in older men, it can occur in younger men also. Luckily, every one the causes of low testosterone in young men are treatable, so in the event that you experience such symptoms at any age, there's no reason to ignore it.
Causes of Low Testosterone in Younger Men
For younger guys, a fall in testosterone levels may be brought on by some illnesses, including type 2 diabetes, diabetes, chronic liver or kidney disease, COPD or other lung disorder, or adrenal gland issues, based on Dr. Samadi.
Genetic causes of low testosterone in males include the diseases Klinefelter syndrome, Kallmann syndrome, Prader-Willi syndrome, and Myotonic dystrophy. Another disease which could result in low testosterone is hemochromatosis, making the body shop too much iron.
"Low testosterone can also result when something happens, like trauma or steroid use, that prevents the testes from making the hormone," says Bruce Gilbert, MD, PhD, an adjunct clinical professor of urology and reproductive medicine at Weill Cornell Medical College and director of reproductive and sexual medicine at the Smith Institute for Urology of the North Shore-LIJ Health System.
Additional causes of low testosterone in males younger than 50 include pituitary gland tumors, HIV disease, and radiation therapy or chemotherapy for cancer.
Doctors categorize causes of low testosterone as primary or secondary.
"Primary hypogonadism stems from a problem in the testicles," Samadi says. "This could be from a developmental issue, injury to the testicles, or radiation or chemotherapy treatment.
Is It Low Testosterone?
Irrespective of the reason, low testosterone symptoms are the same.
"Symptoms include low libido, erectile dysfunction, fatigue, decreased mental acuity, and moodiness," Dr. Gilbert says.
Treatments for Low Testosterone in Younger Men
"When it comes to treating low testosterone in younger guys, we usually reserve treatment for those who have symptoms, such as fatigue and reduced libido," Gilbert says.
In men who don't make the hormone in their testes because of a condition such as Klinefelter syndrome, or those who have lost their testes because of cancer, the only option is testosterone replacement therapy.
In these circumstances,"therapies are usually used only in the brief term, and when a physician has close observation and knowledge of the patient," Gilbert says.
An important consideration for younger men before getting treatment is fertility. "You don't wish to give supplemental testosterone to guys who are interested in being fertile since it can turn off sperm production," Gilbert says.
Once a young man goes off testosterone supplementation, there's a chance his sperm count will never return to what it was before he started. "Therefore, men of reproductive age should consider alternatives that might increase their testosterone in addition to maintain their sperm production," he says. One such choice is a category of drugs known as selective estrogen receptor modulators (SERMs).
Other treatments for low testosterone include weight loss and other lifestyle modifications, like eating healthy and increasing exercise.
The bottom line, however, is that in the event that you have low testosterone symptoms, then it's important to see your doctor. Then, your doctor can rule out more significant causes of your symptoms, including hypertension or a thyroid problem, and offer treatment that can enhance your power and quality of life.