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Low Testosterone

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Testosterone is a hormone produced in the male body. It is a male hormone or androgen that is released by the testes. This hormone is very important as it helps in stimulation of sperm production, increase in sex drive. Other than the sexual stimulation, it is also responsible in building muscles as well as bone mass of men. When the level of testosterone drops from its normal range, it leads to many health symptoms as well as complications. This is a serious medical condition and requires medical help. However, many men tend to overlook the symptoms as a part of aging. Let us learn more about low testosterone from the following paragraphs.

What is Low Testosterone?

Low testosterone (low T) is known medically as hypogonadism. This is a condition where the body fails to produce testosterone. Hypogonadism can occur at birth or one may develop it later. These conditions can be treated with hormone replacement therapy in most conditions.

Types of Low Testosterone

There are two types of hypogonadism-

Primary Hypogonadism

This is the most common type of low testosterone. It occurs when the testes that functioned normally, suddenly stop functioning properly later on in life.

Secondary Hypogonadism

In this condition, the problem is not with the testes, but occurs elsewhere. The testes function normally, but usually do not receive the correct signal from the brain. The problem may occur in the pituitary  gland or hypothalamus. One such example of secondary hypogonadism is a Kallmann’s syndrome or hypogonadotropichypogonadism.

In some cases, low testosterone can be acquired or congenital.

Congenital hypogonadism

This condition occurs when a baby boy is born with Klinefelter syndrome.

Acquired hypogonadism

This condition occurs due to many factors that affect the hormone production. These include:

  • Opioid drug abuse
  • Traumatic brain injury
  • Normal aging called as male menopause

Causes of Low Testosterone

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Primary low testosterone is caused by the following:

  • Klinefelter’s syndrome
  • Congenital problems such as anorchia
  • Excessive alcoholism
  • Exposure to heavy metals
  • Trauma to the testes
  • Mumps infection of the testicles
  • Hemochromatosis
  • Undescended testicles
  • Chemotherapy or radiation therapy

The causes of secondary hypogonadism are as follows:

  • Delay in onset of puberty
  • Kallmann syndrome
  • Pituitary disease
  • Lesions on pituitary gland or hypothalamus
  • Inflammatory diseases such as sarcoidosis, histocytosis, tuberculosis
  • Use of medications like opioids or sex hormones
  • Obesity
  • Male menopause

Symptoms of Low Testosterone

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As mentioned above, hypogonadism can be congenital or acquired. When it is congenital, the body does not produce enough testosterone during the development of the fetus. This leads to impaired growth of the external sex organs. Depending on the amount of testosterone in the fetal body, the male child may be born with:

  • Genitals that are female
  • Presence of underdeveloped male genitals
  • Development of genitals that are neither male or female

When low testosterone occurs during puberty, it leads to delay in onset of puberty. The symptoms include:

  • Delay in development of muscles
  • Less body hair
  • The penis and testicles do not develop
  • Gynecomastia (development of male breast tissues)

When low testosterone occurs in adulthood, it leads to:

  • Infertility
  • Erectile dysfunction
  • Decrease in sex drive
  • Osteoporosis
  • Gynecomastia
  • Reduction in body hair
  • Loss of muscle tone
  • Low semen volume
  • Fatigue
  • Loss of energy
  • Hair loss
  • Increase in body fat
  • Mood fluctuations

Diagnosis of Low Testosterone

A physical examination will help spot low T. To confirm, the doctor may suggest certain tests such as hormone test, semen tests, etc. In some cases, if the testicles seem normal, the doctor may ask to conduct pituitary imaging tests like CT scan or MRI or genetic test (DNA test). When testosterone levels drop from 300 nanograms/deciliter, it indicates low testosterone.

Treatment for Low Testosterone

The treatment for low T includes testosterone replacement therapy (TRT). This helps in increasing the muscle mass, prevention of bone loss, increase in libido, etc. In case of delayed puberty, the treatment includes use of testosterone injections that help increase the hormone levels in young boys. Some may be advised use of the testosterone patch, gel or application of Straint (a putty-like substance that is applied into the gums or cheek).

Low testosterone levels lead to depression in many men. The decrease in libido, erectile dysfunction as well as infertility can lead to low self confidence. It is better to speak to a doctor and find a way to treat low T. In most cases, the condition is treatable and one can live life normally. Speak to your doctor today, before it affects your overall life

Written by: Saptakee sengupta
Date last updated: March 13, 2015

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