Low Testosterone Symptoms
Symptoms of Low Testosterone:
Shifting hormones can have an impact throughout your life. If you have these symptoms, consider the possibility that you might have low testosterone.
Testosterone is an important hormone for men. During puberty
, it helps in the development of the testes and the penis, and it also plays a role in the growth of facial and pubic hair and the deepening of the voice. Testosterone also continues to play an important role long after the teenage years. It helps inform everything from a man's libido to his mood, and when testosterone levels are low, it can have a negative impact on a man's emotional and physical health. If you have any of the following symptoms, talk to your doctor and be sure to ask about your testosterone levels. Thankfully, there are many treatments that can help improve your sexual response and get your hormone levels back on track.
Here are signs of low testosterone in men:
A study performed at the Veterans Affairs Puget Sound Health Care System and the University of Washington in Seattle found that men
with low testosterone were four times more likely to be diagnosed with clinical depression.
Lack of Energy
Low testosterone is also linked to low energy. If you find that your energy has been declining, don't just chalk it up to long hours at work: It could be a sign of low testosterone
Testosterone plays a role in bone strength, so if you feel like you are losing height, or shrinking, it might not be all in your head: It could be low testosterone
Testosterone also plays a role in muscle mass, so if you have decreased strength or endurance but haven't changed your workout regime
, it could be a sign of decreased testosterone.
If you find that your sexual response
has been less intense and that your erections are not as strong, it could be a sign of low testosterone.
You Have Other Health Issues
Testosterone levels can be impacted by other health conditions, most notably obesity, type 2 diabetes
, and thyroid issues, so if you suffer from one or more of these, you might also have issues with low testosterone.
Decrease in Ejaculate
When your testosterone levels decrease, you migh notice that the amount of your ejaculate
decreases in volume.
Low levels of testosterone
can sometimes cause the testicles to shrink and become smaller. Some men also report a feeling of numbness in the testicles.
If you are unable to achieve or maintain an erection
, it could be because of low testosterone levels. Again, talk to your doctor and have your hormone levels tested.
Low testosterone facts
- Testosterone is produced by the testes in males and ovaries in females. The testes are under the hormonal control of the hypothalamus and pituitary in the brain and make testosterone in response to stimulation by FSH and LH.
- Primary hypogonadism occurs because of the inability of the testes to produce testosterone.
- Causes of secondary and tertiary hypogonadism are due to a variety of illnesses or diseases that affect the hypothalamus-pituitary-gonadal axis.
- Symptoms of low testosterone depend upon when in the life cycle it occurs.
- and loss of muscle mass significant complications of low testosterone.
- In the United States, testosterone replacement therapy is available as an FDA-approved treatment in men only. It may be administered by injection, patch or gel, or gum and cheek putty.
What is testosterone?
Testosterone is an anabolic-androgenic steroid hormone which is made in the testes in males and in the ovaries in women (a minimal amount is also made in the adrenal glands).
Testosterone has two major functions in the human body.
- Testosterone is needed to form and maintain the male sex organs and secondary male sex characteristics (in both men and women) such as voice deepening and hair growth patterns. This function is related to its androgenic properties.
- Testosterone is the facilitation of muscle growth as well as bone development and maintenance. This is a result of its anabolic properties.
Testosterone production is regulated by hormones released from the brain. The hypothalamus and pituitary gland located in the brain produce hormonal signals that ultimately result in the production of testosterone. The hypothalamus is located just above the brain stem, and among its many functions, it produces hormone (GRH). GRH travels a short distance to the pituitary gland located in the base of the brain stimulating the gland to release FSH (follicle stimulating hormone) and LH (luteinizing hormone). These hormones travel through the bloodstream to activate the sex organs in both men and women. Subsequently, these hormones also have a role in regulating testosterone levels in the bloodstream. The majority of testosterone circulates in the blood bound to a carrier protein (a hormone is produced in one are of the body and has its effect on another area. Often a carrier protein that assists the hormone travel through the bloodstream). In this case the carrier protein is called "sex hormone binding globulin," or SHBG. When testosterone is being carried by SHBG, it is considered "bound". Bound testosterone does not play an active role in the body; only the unbound or "free" testosterone is able to enter the different cells of the body and exert its androgenic and anabolic effects. Thus, anything that affects the function or the amount of SHBG can also affect the total circulating amount of active testosterone.
Picture of the endocrine system including the testes and ovaries
What is low testosterone?
The human body functions within a relatively narrow range of normal; when chemicals such as hormones fall outside those normal levels, there can be consequences that affect the body at a cellular, or systemic (body-wide) level. Blood tests used to measure testosterone are usually performed in the morning. Testosterone sampling is difficult since the levels normally tend to bounce around a fair bit during the course of the day. The normal value for total testosterone in males is 270-1070 ng/dl.
However, this depends to some extent on the individual laboratory being used, and the range can vary as a result.
In women, there is about the accuracy of testosterone measurements, because the circulating values are so much lower than in males and are harder to accurately me
s people age, the amount of testosterone the body produces gradually falls in both men and women. Free testosterone levels can be measured and normal levels depend upon an individual's age. Interestinglyitself does not seem to play a role in a reduction of testosterone levels in women beyond that of advancing age.
What are the causes of low testosterone?
Low testosterone levels may be caused by a number of factors. For example – there may be a problem at the level of the hypothalamus or pituitary to produce appropriate amounts of LH and FSH to stimulate testosterone production. Another possibility is that the organs that make testosterone do not function normally or are not able to respond to stimulation by the brain. Also, as mentioned, changes in SHBG can affect the amount of testosterone that is available to exert its effects.
- When the problem is in the organs that produce testosterone (the ovaries or testes, for the most part), it is called a "primary" problem". In medical terminology, the decrease in normal testosterone production is called "hypogonadism."
- When the problem is related to the pituitary and its ability to regulate testosterone, it is called "secondary hypogonadism," and
- If the problem is thought to be at the level of the hypothalamus, it is called "tertiary hypogonadism."
Some common causes hypogonadism or failure of the gonads (the medical term for the sex organs, or testes and ovaries) may include the following:
- Undescended testicles: If the testes fail to migrate from inside the abdomen into the scrotum during fetal development or in the first year or two of life, the testes may become damaged and unable to produce adequate amounts of testosterone.
- Injury to the scrotum: Ifre injured, they may not be able to produce adequate testosterone. Damage to one testicle does not often to lead to low levels if the other testis remains normal.
- Cancer therapy and radiation therapy can damage the interstitial cells in the testes responsible for testosterone production. This decrease in testosterone production may be temporary as the cells recover, or it may be permanent.
- Aging: Testosterone levels gradually decrease with aging. Usually, enough testosterone is manufactured to allow for adequate bodily functions, but there is some research that suggests that lower testosterone levels can result in a variety of medical problems such as bone and muscle loss, and erectile dysfunction.
- Mumps orchitis: The mumps virus can cause inflammation of the testes in males, and if the illness occurs in puberty or adulthood, the damage to the testes may lead to low testosterone production. Immunization against the mumps has significantly decreased the incidence of this illness.
- Chromosomal abnormalities: A normal male has one X and one Y chromosome (a normal female has two osomes). In Klinefelter's syndrome, in males, an extra me is present and among other anatomic issues, there is abnormal development of the testes and decreased to manufacture testosterone.
- Ovary conditions in women ovarian failure and surgical removal of both ovaries (bilateral oophorectomy) are conditions associated with lower circulating testosterone levels.
Secondary and tertiary hypogonadism
may be due to damage the hypothalamus or pituitary and/or the failure of the production of hormones (GRH, TSH and/or LH) to stimulate the gonads. Causes of secondary and tertiary hypogonadism include:
- Damage to the pituitary gland may occur because of tumors of the gland itself or because of damage caused by the side effects of treatment of nearby brain tumors.
- Hypothalamus malformations can prevent normal function. Kallman's syndrome is one example.
- Decreased blood flow to these glands from other conditions including significant bleeding and shock.
- Inflammation caused by tuberculosis and sarcoidosis may affect the pituitary gland.
- may also cause inflammation of both the hypothalamus and pituitary.
- Illegal use of anabolic steroids, for example in athletes and body builders, can cause hypogonadism and low testosterone levels.
It should be noted also can be a cause of low testosterone. While it can be associated with other causes, obesity specifically enhances the conversion of testosterone to estrogen. This is a naturally occurring process in both men and women, and this conversion occurs predominantly in fat cells. In the case of obesity, fat cells enhances this process, and testosterone levels may fall due to excessive conversion to estrogen. There are rarer causes of hypogonadism that can occur, dealing with cellular mechanisms and receptor binding. These are beyond the scope of this discussion.
What are the symptoms of low testosterone?
Low testosterone symptoms in males
In males, symptoms of decreased testosterone depend upon when the low levels occur. If there is inadequate testosterone in the fetus, genital development may be affected. There may be development of the penis and scrotum, with an appearance of female genitalia or ambiguous genitalia that are neither male nor female. Remember that the definition of male is based upon the type of chromosomes present and not necessarily upon the outward physical appearance. If low testosterone occurs before or during puberty, there may be a lack of sexual maturation. Signs may include failure to develop muscle mass, failure of the voice to deepen, poor growth of body hair, enlarged breasts ( gynecomastia ), and faipenis and testes to enlarge. In adulthood, low testosterone may lead to decreased sexual function and desire,infertility , and
erectile dysfunction .
Loss of decreased muscle mass, or decreased bone density may occur.
Low testosterone symptoms in females
While low testosterone is usually thought of as a male disease, low levels may occur in women and cause significant issues. Symptoms may
irritability, loss of sexual desire (decreased libido ), and
. Loss of muscle decreased bone density (osteoporosis), and loss of body hair may also be seen.
When should I contact the doctor for low testosterone?
For infants, routine screening examination is useful in checking for normal placement of the testes within the scrotum. As puberty approaches in males, it is important that parents and health care practitioners look for the development of secondary sex characteristics such as lowering of , development of characteristic hair growth, and increased muscle mass. In adults, most males will seek help with erectile dysfunction and decreased libido. In women, a loss of sexual desire and libido are often the presenting complaints.
How is low testosterone diagnosed?
Many of the symptoms that lead to the diagnosis of low testosterone are nonspecific, and the health care professional may want to take a history of symptoms and perform a physical examination prior to ordering blood tests to assess for low testosterone levels in the body. The diagnosis also depends upon at what age the concern occurs. Many times the diagnosis in the pediatric age group occurs because the parent and health care professional to observed abnormalities or delays in physical development. If the diagnosis of low testosterone or hypogonadism is considered, blood tests to measure testosterone levels may be ordered. The level of testosterone varies depending upon the time of day, and most often, early morning testosterone levels are measured. Based the clinical situation, further tests may be considered to determine whether the low testosterone is due to primary or secondary hypogonadism.
What is the treatment for low testosterone?
The initial consideration for treating low testosterone is to find the underlying cause and address that issue. While the testosterone levels fall with aging, there is no evidence that this is an abnormal condition requiring treatment. However, research results are inconclusive, and studies measuring the effect of testosterone in men age 60 to 80 found no benefit in mental or physical function.
Treatment of low testosterone in men
In men, low testosterone levels in the body can be supplemented by hormone replacement with testosterone. Testosterone replacement therapy can be prescribed as an intramuscular injection usually given on a biweekly basis, as a patch or gel placed on the skin, or as putty that is applied to the gums of the mouth. Each of the treatments has its risks and benefits. The decision as to which form of testosterone to use depends upon the clinical situation. Discussions between the patient and health care practitioner often decide which medication to use.
Treatment of low testosterone in women
In women, in the United there are currently no preparations that are FDA approved for testosterone replacement.Esterified estrogens and methyltestosterone
(Estratest), manufactured by Solvay Pharmaceuticals, a combination of estrogen and methyl testosterone that was formerly available, was discontinued by the manufacturer in the spring of 2009. Some doctors will advise women to cut the patches for men into smaller sizes, or to use the gel in smaller doses; however, the accuracy of these methods is questionable, as is the safety.
What are the complications of low testosterone?
Complications of low testosterone levels depend upon when in life the situation occurs. Low testosterone levels in infants can lead to poor development of sexual organs. Near puberty, it can lead to failure of development of secondary sexual characteristics. In adulthood, osteoporosis, loss of muscle mass, and decreased sexual function including erectile dysfunction and decreased libido may occur.
Can low testosterone be prevented?
Low testosterone is due to the failure of at least one part of the axis. Many illnesses and diseases that affect these organs are inherited and cannot be prevented. Other causes are unavoidable consequences such as cancer therapy and infection. However, some causes are preventable including obesity and
What is the outlook (prognosis) for a patient with low testosterone?
The ability to treat the condition depends upon recognizing symptoms and seeking medical care. Once the cause for the low testosterone levels is diagnosed, testosterone replacement therapy may be helpful in reversing the symptoms related to those low levels. Maintaining adequate testosterone levels within the body may minimize future risk of muscle and bone loss.