Low testosterone, medically referred to as male hypogonadism, is a condition where the testicles do not manufacture sufficient amounts of testosterone, the principal male sex hormone. Testosterone is primarily produced in the Leydig cells present in the testicles in individuals assigned male at birth (AMAB). This includes cisgender men, non-binary individuals, and transgender women not undergoing feminizing hormone therapy.
Testosterone, the key androgen, is instrumental in promoting the development of male characteristics. It is essential for sperm production (spermatogenesis). In AMAB individuals, testosterone helps maintain and develop:
Sex organs and genitalia.
Muscle mass.
Adequate levels of red blood cells.
Bone density.
Sense of well-being.
Sexual and reproductive function.
The body meticulously regulates the levels of testosterone in the blood. Levels are typically highest in the morning and decline throughout the day.
The hypothalamus and pituitary gland typically control the quantity of testosterone your testicles produce and release. The hypothalamus releases gonadotropin-releasing hormone (GnRH), which triggers your pituitary gland to release luteinizing hormone (LH). LH then travels to your gonads and stimulates the production and release of testosterone. Any issue with your testicles, hypothalamus, or pituitary gland can cause low testosterone.
Male hypogonadism can affect individuals with testicles at any age from birth through adulthood. It's challenging for researchers to estimate how common low testosterone is, given the different definitions used in various studies. Data suggest that about 2% of AMAB individuals may have low testosterone. Other studies estimate that over 8% of AMAB individuals aged 50 to 79 years have low testosterone.
Low testosterone can lead to various symptoms, which can be subtle or more pronounced, depending on the severity of the condition.
Decreased Libido
Testosterone plays a key role in libido. A drastic drop in sex drive may be experienced in individuals with low testosterone levels.
Difficulty in Achieving and Maintaining an Erection
Testosterone aids in achieving and maintaining an erection. However, with low testosterone, individuals may find it challenging to achieve an erection before sex or experience spontaneous erections, such as during sleep.
Hot Flashes
Hot flashes, characterized by a sudden sensation of warmth, heavy sweating, reddening
Physical Changes
Several physical changes may point to low testosterone. These include balding, increased body fat, decreased muscle mass, and reduced bone mass.
Mental and Emotional Changes
Low testosterone can lead to mood changes and memory issues. It has been theorized that lower testosterone levels could contribute to affected memory.
Various factors can contribute to low testosterone levels. These include aging, certain illnesses like type 2 diabetes and obesity, pituitary gland problems, testicle injuries, vitamin deficiencies, lack of sleep, stress and certain treatments like radiation therapy and chemotherapy.
Testosterone replacement therapy (TRT) may be recommended for individuals with low testosterone. This treatment can strengthen muscles, protect bones, improve sex drive, improve erectile dysfunction, and contribute to improved mood. However, the treatment's effects can vary from person to person.
Testosterone therapy can be administered in various forms, including shots, gels, patches, and tablets. Each form has its pros and cons, and the choice of treatment usually depends on the patient's preference, lifestyle, and health status.
Testosterone therapy can have potential side effects. These may include an increase in red blood cells, sleep apnea, an enlarged prostate, and acne. Long-term use of testosterone might also increase the risk of heart disease, although the evidence is inconclusive. In conclusion, low testosterone is a common but treatable condition. If you're experiencing symptoms of low testosterone, it's vital to consult your healthcare provider for an accurate diagnosis and appropriate treatment.