Low Testosterone | Urology | Loyola Medicine

Low Testosterone

Overview and Facts about Low Testosterone

Low testosterone is a condition in men in which the testicles do not produce enough of the hormone testosterone, which is the male sex hormone necessary for normal male sexual development and function. This hormone also helps maintain and develop adequate levels of red blood cells, keeps bones strong, boosts mood, and aids thinking ability. A diagnosis of low testosterone is made when one’s testosterone levels are consistently low and there are symptoms which may be attributed to it.

Signs and Symptoms of Low Testosterone

Testosterone levels peak by early adulthood and drop about 1 to 2 percent a year beginning in the 40s. As men reach their 50s and beyond, low levels may lead to signs and symptoms such as:

  • Low sex drive 
  • Erectile dysfunction
  • Fatigue
  • Reduced muscle mass
  • Irritability
  • Depression or anxiety
  • Weight gain
  • Development of breast tissue (gynecomastia)

Causes and Risk Factors of Low Testosterone

While falling testosterone levels are a normal part of aging, certain conditions can accelerate the decline. These include:

  • Obesity
  • Stress
  • Alcoholism
  • Testicular injury or infection
  • Chemotherapy or radiation treatment for cancer
  • Medications, especially hormones used to treat prostate cancer and corticosteroid drugs
  • Chronic illness (liver and kidney disease, type 2 diabetes, and HIV/AIDS)
  • Certain genetic conditions (Klinefelter syndrome, Kallmann syndrome, or Prader-Willi syndrome)

Tests and Diagnosis of Low Testosterone

Doctors make a diagnosis of low testosterone based on a physical exam, a review of symptoms, and blood tests that measure the amount of total blood testosterone level. Since levels tend to fluctuate daily, several tests are needed to help make a definitive diagnosis. Testing is typically done between 7:00 and 10:00 a.m. when the levels are highest.

Other blood tests may also be ordered to help determine an underlying cause, such as a pituitary gland problem.

Treatment and Care for Low Testosterone

Those diagnosed with low testosterone may be prescribed testosterone replacement therapy. A discussion between patients and the urologist should occur before beginning this type of therapy due to the uncertainty related to long-term safety and associated risks. Even when testosterone levels are low, therapy is not always the first course of action. If a doctor can identify the source for declining levels, such as weight gain or certain medications, he or she may first address that problem. If the testosterone levels are normal are at baseline, adding “extra” testosterone has no benefit but can increase risks.

When testosterone therapy is found to be the best treatment option, there are several delivery methods to consider:

  • Topical applications, such as gels, creams, liquids, and patches
  • Injections given either weekly, bi-weekly, or monthly
  • Tablets that stick to the gums
  • Testosterone pellets inserted under the skin

Any signs of improvement will likely appear within 3 to 6 months of treatment.