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7 signs you could have low testosterone

Low testosterone can affect men of any age, but do you know the main signs of low testosterone?

Low testosterone can affect men of any age, but the signs of low testosterone are more likely to affect people as they get older.

The symptoms of ageing often intertwine with the symptoms of low testosterone, but researchers are still trying to work out the exact relationship between low testosterone and ageing. We do know, though, that spotting low testosterone and treating it in the right way can be beneficial.

That’s why it’s helpful to understand the signs of low testosterone so that you can look out for them and act if you need to.

What is testosterone?

Testosterone is a sex hormone that is essential for sex drive, muscle mass, fertility, and mood. In men, testosterone is produced in the testes and is associated with increased muscle and bone strength and deepening of the voice.

In most men, levels of testosterone increase from puberty to adulthood, then gradually decline from the mid-30s or 40s onwards. Some people call this middle-aged drop or the ‘andropause’ – although the NHS describes the male menopause term as being a little misleading! That’s because it suggests the symptoms are down to a sudden drop in testosterone in middle age, like what occurs in female menopause, which isn’t true. While testosterone levels do fall as men age, it’s a steady decline or less than 2% a year from around 30-40 years old.

Hypogonadism is when your body stops producing enough testosterone. Even though most men have normal age-related hypogonadism or late-onset hypogonadism, some men can have issues that cause testosterone levels to drop earlier in life, which is called early primary or secondary hypogonadism.

Seven signs of low testosterone

  1. Low libido
    Testosterone helps to fuel your sex drive. If your libido has gone from normal to low or non-existent, low testosterone could be to blame. Low libido doesn’t just mean that you’re less interested in sex but can also refer to your feelings during sex itself.
     
  2. Erectile dysfunction
    Having an erection is a more complicated affair than you might think. The process is a culmination of vascular, neurological, anatomical, situational, and psychological factors. One other factor is endocrinological – hormones. Any disruption between your testes and your brain, like low testosterone, can cause erectile dysfunction. So, if you’re struggling to have or maintain an erection, low testosterone may be to blame. We also tend to get nocturnal erections during REM sleep, which we often know about when waking up with one. If your ‘morning glory’ stops happening altogether, it could be a sign that your testosterone is low.
     
  3. Lack of muscle gains
    Testosterone is one of the most potent anabolic hormones responsible for building things up. It works directly on muscles to build them up and stop them from being broken down. The receptors on these muscles decline as we age, which means muscles don’t grow as much over time. But if you don’t have enough testosterone to stimulate these receptors, your muscle mass will also decline. If you’ve noticed you’re getting weaker or your muscle mass is falling off over time, then it might be a good idea to check your testosterone.
     
  4. Low mood and memory
    Testosterone acts as a signaler in the brain. Although mental health is very complex and unique to every person, testosterone plays a small but integral role. Low testosterone can increase anxiety, lower your mood, possibly leading to depression and negatively impacts your memory. We tend to see this most often in men as they get older, so if you have a low mood and you have low testosterone, you might be able to improve your symptoms with some simple therapy.
     
  5. Fatigue
    Similar to the last point, low testosterone is associated with fatigue and feeling exhausted. So, if you find yourself constantly tired and don’t know why then checking your testosterone is not an unreasonable move.
     
  6. Body fat and man boobs
    Testosterone enhances the breakdown of fat and reduces fat uptake into tissues. As your levels drop, your body finds it easier to lay fat down visceral fat around the tummy, which is associated with cardiovascular disease. Yet, being overweight also causes low testosterone, which makes it harder to lose weight. Fat can lay down around the nipples, too, leading to man boobs (gynecomastia). If you’re gaining weight or you’ve noticed man boobs, it’s time to check your testosterone.
     
  7. Hair growth or loss
    Curiously, testosterone and its by-products can lead to both hair growth and hair loss. Again, there are different factors at play here, but some men with healthy testosterone levels will lose hair on the head but can grow a nice beard and other body hair. For these men, if beard or body hair growth becomes difficult over time, low testosterone may be to blame. In some young men, low testosterone levels may contribute to early baldness. In these cases, you will also probably note other low-testosterone symptoms. 

Is low testosterone a natural part of ageing?

Researchers are still looking into whether low testosterone is part of ageing or not. And they’ll be doing so for many years to come. The most important thing is learning to understand yourself as a whole – both physically and mentally. Low testosterone is a complex issue. On one hand, low testosterone can cause symptoms, but some issues can lead to low testosterone.

How to investigate yourself

Understand your physical self on the outside:

  • What’s your weight?
  • How much alcohol do you drink?
  • Do you smoke?
  • What’s your diet like?

Understand your mental health:

  • Assess your mood (both by yourself and with your trusted friends and family).
  • Try to gauge your stress levels.
  • Try to assess your sleep.
  • Focus on your memory and make a mental note if you find it difficult to remember certain words.

Understand yourself on the inside:

  • Do a blood test to look at your body as a whole. This should be an early morning sample. 

What to do about it:

Before we get to testosterone replacement therapy (TRT), it’s best to see if there are some easily reversible causes to work on – particularly if you’re in your 30s to 50s.

  • Try to cut down on alcohol if you’re a heavy drinker. If you need extra support, some organisations can help with stopping drinking.
  • Get help to quit smoking through the NHS.
  • Get moving. Five times a week, mixing cardio and resistance exercise is proven to boost your testosterone.
  • Measure your BMI – are you overweight, obese or have central visceral fat? Losing weight in these situations may increase testosterone. 
  • Think about what you’re eating, too. Try to move to a whole food, home-cooked diet.
  • Improve your sleep hygiene. Cut out caffeine and screens just before bed.
  • Low vitamin D? Take a simple over the counter supplement (your pharmacist can help you if you don’t know which one to choose). This can help to optimise your testosterone production.

Testosterone Replacement Therapy (TRT)

When testosterone levels drop too low you may benefit from TRT in conjunction with the above tips. We’ve seen proven benefits from men who take TRT, including increased mood and increased sex drive. But it’s important to know that taking TRT comes with risks and the research isn’t yet there to know the long-term harm.

The key is to use TRT in conjunction with your GP’s input. It’s important to find the right formula for your lifestyle and to have a physical check-up each year. We also recommend keeping an eye on your levels with regular six-monthly monitoring via an Advanced TRT Blood Test. This will keep an eye on your hormones and make sure your red cells, cholesterol, sugar, and liver regulation don’t get thrown off by your therapy.

Remember, low testosterone is a complex issue but understanding your body inside and out is a great first step to ensuring your feel your best self for as long as possible.


References

  1. Up To Date – Clinical Features and Diagnosis of Male Hypogonadism: https://www-uptodate-com/contents/clinical-features-and-diagnosis-of-male-hypogonadism?search=testosterone&topicRef=7457&source=see_link
  2. Up To Date – Approach to Older Men with Low Testosterone: https://www-uptodate-com/contents/approach-to-older-men-with-low-testosterone?search=testosterone&source=search_result&selectedTitle=3~148&usage_type=default&display_rank=2#H2505005012
  3. Testosterone Deficiency, Weakness, and Multimorbidity in Men. Peterson, M. Scientific Reports 8, Article number 5897 (2018), https://www.nature.com/articles/s41598-018-24347-6
  4. Review of health risks of low testosterone and testosterone administration. Jia H et al. World Journal of Clinical Cases. 2015 Apr 16; 3(4): 338-344 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4391003/
  5. Diagnosing and managing low serum testosterone. Rivas AM et al. Proceedings Baylor University Medical Centre. 2014 Oct: 27(4): 321-324 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4255853/
  6. Physiology of Penile Erection and Pathophysiology of Erectile Dysfunction. Dean RC, Lue TF. Urology Clinics of North America. 2005 Nov; 32(4): 379-v. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1351051/