Are you experiencing fatigue, mental fogginess, or decreased sex drive? If yes, chances are you will develop low testosterone levels. It occurs when your body is not able to produce enough testosterone to function optimally. Many factors can cause low testosterone in the body, which results in many symptoms based on your age. Fortunately, it is treatable. Learn about low testosterone causes, symptoms, diagnosis, and treatment options in this article. If you want to know more about urological health, visit us at Doral Health and Wellness Urology Center and consult with the best nephrologists and urologists in East New York.
Causes & Symptoms of low testosterone in men
Low testosterone in men, also known as male hypogonadism, may be caused by many things, such as aging, hormone changes, chemotherapy, and others. These causes are divided into two types:
- Primary hypogonadism (testicular disorder)
- Secondary hypogonadism (pituitary/hypothalamic dysfunction)
The causes of these two types are also divided into congenital (at birth) and acquired (developed later in childhood or adulthood):
- Primary hypogonadism:
This occurs when something is wrong with your testicles that stops producing a normal amount of testosterone. It is also known as hypergonadotropic hypogonadism. This produces low levels of testosterone because the pituitary gland produces more luteinizing hormone (LH) and follicle-stimulating hormone (FSH), also known as gonadotropins. Normally, these hormone levels are high to stimulate the testicles to produce more testosterone and sperm. However, if you have damaged or missing testicles, then the testicles don’t respond well to increased levels of gonadotropins, which lead to too little or no testosterone and sperm. Not having enough testosterone levels impacts optimal growth and health. Sometimes, testosterone levels are within normal range, and gonadotropins are high; then your doctor helps you understand if you need treatment or not. Normal testosterone levels are necessary for optimal health and growth. The causes of primary hypogonadism may include:
Inherited conditions that may cause primary hypogonadism include:
- Undescended testicles: This occurs when testicles fail to descend into the abdomen before birth.
- Klinefelter syndrome: In this condition, a person is born with 3 sex chromosomes: X, X, and Y.
- Hemochromatosis: This occurs when you have too much iron in the blood, which causes testicular failure or pituitary damage.
- Anorchia: This occurs when you are born with no testicles at birth.
- Cryptorchidism: This occurs when you are born with undescended testicles.
- Leydig cell hypoplasia: A condition where Leydig cells of the testicles are underdeveloped.
- Noonan syndrome: A rare genetic condition that occurs due to delayed puberty, undescended testicles, or infertility.
- Myotonic dystrophy: It is a part of a group of inherited disorders called muscular dystrophies.
Acquired conditions affecting your testicles that lead to primary hypogonadism include:
- Physical injury to the testicles: Any injury or removal of any or both testicles will affect testosterone levels.
- Mumps orchitis: Orchitis is a type of inflammation that occurs in one or both testicles, often caused by a bacterial infection, such as a sexually transmitted infection, it also occurs due to a viral infection, such as mumps.
- A certain type of tumor also causes primary hypogonadism.
- Cancer treatment: Cancer treatment, like chemotherapy or radiation therapy, can damage the testicles.
- Anabolic steroids used to grow muscles can also affect testosterone levels.
- Secondary hypogonadism:
Secondary hypogonadism occurs when the hypothalamus or pituitary gland is damaged and not working properly. These parts of the brain control testosterone production by the testes. It is also known as hypogonadotropic hypogonadism because it occurs when low levels of luteinizing and follicle-stimulating hormones are produced that leading to decreased testosterone and sperm production.
Congenital conditions that can cause secondary hypogonadism include:
- Kallmann syndrome: A rare genetic condition that occurs due to the loss of development of nerve cells in your hypothalamus that produce gonadotropin-releasing hormone.
- Prader-Willi syndrome: A rare genetic multisystem disorder that causes hypothalamic dysfunction.
- Isolated hypogonadotropic hypogonadism: A condition that affects the production of gonadotropin-releasing hormone from birth.
Acquired conditions that cause secondary hypogonadism include:
- Pituitary disorders that are caused by drugs, kidney failure, or small tumors.
- HIV/AIDS affecting the pituitary gland, hypothalamus, and testes.
- Inflammatory diseases such as sarcoidosis, tuberculosis, and histiocytosis can affect the pituitary gland and the hypothalamus.
- Iron overload (hemochromatosis).
- Normal aging: Aging affects the production and response to hormones. Males experience a deterioration of hypothalamic-pituitary function and Leydig cell function that leads to low testosterone levels and sperm production. It is known as Late-onset hypogonadism, which is more common in men who have type 2 diabetes, are overweight, or obese.
- Medications: Certain medications, including estrogens, psychoactive drugs, metoclopramide, opioids, steroids, leuprolide, goserelin, triptorelin, and new androgen biosynthesis inhibitors, can affect the pituitary gland and hypothalamus function.
- Concurrent illness: Severe emotional or physical stress from an illness or surgery can lead the reproductive system to temporarily shut down.
- Brain and head injury.
- Cirrhosis of the liver.
- Hyperprolactinemia.
- Alcohol use disorder.
- Obstructive sleep apnea.
Some people may be affected by mixed hypogonadism, which is more common with increased age. People who undergo glucocorticoid therapy can develop the condition. It mostly affects people with sickle-cell disease, thalassemia, or alcoholism.
Low levels of testosterone can cause many symptoms, which vary depending on their age group. It includes:
- Fetal development:
If hypogonadism starts during fetal development, it will impair the growth of external sex organs. Depending on when hypogonadism starts and the level of testosterone during that time, a male child can develop:
- Female genitals.
- Ambiguous genitals, which are neither male nor female.
- Underdeveloped male genitals.
- Puberty:
Normal growth requires normal levels of testosterone. If hypogonadism occurs during puberty, you may experience problems with:
- Muscle development
- Lack of body hair
- Underdeveloped genitals
- Deepening of the voice
- Overly long limbs
- Enlarged breasts (gynecomastia)
- Adulthood:
Later in life, low levels of testosterone can lead to other problems such as:
- Low muscle mass
- Infertility
- Erectile dysfunction
- Slow hair growth or hair loss
- Loss of bone mass
- Decreased sex drive
- Gynecomastia
Fatigue and mental fogginess are some of the most common mental and emotional symptoms in men with low testosterone.
Diagnosis
To diagnose low testosterone in men, the doctor will perform a physical exam to check your signs and symptoms. They’ll also ask questions about your medical history, medications, smoking history, and any symptoms you currently have. To confirm the cause, the doctor will order some specific blood tests, including:
- Total testosterone level blood test: This test is used to measure the amount of testosterone in the blood. You need to give two samples of blood between 8 am to 10 am, when testosterone levels are the highest. If you’re sick or have recently been sick, you should tell your doctor because an acute illness can give a false result.
- Luteinizing hormone (LH) blood test: This test is used to check the levels of LH in the blood if the cause of low testosterone is due to a problem with your pituitary gland.
- Prolactin blood test: High prolactin levels in the blood can be a sign of pituitary gland issues or tumors.
Treatment
Usually, low testosterone is treated with testosterone replacement therapy (TRT). A doctor will recommend TRT if the person has symptoms of low testosterone and blood test results show a deficiency. TRT can be delivered by several methods based on how severe your low testosterone is. It includes:
- Skin patches
- Gels
- Oral tablets
- Injections
- Surgically implanted pellets that release the hormone
Most people start noticing the difference within 3 to 6 weeks (about 1 and a half months) of starting TRT; however, this can vary depending on the symptom.
Low testosterone in men can occur due to many reasons and cause many different symptoms based on your age. Luckily, it is treatable with testosterone replacement therapy (TRT) based on the severity of your condition. Make sure to notice the symptoms of low testosterone in time to get it treated.
If you want to confirm whether you have low testosterone or not, visit our endocrinology clinic in Brooklyn to get professional medical help. Call us to book your appointment now!!!!!! At Doral Health and Wellness Urology Center, our team of urologists will work with you in managing your disease and your quality of life. We also offer services, such as renal and bladder ultrasound. To schedule an appointment, please visit us at 1797 Pitkin Avenue, Brooklyn, New York 11212 or call +1-718-367-2555 You can also visit our website at https://www.urologistbrooklyn.com/.
