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What Causes Low Testosterone?

As men begin to age, the amount of testosterone in their bodies decreases. This natural aging process is often what causes decreased testosterone. Up to 40 percent of men begin to experience a reduction in this male hormone in their 40s.

Deficient testosterone levels in young men are less common, and they can happen for a number of different reasons. Read on to learn what causes low testosterone and testosterone deficiency and whether you could be at risk.

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What Is Low Testosterone?

Testosterone is important for male development and fertility. This hormone, produced in the testicles, is responsible for the bodily changes that happen during puberty and for making sperm. Testosterone levels are considered low when the body does not produce enough testosterone on its own.

Testosterone is a crucial hormone in the development of the body. It is responsible for the growth of muscle mass, bone density, even facial and body hair. It also influences the deepening of the voice, the production of sperm, the growth of the prostate, and the sex drive of the individual.

Symptoms of Low Testosterone

Men with a testosterone deficiency may notice physical symptoms, such as fatigue, erectile dysfunction, or an inability to conceive with their partner.

Symptoms of low testosterone are sometimes difficult to recognize since they can look similar to symptoms of other conditions. They also may vary by age. Symptoms include:
• Infertility.
Erectile dysfunction.
• Low body fat.
• Depression or other changes in mood.
• Low sex drive.
• Low muscle mass.
• Hair thinning.
• Fatigue.

What are the Causes Low Testosterone?

Testosterone deficiency syndrome and hypogonadism are other terms often used to describe testosterone levels that have dropped. Some men have low testosterone levels all their lives, while others develop it later in life.

Hypogonadism is a combination of low testosterone levels on evaluation and symptoms suggestive of having low testosterone. There are two main types of hypogonadism: primary and secondary.

Primary hypogonadism

Primary hypogonadism is either inherited or occurs after an illness or injury. It is a testicular problem — the testes do not produce enough testosterone. Primary hypogonadism can be caused by:
• Testicles that failed to descend at birth.
• High levels of iron.
• Klinefelter syndrome.

Secondary hypogonadism

Secondary hypogonadism happens when certain parts of the brain — such as the pituitary gland, which produces hormones, or the hypothalamus, which helps regulate hormones — are damaged.

Factors related to secondary hypogonadism are:
• Age.
• High levels of body fat.
• Autoimmune diseases.

Hypogonadism Treatment

Hypogonadism is a treatable condition with a variety of treatment options, although primary hypogonadism is more difficult to treat. Men who have Type 1 or Type 2 diabetes are especially at risk. Doctors often will perform a blood test if you are showing symptoms of deficient testosterone levels before prescribing any treatment.

Low testosterone treatment options

There are many options to increase testosterone in cases of low testosterone, such as:
• Gels
• Creams
• Patches
• Injections
• Implants

While all of these treatments will introduce testosterone into the body in a controlled way, there may be side effects of these treatments, such as acne, worse sleep apnea,  breast enlargement, testicle shrinkage, and excess red blood cell production resulting in blood clots. Be sure to contact your doctor if your testosterone treatment is having any of these side effects.

For more information about primary and secondary hypogonadism, visit the UPMC Men’s Health Center or call 1-877-647-4636(4MEN).

Editor's Note: This article was originally published on , and was last reviewed on .

About Men’s Health Center

The UPMC Men’s Health Center evaluates and treats conditions affecting men’s sexual and reproductive health. With years of clinical experience in male sexual medicine and surgery, our team has treated a wide variety of conditions and performed thousands of surgeries. We are dedicated to providing patients the highest level of quality care. Our providers understand the intimate nature of male sexual difficulties, and we will work to help you restore your normal level of sexual function in a comfortable, educational, and discreet environment.