A natural and gradual decline in testosterone is normal in men as they age. But some conditions and medications - and even being overweight - can trigger abnormally low levels. A lull in your sex drive may be just one of many subtle clues that could point to an abnormal decline in testosterone.
Though the signs and symptoms are often vague and inexact, a blood test can help tell if your body isn't producing enough testosterone. When this happens, it's called hypogonadism.
What are the symptoms?
Symptoms may include:
- Trouble concentrating
- Hot flashes
- Weak bones
And because testosterone is responsible for male characteristics, a decrease can cause:
- Erectile dysfunction
- Less facial and body hair
- Growth of breast tissue and body fat
- Decreased muscle mass
What causes male hypogonadism?
Some men are born with hypogonadism, while others develop it later in life. It can be caused by a problem in the testicles. Or it can be triggered by faulty hormone signals from the brain that don't stimulate the testicles to produce testosterone.
Other causes of hypogonadism include:
- A genetic abnormality, such as Klinefelter's syndrome, in which males have an extra "X" chromosome. This can cause testicular failure and low testosterone.
- Undescended testicles.
- Problems with hypothalamus or pituitary gland function. These organs produce and control levels of testosterone. Problems may include cancer, injury, inflammation, and autoimmune disease.
- Injury or infection of the testicles.
- Testicular cancer or its treatment.
- Liver or kidney damage.
- Thyroid problems.
- Iron overload (hemochromatosis).
- Effects of alcoholism.
- Use of certain medications:
- Certain corticosteroids
- Antifungal medications
- Certain diuretics or anticonvulsants
How is it treated?
Treatment of hypogonadism depends on the underlying cause. Sometimes testosterone replacement therapy is needed. This is available in several forms, including injections, patches, or gels.
There are some side effects of testosterone therapy. They include prostate enlargement, infertility, and sleep problems.
If you have symptoms that could be hypogonadism, ask your doctor whether you might need your testosterone level checked.
Created on 02/27/2008
Updated on 05/09/2011
- Pallais JC, Au M, Pitteloud N, Seminara S, Crowley WF. Isolated gonadotropin-releasing hormone (GnRH) deficiency overview. GeneReviews. Updated 2010.
- The Endocrine Society. Testosterone therapy in adult men with androgen deficiency syndromes. Journal of Clinical Endocrinology and Metabolism. 2010;95(6):2536-2559.
- Dartmouth-Hitchcock Medical Center. Endocrinology: male hypogonadism.
- Pituitary Network Association. Pituitary disorders: hypogonadism.