The signs, symptoms and treatment of low testosterone
What is testosterone?
Testosterone (sometimes referred to as an androgen) is naturally occurring and is one of the most important hormones in the male body.
Hormones act as the body's chemical messengers which help to control a number of different functions. Testosterone is mainly produced by the testes and production is controlled by two centres in the brain, known as the hypothalamus and the pituitary.
Why is testosterone so important to men?
Testosterone is so important because it plays many crucial roles in our bodies throughout our lives and even before we're born. For example, testosterone helps to determine the gender of the foetus in the womb. Testosterone leads to the development of the male genitals (the penis and testicles) in the womb and at puberty helps all of the male characteristics to develop - like deeper voice, increased muscle mass, body and facial hair etc. Testosterone also continues to be important during all stages of a man's life. In fact testosterone could be thought of as being central to a man's mind, body and sexual function.
What is low testosterone?
Basically, low testosterone occurs when a man's testosterone level is below normal. This medically recognised condition is known as hypogonadism (pronounced: high-poh-go-nad-izzm). Hypogonadism can be caused by malfunction of the testes where testosterone is produced (this is known as primary hypogonadism), or it can be caused by malfunction of the areas of the brain which regulates testosterone production (secondary hypogonadism).
What causes low testosterone (hypogonadism)?
Hypogonadism can be caused by malfunction of the testes or the areas of the brain which regulate testosterone production. For example, injury or cancer of the testes could lead to low testosterone if the testes were not able to produce as much testosterone as normal (primary hypogonadism). Similarly, injuries or infections which affect those areas of the brain which control testosterone production can also lead to lowered testosterone levels (secondary hypogonadism).
Hypogonadism is quite common in men as they grow old. Here there's usually a combination of primary causes (impaired function of testes) AND secondary causes (impaired function of the areas of the brain which control testosterone production). This does not necessarily mean that you have a serious illness affecting the testes or brain, but it could be that these organs are not functioning as well as they used to. When hypogonadism occurs in older men, it is called Late-Onset Hypogonadism (sometimes abbreviated as LOH).
How common is hypogonadism?
Hypogonadism is common in older men, so if you do suffer with low testosterone don't worry, you are not alone! In fact, it has been estimated that up to 1 in 10 men over the age of 50 - increasing to 1 in 5 over 60 - have hypogonadism and have testosterone levels below normal.
As we age, our bodies do not function as well as they did when we were younger, and in men it is expected that testosterone levels will decline with age. However, it is important to note that this is different from hypogonadism where testosterone levels fall below normal. So do remember that hypogonadism is a recognised medical condition and should NOT be considered as an inevitable consequence of aging.
Why is testosterone so important to my health?
Testosterone plays a number of important roles in men. For example, this hormone influences aspects of our short-term health like mood and sex drive, as well as being important to our long-term health by helping to maintain strong bones and a healthy body shape.
How do I know if I have hypogonadism?
It is important to remember that there are many different signs and symptoms associated with hypogonadism and these can vary between different men. The list below shows examples of the signs and symptoms commonly associated with hypogonadism.
Again, please remember that if you do suffer with one, or some of these symptoms, it does not mean that you definitely have hypogonadism - other illnesses can cause these symptoms. Your doctor is the best person to confirm whether you have low levels of testosterone by measuring it. When talking to your doctor or nurse it is important to remind them of all of your current and previous illnesses and medications - because these may be related to low testosterone levels.
 Low mood (feeling depressed) |
MIND |
| Poor concentration |
|
| Unusual or excessive tiredness/lack of energy |
|
| Reduced muscle mass and/or strength |
BODY |
| Increased body fat |
|
| Osteoporosis (‘brittle bone disease’) |
|
| Anaemia (low levels of red blood cells) |
|
| Reduced sex drive - possibly with
erection problems |
SEXUAL FUNCTION |
How is my testosterone level measured?
Measuring your testosterone level is quick and simple. You will have to give a small blood sample (usually in the morning) from which your testosterone level can be measured. It is worth noting that testosterone can be measured in a number of ways. Some doctors measure the total testosterone levels in blood, others measure what is known as 'free' testosterone (testosterone which isn't attached to any other compounds).
Will I need any other tests?
This will depend upon your doctor, your symptoms and your medical history. For example, as well as measuring testosterone levels, some doctors may also use a questionnaire to help assess whether you are suffering with hypogonadism. Additionally, there may be other aspects of your health that may need further examination - like the health of your bones or prostate (a small gland near your bladder).
Should I talk to my doctor about my testosterone level?
Yes - if you think you may have hypogonadism and you can identify with some of the signs and symptoms highlighted earlier, you should discuss this with your doctor. Remember, hypogonadism is a medical condition. There is nothing to be embarrassed about as if you are over 50 years of age you could be among the 1 in 10 men who suffer with the type of hypogonadism associated with age (late-onset hypogonadism: LOH).
What treatments are available for hypogonadism?
There are now many different treatments available for hypogonadism. Treatment that replaces the body's levels of testosterone is referred to as Testosterone Replacement Therapy (TRT) and the different ways in which TRT can be administered currently include oral, injectable and topical therapy.
Is there any further help or information available?
In addition to talking to your doctor or nurse the following organisations may be able to offer further help.
The Pituitary Foundation
PO Box 1944, Bristol
BS99 2UB
0845 450 0375
www.pituitary.org.uk
The Testosterone Deficiency Centre
Klinefelter's Syndrome Association UK
National Coordinator
Klinefelter's Syndrome Association
56 Little Yeldham Road
Little Yeldham
Halstead
Essex CO9 4QT
0845 230 0047
www.ksa-uk.co.uk
The Men's Health Forum
32-36 Loman St
London
SE1 0EH
020 7922 7908
www.menshealthforum.org.uk
www.malehealth.co.uk
