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What Are the Signs of Low Testosterone in Men?

Dr. Patrick Carroll, MD
Medically reviewed by Patrick Carroll, MD Written by Our Editorial Team Last updated 3/6/2020

Of testosterone’s many roles in human function and development (for men and women), most of us know it as  the hormone that turns boys into men.

It causes hair to start growing on your face and chest. It causes your voice to deepen. It causes a whole host of other changes, both mental and physical.

The male body produces this essential hormone at a specific rate and it plays a role in many sexual and developmental processes. But what happens when your body doesn’t produce enough testosterone?

Keep reading to learn more about the signs of low testosterone as well as its effects.

What is Testosterone?

Testosterone is the male sex hormone and it belongs to a class of hormones called androgens. Though testosterone is present in both males and females, it is produced in much higher quantities in males and it plays a role in the development of the male reproductive organs and other sex-specific characteristics. 

In men, testosterone is produced in the testicles where it also stimulates sperm production. Production of this hormone ramps up during puberty and begins to slowly decline after the age of thirty.

Though a decrease in testosterone levels is normal, it can occur at an abnormally fast rate for some men. Changes in testosterone production can lead to problems with sex drive, sperm production, muscle mass, fat distribution, bone density, and even red blood cell production. 

Even though it may not be life threatening, low testosterone can contribute to some significant side effects.

What Are the Most Common Signs of Low-T?

When it comes to the symptoms of low testosterone you must consider the difference between total testosterone, and free testosterone and bioavailable testosterone. A study of healthy non-obese American and European men between 19 and 39 years old found the normal range of total testosterone levels to be  between 264 and 916 ng/dL. 

if you fall somewhere within that range, treatment generally isn’t necessary, but you may still want to take a look at your free testosterone level.

Free testosterone is a measure of how much of the hormone is not bound to proteins, while bioavailable testosterone is a sum of the amount that is not bound to protein (free) in addition to the amount bound to albumin, a specific type of protein made in the liver.  

If your total testosterone level is within the healthy range but you are experiencing symptoms of low-T, it could be that your bioavailable  testosterone levels are low. Low free testosterone levels are sometimes linked with sexual dysfunction — these are the primary symptoms associated with low-T in general.

Here is an overview of some of the most common signs of low testosterone in men:

  1. Reduced sex drive (libido). Many men experience a drop in libido as they get older, but low-T can cause a more drastic reduction, particularly in younger men.
  2. Erectile dysfunction. Low-T can make it difficult for you to achieve and maintain an erection. Your body needs testosterone to stimulate the production of nitric oxide which triggers a set of reactions that allow for an erection to occur.
  3. Decreased semen volume. In addition to affecting your ability to achieve an erection, low-T can also make it more difficult to ejaculate and may affect the volume of semen in your ejaculate.
  4. Hair loss. Though hair loss is genetic for many men, low testosterone can speed up the process or cause it to affect the face and body as well as the head.
  5. Low energy levels. Many men with low-T report a decrease in energy levels or even severe, chronic fatigue even when they get enough sleep.
  6. Increase in body fat. When your hormone levels become imbalanced, it can affect your metabolism and the way your body burns or stores fat. When testosterone and estrogen levels are out of balance, you may gain body fat — particularly in the breasts.
  7. Decrease in muscle mass. Testosterone plays a key role in building muscle mass so low-T might lead to a decrease in lean muscle mass. Keep in mind, however, that changes in muscle mass don’t always accompany changes in strength or muscle function.
  8. Loss of bone mass. The hormone testosterone plays a role in producing and strengthening bone, so low-T can sometimes contribute to osteoporosis, or a loss of bone density. Low bone density may increase your risk for bone fractures and breaks.
  9. Changes in mood. Not only does testosterone play a role in many physiological processes, but it can also impact your cognitive function and your mood. Men with low-T have a higher risk for depression, trouble concentrating, and irritability.
  10. Sleep disturbances. Though low-T sometimes causes extreme fatigue, it may also lead to insomnia or other sleep disturbances.

What Can You Do About Low T?

As you get older, your hormone levels naturally change. For women, production of the primary female hormone estrogen drops rapidly during menopause and production eventually stops altogether. For men, however, testosterone levels decrease gradually and never completely bottom out. Once your testosterone levels reach about 300 ng/dL you are likely to start experiencing symptoms. At that point, it is up to you and your doctor to determine whether you want to undergo some form of treatment.

For very low testosterone, hormone replacement therapy is an option.

Though testosterone replacement therapy (TRT) may improve some of your symptoms, it is not without its risks. Testosterone therapy could increase your risk for blood clots which, in turn, raises your risk for stroke. There is also some evidence to suggest that TRT may be linked with an increased risk for prostate cancer, though it has not been definitively proven.

If you are concerned about your testosterone levels but TRT is not for you, there are some other options available. Engaging in high-intensity interval training (HIIT), for example, has been shown to naturally boost testosterone levels. Achieving and maintaining a healthy bodyweight with plenty of lean muscle mass is also beneficial for your hormonal balance

Even though it is natural for your testosterone levels to decrease over time, you shouldn’t lie back and accept the consequences - you have options! By being open and honest with your doctor about your symptoms, you can come up with a course of action that will help you to preserve or increase your testosterone production.

Don’t be embarrassed — speak up and stand up for yourself! You are the only one who can.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.