Low testosterone (Low T): Signs, diagnosis, and treatment

In the hormone-driven symphony that composes the music of life, testosterone commands the stage. This potent hormone, mostly linked to masculinity, is more than physical strength and machismo. 

Understanding the significance of testosterone is essential for both men and women to discover the keys to vigor, power and general quality of life.

Together, we will explore the causes and effects of low testosterone to restore our ideal energy, strength and well-being.

What is the role of testosterone?

The “male hormone,” testosterone, has a variety of functions in both men and women. Beyond its link to masculinity, this hormone is an important participant in many physiological processes that support general health and well-being [1]. 

Let’s examine testosterone’s main roles and effects in the human body in more detail.

What is the role of testosterone?
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1. Sexual development and reproduction

The differentiation of male reproductive organs like the penis and testes occurs during fetal development due to testosterone.

It stimulates the formation of secondary sexual traits in males throughout puberty, including facial and body hair, voice deepening and increased muscle mass.

Testosterone helps the ovaries and uterus, two reproductive tissues, in females, develop and remain healthy [2].

2. Libido and sexual function

The male hormone greatly influences the libido and performance of sexual activity.

Nitric oxide, a chemical that dilates blood vessels in the vaginal region and improves blood flow and makes erections easier for males, is stimulated during this process [3].

The effects of testosterone on female sexual arousal and sensitivity are positive.

3. Muscle mass and strength

Since testosterone is anabolic, it encourages the development and maintenance of muscular tissue.

It increases muscular growth, strength and general physical performance by promoting protein synthesis. Due to this, it is frequently linked to athletic ability.

4. Bone health

For maintaining ideal bone density and strength, testosterone is essential. Inhibiting bone resorption while promoting bone mineralization lowers the risk of osteoporosis and fractures. Low male hormone levels can result in bone loss and an elevated risk of fracture [4].

5. Mood and cognitive function

Testosterone affects mental health in general, including mood and cognitive function. Its effects on mood, cognitive performance, and focus are positively correlated. Conversely, low levels can lead to irritation, mood fluctuations and problems with concentration and memory.

6. Red blood cell production

In the bone marrow, testosterone encourages the creation of red blood cells. By ensuring that tissues are properly oxygenated, supports overall energy levels, endurance and vitality.

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Testosterone levels and optimal health

While testosterone is necessary for several body processes, it’s crucial to remember that different people’s ideal levels differ from one another and might change with age.

Male testosterone levels normally peak in early adulthood and then start to fall as they age. This normal aging process, often known as andropause or “male menopause,” can have various side effects on one’s health.

The ovaries and adrenal glands in women generate less testosterone. It boosts libido, physical stamina and general vigor.

Menopause or disorders like polycystic ovarian syndrome (PCOS) can cause imbalances in testosterone levels, which can cause certain symptoms and health issues [5].

The foundation for understanding the possible effects of low male hormones and the significance of maintaining appropriate levels is understanding this hormone’s role.

We can better understand the relevance of identifying imbalances and treating them to attain optimal health and well-being by understanding how the male hormone affects our bodies.

How do you know if you have low testosterone levels?

Numerous physical, emotional and psychological symptoms may appear due to low testosterone, commonly known as hypogonadism. Spotting these symptoms is crucial for early detection and quick action. 

Let’s explore the usual warning signs and symptoms of low testosterone in both males and females.

Physical symptoms

1. Decreased libido and sexual dysfunction 

A decline in sexual desire (libido) and performance is one of the defining characteristics of low testosterone.

Men may become less interested in having sex, have trouble getting or keeping an erection and have fewer morning erections on their own [6].

The desire and reactivity to sex may also decrease in women with low levels.

2. Fatigue and low energy levels

People with low testosterone frequently experience ongoing weariness, poor energy and general lethargy.

They could still feel worn out and lack the desire to do any physical or mental tasks, even after getting enough sleep.

3. Loss of muscle mass and strength

A key factor in the growth and maintenance of muscles is testosterone. Reduced muscle mass, which results in decreased strength and endurance, can be caused by low levels [7].

People may experience reduced physical performance and trouble toning or growing muscle.

4. Increased body fat and weight gain

The distribution of fat inside the body is regulated by testosterone. Body fat might grow due to low levels, especially in the abdominal area. This may result in weight gain and a modification of overall body composition.

Emotional and psychological symptoms

1. Mood swings and irritability

Low testosterone levels can impact mood control, which can result in mood swings that are more frequent, impatience and greater emotional sensitivity [8].

People may notice that their emotions might change suddenly and that they get angry or annoyed more readily.

2. Depression and anxiety

The maintenance of emotional health involves the male hormone. Low levels have been linked to a higher chance of developing symptoms of anxiety and depression.

The emotions of despair, helplessness, worry and a diminished sense of general well-being may be felt by the individuals.

3. Lack of focus and concentration

The amount of testosterone can impact cognitive processes, including concentration, focus, and memory. Concentration issues, memory lapses and overall mental fogginess may be exacerbated by low testosterone.

4. Decreased motivation

It is well-recognized that the male hormone affects motivation and drive. Low testosterone levels can cause people to lose their motivation, lose their excitement and generally lose interest in things they formerly found enjoyable.

What are the causes and risk factors of low testosterone?

Hypogonadism has a variety of risk factors and causes. Accurate diagnosis and successful therapy depend on understanding the underlying causes of low testosterone levels [9]. 

Let’s look at some typical reasons and danger signs of low testosterone.

Causes of low testosterone

1. Aging

It is usual for male hormone levels to decrease as people age gradually. Around 30, this drop normally starts, and it lasts the rest of adulthood. However, not everyone will have severe symptoms or problems due to age-related hormone decrease.

medical conditions and diseases
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2. Medical conditions and diseases

Certain medical conditions can interfere with hormone production and function. These may include:

  • Hypogonadism is when there is inadequate testosterone production from the ovaries or testes. While secondary hypogonadism results from problems with the pituitary gland or brain, which controls male hormone production, primary hypogonadism is caused by problems with the testes.
  • Chronic illnesses: Low testosterone levels can result from chronic conditions that affect hormone synthesis, such as renal disease, liver disease and HIV/AIDS [10].
  • Obesity: Excess body weight, particularly visceral fat, can contribute to low testosterone levels. A hormonal imbalance is caused when adipose tissue changes testosterone into estrogen.
  • Diabetes: Uncontrolled diabetes can affect hormone production and function, contributing to low testosterone levels.
  • Pituitary and hypothalamic disorders: The hormonal signals that control the synthesis of the male hormone can be interfered with by tumors or other disorders in the pituitary gland or brain.

3. Testicular or ovarian injury or dysfunction 

Testosterone production can be affected by surgery, testicular or ovarian damage, hereditary disorders, or other factors.

Low male hormone levels may result from treatments for testicular cancer, orchitis (testicular inflammation), testicular trauma or other diseases [11].

Hormonal imbalances in women can be exacerbated by ovaries-related disorders such as polycystic ovary syndrome (PCOS) or surgical ovarian excision.

Risk factors for low testosterone

1. Age

Aging is a substantial risk factor for decreased testosterone levels in both men and women. Naturally, hormone production decreases as people age.

2. Gender

A lower quantity of testosterone is also produced by girls, even though this hormone is most commonly associated with males. Low testosterone can affect both men and women, albeit it may have distinct physiological effects.

3. Lifestyle factors

Certain lifestyle choices and habits can contribute to low testosterone levels. These may include:

  • Obesity: Low testosterone is linked to excess body weight, especially belly fat, and hormonal abnormalities.
  • Sedentary lifestyle: Lack of physical activity and exercise can contribute to hormonal imbalances and low levels.
  • Poor diet: Hormone production and function can be impacted by bad eating practices, such as a diet heavy in processed foods, sugar and harmful fats.
  • Excessive alcohol consumption: Alcohol abuse can disrupt hormone control and reduce production.

4. Medications and treatments

Particular drugs and therapies can impact the levels of testosterone. Long-term opioid usage, corticosteroid use, chemotherapy and radiation therapy are a few examples.

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How is low testosterone diagnosed?

To diagnose and treat low testosterone levels, accurate diagnosis is essential.

It’s crucial to speak with a healthcare provider if you think you may have low testosterone or are exhibiting connected symptoms.

They will carry out a thorough examination and evaluate your hormone levels using a variety of testing instruments.

Understanding the warning signs and symptoms of low testosterone is the first step in getting a diagnosis.

Let’s look at the typical techniques for identifying low testosterone.

Medical history and physical examination

Your healthcare provider will review your history thoroughly at your session to learn about your symptoms, medical problems, medicines, and lifestyle choices.

They can ask about any present or previous medical conditions linked to low male hormone levels.

A medical examination will also be conducted to evaluate your general health and search for indications of hormone imbalances or associated diseases.

Blood tests and hormone analysis

The main way to identify low testosterone is through blood testing. These tests check your bloodstream for total and free testosterone levels and occasionally other associated hormones.

The most common time to take blood samples is in the morning when hormone levels are greatest. Given that hormone levels might change during the day, many blood tests could be required to establish low testosterone levels.

Additional diagnostic tools

Your doctor could occasionally suggest using additional diagnostic methods to examine the causes and effects of low testosterone. These may consist of:

  • Bone density scan: An examination of bone density, such as a dual-energy X-ray absorptiometry (DXA) scan, may determine the risk of osteoporosis, which has been linked to low testosterone, and can examine the condition of the bones.
  • Genetic testing: If there are concerns about genetic abnormalities or illnesses that impact hormone synthesis, genetic testing may be advised.
  • Imaging studies: To evaluate the shape and condition of the reproductive organs or the pituitary gland, imaging tests such as ultrasound, magnetic resonance imaging (MRI) or computed tomography (CT) scans may be used in some cases.

Consulting a specialist

For further assessment and management, your healthcare provider may occasionally recommend that you see an endocrinologist or an expert in hormone-related illnesses.

Diagnosing and treating hormonal abnormalities, and deficient testosterone, are areas of competence for these professionals.

How do you fix low testosterone?

Several treatments are available to restore hormonal balance and relieve symptoms when low hormone levels are identified.

The underlying reason influences the course of therapy, the patient’s choices and the advice of medical specialists. Here are some common treatment methods:

1. Lifestyle changes

Sometimes, just changing one’s way of life might help raise hormone levels and reduce symptoms of low testosterone. These modifications might involve:

  • Diet and exercise: A wholesome, well-balanced diet full of foods high in nutrients can promote the production of hormones and general well-being. Regular exercise, including aerobic and weight training, can help increase hormone levels and support a balanced hormonal system.
  • Weight management: Increased testosterone levels may result from maintaining a healthy weight, particularly by eliminating extra body fat. Weight loss through exercise and a healthy diet can help improve hormonal balance.
  • Stress reduction techniques: Chronic stress affects hormone production and function. Incorporating stress-reduction strategies like yoga, meditation or relaxation exercises can help increase testosterone production.

2. Testosterone Replacement Therapy (TRT)

It may be advised to use TRT for people with severe symptoms or underlying disorders producing low testosterone.

TRT seeks to replenish the body’s testosterone levels to fall within a healthy range. It can be given in a variety of ways, including:

  • Injections: A medical expert can inject testosterone intramuscularly, commonly done every few weeks. This technique makes a regulated release of the hormone into circulation possible.
  • Gels and creams: Daily application of creams and lotions containing testosterone increases hormone production as the skin absorbs the creams and gels and enters the bloodstream.
  • Patches: These work similarly to gels and creams but are applied on the back, arms or belly. During the day, they gradually release the hormone into the blood.
  • Pellets: Small implants called testosterone pellets are frequently inserted beneath the skin of the buttocks. Over several months, these pellets steadily produce testosterone; when they run out, more must be purchased.

Alternative and complementary approaches

Certain people may look for alternate or complementary methods to control low testosterone in addition to lifestyle modifications and TRT. These may consist of:

  • Natural supplements and herbal remedies: Dehydroepiandrosterone (DHEA) and herbal treatments like ashwagandha or Tribulus Terrestris have been proposed as natural supplements to boost hormone production. However, these supplements’ safety and efficacy might vary, so speaking with a healthcare provider before using them is crucial.
  • Acupuncture and Traditional Chinese Medicine: To improve general well-being and hormonal balance, treatments like acupuncture, traditional Chinese medicine or Ayurveda may be combined with other therapeutic modalities. However, each person may experience these factors differently and with varying effects on hormone levels.

What happens if low testosterone is left untreated?

Low testosterone may significantly impact general health and well-being if left untreated.

Ignoring the signs and not treating hormonal imbalances can result in several problems and perhaps long-term repercussions.

Let’s look at a few of the typical problems:

1. Impact on sexual health and relationships

Sexual health and close relationships can be greatly impacted by low testosterone. Without the right care, individuals may face difficulties like:

  • Decreased libido: Low male hormone levels can cause a reduction in sexual desire, libido and interest in engaging in sexual activities.
  • Erectile dysfunction: Men who suffer from this condition experience erectile dysfunction, affecting relationships, closeness, and sexual pleasure.
  • Loss of intimacy and relationship strain: Lack of intimacy, communication problems, and general relationship discontent can result from untreated low testosterone’s physical and emotional impacts.
Impact on sexual health and relationships
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2. Decreased bone density and osteoporosis

The strength and density of bones are largely maintained by the male hormone. Osteoporosis, characterized by brittle and fragile bones, might raise the chance of developing if this hormone disorder is left untreated [12].

Without the right care, people suffering from this condition may encounter:

  • Loss of bone density: Low male hormone levels can increase the risk of bone loss, resulting in lower bone density and a higher risk of fractures.
  • Increased fracture risk: This disorder also causes weaker bones, which makes affected individuals more prone to fractures, especially in the hips, spine and wrists.

3. Cardiovascular health risks

Low testosterone has been associated with several cardiovascular health risks. If untreated, it could contribute to:

  • Increased risk of heart disease: A higher risk of developing cardiovascular diseases such as coronary artery disease, high blood pressure and heart attacks has been associated with the disorder.
  • Negative impact on lipid profile: A low testosterone level can have a deleterious impact on lipid profiles, including elevated levels of LDL (bad) cholesterol and total cholesterol and other undesirable alterations.

4. Psychological and emotional well-being 

Significant psychological and emotional repercussions may result and individuals may go through:

  • Depression and mood disorders: An increased chance of developing mood disorders, depressive symptoms, and a decline in general psychological health have all been linked to low testosterone levels.
  • Decreased quality of life: Low male hormone levels can negatively affect mood, energy levels, cognitive ability, and general well-being.

5. Increased risk of metabolic disorders

Diabetes and insulin resistance are two metabolic diseases that may be exacerbated by untreated low testosterone.

  • Insulin sensitivity: Reduced insulin sensitivity has been linked to low testosterone, and this can lead to metabolic imbalances and an elevated risk of type 2 diabetes.
  • Weight gain and obesity: The risk of metabolic diseases is further increased by low testosterone, which can lead to weight gain and the buildup of belly fat.

Hence, the risk of long-term health issues can be decreased and these possible repercussions can be mitigated by receiving the proper medical care and treatment.

Closing thoughts

Promptly treating low testosterone can reduce consequences and improve general health and enjoyment.

Remember, get medical advice from a qualified physician for a correct diagnosis and individualized treatment plan if you may have low male hormones or exhibit associated symptoms.

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[1] https://www.everydayhealth.com/hormones/guide/
[2] https://www.ncbi.nlm.nih.gov/books/NBK526128/
[3] https://www.health.harvard.edu/medications/testosterone–what-it-does-and-doesnt-do
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5036835/
[5] https://www.medtextpublications.com/open-access/imbalance-of-hormones-women-with-high-testosterone-1144.pdf
[6] https://www.healthline.com/health/low-testosterone/conditions-that-cause-low-libido
[7] https://pubmed.ncbi.nlm.nih.gov/21058750/
[8] https://pubmed.ncbi.nlm.nih.gov/24016385/
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2948422/
[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9415930/
[11] https://www.gaurology.com/condition/testosterone-deficiency/
[12] https://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-020-0509-6

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