Low Testosterone (Hypogonadism)
Below-normal testosterone levels in men causing fatigue, low libido, and other symptoms.
Overview
Low testosterone (male hypogonadism) occurs when the testes don't produce enough testosterone. This causes symptoms including fatigue, decreased libido, erectile dysfunction, mood changes, and loss of muscle mass. Testosterone naturally declines with age (about 1% per year after 30), but true deficiency is when levels fall below normal range with symptoms. It affects about 2% of men overall but increases significantly with age and obesity.
Common Age
Increases with age; common after 45
Prevalence
About 2% overall; 10-25% of men over 60
Duration
Chronic if untreated; manageable with therapy
Common Symptoms
- Fatigue and decreased energy
- Reduced libido (sex drive)
- Erectile dysfunction
- Depressed mood
- Difficulty concentrating
- Decreased muscle mass and strength
- Increased body fat (especially belly)
- Loss of body hair
- Breast enlargement (gynecomastia)
- Decreased bone density
- Sleep disturbances
- Hot flashes (in severe cases)
Possible Causes
- Aging (gradual decline after 30)
- Obesity
- Type 2 diabetes
- Pituitary gland problems
- Testicular injury or infection
- Chemotherapy or radiation
- Chronic diseases (liver, kidney, HIV)
- Medications (opioids, steroids)
- Klinefelter syndrome
- Excessive alcohol
- Obstructive sleep apnea
- Stress and cortisol elevation
Note: These are potential causes. A healthcare provider can help determine the specific cause in your case.
Quick Self-Care Tips
- 1Get testosterone level tested (morning)
- 2Lose weight if overweight
- 3Exercise, especially resistance training
- 4Prioritize sleep
- 5Reduce alcohol consumption
- 6Manage stress
- 7Review medications with doctor
- 8Don't use testosterone without proper diagnosis
Disclaimer: These are general wellness suggestions, not medical treatment recommendations. They may help manage symptoms but should not replace professional medical care.
Detailed Treatment & Solutions
1DIAGNOSIS
Total testosterone test (morning, fasting). If low, repeat with free testosterone. Check LH/FSH to determine cause (testicular vs. pituitary). Rule out other causes of symptoms.
2LIFESTYLE MODIFICATIONS
Weight loss can significantly increase testosterone. Resistance exercise boosts T. Sleep 7-8 hours. Reduce alcohol. Manage stress. These may be sufficient for borderline cases.
3TESTOSTERONE REPLACEMENT THERAPY (TRT)
For confirmed hypogonadism with symptoms. Options: injections, gels, patches, pellets. Requires ongoing monitoring. Can affect fertility.
4MONITORING ON TRT
Regular blood tests: testosterone, hematocrit (can rise), PSA. Adjust dose based on levels and symptoms. Watch for side effects.
5FERTILITY CONSIDERATIONS
TRT suppresses sperm production. If fertility desired, alternatives include hCG or clomiphene to stimulate natural production.
6ADDRESS UNDERLYING CAUSES
Treat sleep apnea. Manage diabetes. Review medications. Pituitary issues need investigation. Treat any identified causes.
Important: Always consult a healthcare professional before starting any treatment regimen. The solutions above are for educational purposes and may not be suitable for everyone.
Risk Factors
- Age over 45
- Obesity
- Diabetes
- Opioid use
- Chronic disease
- Sleep apnea
Prevention
- Maintain healthy weight
- Regular exercise
- Adequate sleep
- Limit alcohol
When to See a Doctor
Consult a healthcare provider if you experience any of the following:
- Symptoms of low testosterone
- Fatigue and low libido affecting quality of life
- Erectile dysfunction
- Before considering testosterone supplements
- If using testosterone, regular monitoring needed
Talk to a Healthcare Provider
If your symptoms are persistent, severe, or concerning, please consult with a qualified healthcare professional for proper evaluation and personalized advice.
Frequently Asked Questions
QDoes testosterone decrease with age?
Yes, testosterone naturally declines about 1-2% per year after age 30. This is sometimes called "andropause" or "late-onset hypogonadism." However, many men maintain adequate levels into old age. True deficiency requires both low levels AND symptoms. Age-related decline alone doesn't always require treatment.
QIs testosterone therapy safe?
When properly prescribed for diagnosed deficiency and monitored, TRT is generally safe. Risks include increased red blood cells (polycythemia), possible prostate issues (controversial), skin reactions, sleep apnea worsening, and infertility. Don't use testosterone without medical supervision or proper diagnosis.
Related Conditions
Sleep Apnea
A disorder where breathing repeatedly stops and starts during sleep.
Depression
A mood disorder causing persistent feelings of sadness and loss of interest.
Sleep Apnea
A serious sleep disorder where breathing repeatedly stops and starts during sleep.
Type 2 Diabetes
A chronic condition affecting how the body processes blood sugar.
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Medical Disclaimer
The information on this page is for educational purposes only and is not intended as medical advice. It should not be used for self-diagnosis or self-treatment. Always seek the guidance of a qualified healthcare professional with any questions you have regarding a medical condition. If you are experiencing a medical emergency, call your local emergency services immediately.
Information last reviewed: January 2026
This page provides educational information only. It is not medical advice.