Low Testosterone

What is Low Testosterone?

Testosterone is a hormone that men and women produce for reproductive and sexual function.  In men it is the primary sex hormone that regulates.  It assists with the development of the penis, testis, facial hair, muscle and bone growth during puberty.  Testosterone maintains bone and muscles during a man’s life and impacts on his mood and libido.  Low testosterone can affect a man’s quality of life, social and mental wellbeing.  There is a wide range of opinion on what the lower level of Testosterone that indicates treatment is required.  Talking to your GP rather than taking advice from other sources is always recommended.

How do I know if I have it?

There are a number of things that you may notice if you have low testosterone.  They include low libido, poor erections, less hair on your body face or head, low muscle mass, fatigue, putting on weight and feeling like you’re depressed.  Other things like poor memory, poor concentation, low energy and issues at the workplace may also indicate low testosterone levels.  To test for this, you will need to be reviewed by your GP.  They will discuss with you how you are feeling, examine you and arrange for a blood test.  The level that is found will indicate the type of treatment that is required.  At times a referral to a specialist called an Endocrinologist may be required. 

How does this happen?

There are a number of reasons that a man can develop low testosterone.

The most likely reasons are:

  • Age: as men get older the testosterone level drops by 1% per year from his 30’s.
  • Obesity: Metabolic syndrome (high blood pressure, high blood sugar, unhealthy cholesterol levels, and belly fat). Use of medications such as antidepressants and narcotic pain medications.

Rare causes include:

  • Genetic: Klinefelter syndrome, Noonan syndrome, Ambiguous genitalia (all occur at birth)
  • Injury to the testis: trauma, removal of testis due to cancers and chemotherapy or radiotherapy.
  • Pituitary gland: injury or disease of the pituitary gland reduces the hormone that tells the body to produce testosterone.
  • Autoimmune disease: this is when the body forms antibodies to itself and destroy the cells that produce the testosterone.

How do I fix it?

After a complete history, examination and investigation has been undertaken by your GP, they will consider if a referral to an endocrinologist is warranted.  They may choose to start the man on replacement therapy.  There are a variety of methods of delivery for testosterone including, injection, patches, gels and pills.  Your doctor will discuss which of these is most suitable for you.  There are some possible side effects of using such medications, weight gain, acne, exacerbation of heart disease and develop of cancers such as prostate cancer.

Where can I get more information?