Low Testosterone in Men: Symptoms and What to Expect

Patient Expert

Since the mid 2000’s there has been a surge in both discussion and treatment of low testosterone. Men have begun to recognize that a cascade of symptoms including low energy, low libido, and issues related to building muscle may be due to low testosterone levels. In the United States alone, approximately 4-5 million males suffer from low testosterone.[1]

The Basics of Low Testosterone – Testosterone is the predominant male sex hormone that is produced primarily in the testicles, and the failure to produce enough testosterone is called hypogonadism. Testosterone aids in building muscle, maintaining a healthy weight, bone density, sperm production, energy production, immune function, and supports libido function.

Conditions Associated with Low Testosterone – People living with certain conditions also have higher rates of low testosterone. These conditions include sellar masses, general diseases of the sellar region, HIV, end-stage renal disease, severe lung disease, metabolic syndrome, type 2 diabetes, and erectile dysfunction.[2]

Symptoms associated with a testosterone deficiency can vary by person, and therefore determining when and if treatment is necessary is not always black and white. Listed below are the most common symptoms associated with low testosterone.

Symptoms Associated with Low Testosterone** [3]**:

  • Reduced sex drive
  • Erectile dysfunction
  • Low sperm count
  • Swelling of breast tissue (also called Gynecomastia)
  • Sexual development issues or reduction in testicle size
  • Reduced muscle strength
  • Low bone density
  • Hot flashes
  • Loss of body hair (especially pubic and armpit hair)
  • Decreased mood or fatigue, motivation, self-confidence, and aggressiveness
  • Depression symptoms
  • Disturbances in sleep patterns
  • Concentration difficulties
  • Increased body fat
  • Decreased work performance
  • Decreased physical performance

General rule of thumb, you should seek medical advice when any of the following symptoms cause mental, physical, or sexual distress. The first step of testosterone therapy is meeting with your healthcare provider. Diagnosis and initiation of testosterone therapy is usually based on the level of testosterone in your blood and the presence and severity of your symptoms.

[1] Edelstein, D., Dobs, A., & Basaria, S. (2006). Emerging drugs for hypogonadism.

[2] Corona, G., Rastrelli, G., Forti, G., & Maggi, M. (2011). Update in testosterone therapy for men (CME). The journal of sexual medicine, 8(3), 639-654.

[3] Bhasin, S., Cunningham, G. R., Hayes, F. J., Matsumoto, A. M., Snyder, P. J., Swerdloff, R. S., & Montori, V. M. (2013). Testosterone therapy in adult men with androgen deficiency syndromes: an endocrine society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism.