Testosterone is a sex hormone produced mainly in men by their testicles, although it’s present at low levels in women, too. A lot of men think of it as a pure “sex” hormone, meaning that it’s only function is to improve erectile function. However, testosterone has much more widespread effects. Testosterone affects facial and body hair growth as well as sexual development, including stimulating sperm production and supporting a man’s libido, or sex drive. It also helps build muscle and bone mass to produce the characteristic “male” appearance. Additionally, it is involved in mood, brain health, heart health, and so on.
Testosterone production usually decreases with age, and according to the American Urological Association, about two out of 10 men over age 60 have low testosterone levels (low T), while three out of 10 men in their 70s and 80s have low T. Low T, though, can happen at any age and for a variety of reasons from diet to blood pressure to thyroid problems.
According to the Food and Drug Administration, a normal T range is typically 300-1,000 ng/dL, which is determined by a serum testosterone blood test. If the level drops below 300, men can experience a wide range of symptoms. The testing for low T is a bit more complicated than this range, and those numbers are often not quite accurate, but they are a good starting point.
Here at the office of urologist Dr. William Brant, we specialize in men’s health issues, including low T, and we can provide you with the treatment you need to feel like yourself again. Here’s what you need to know about recognizing the signs and symptoms of the condition.
What are common symptoms of low testosterone levels?
There are a number of symptoms of low T in men. Some of the most common include:
Testosterone plays a large part in a man’s sex drive. Though men can experience a lowered libido as they get older, someone with low T will experience a more noticeable drop in their desire to have sex.
Testosterone not only supports sex drive, but it also helps to achieve and maintain an erection. It’s only one of many components to do so, but it works by stimulating brain receptors to produce nitric oxide, a molecule that triggers a series of chemical reactions required to produce an erection.
With low T, men can have difficulty achieving an erection before sex or having spontaneous erections, though it’s only one component in the process. Research, however, is inconclusive about the value of testosterone replacement in treating ED.
In a review of studies, nearly half showed no improvement in erectile problems with testosterone replacement. That’s most likely because other factors, such as obesity, diabetes, thyroid problems, stress and anxiety, and high cholesterol and blood pressure, also play a role.
Male pattern baldness has a strong genetic component, and it’s a natural part of aging for most men. Testosterone is converted to another hormone, which is responsible for the loss of hair on the head. Some men with very low T may experience a loss of body and facial hair.
Loss of muscle mass
Testosterone plays a key role in building muscle, so men with low T might might experience a decrease in muscle mass, or a new inability to gain muscle at the gym. Studies, however, have shown that although low T does decrease muscle mass, it may not necessarily affect muscle strength or function.
Decreased bone mass
Osteoporosis and osteopenia, the thinning of bone mass, is a condition normally associated with women — especially small, white women of European descent. However, men with low T can also develop osteoporosis since testosterone helps produce and strengthen bone. That means they have lower bone volume and are more prone to bone fractures. Bone density can easily be measured with a DEXA test, and there are medications available to treat the condition, although it’s preferable to get testosterone levels back in the normal range.
Increased body fat
Men with low T not only experience increases in body fat, they can also develop gynecomastia, or enlarged breast tissue. Current understanding pegs this as an imbalance between testosterone and estrogen (the female hormone, which men have in small quantities), since the testosterone level is no longer where it should be. It is important to not just check T in these cases, but also the estrogen level.
Men with low T can have a hard time falling or staying asleep. They also have an increased risk of sleep apnea, a potentially serious disorder in which a person temporarily stops breathing. This not only disrupts sleep, but it can also cause a wide range of physical problems, including heart disease.
Decreased energy levels and mood changes
Low T can reduce energy levels and lead to fatigue, even after adequate rest. And according to some evidence, this may also be paired with mood alterations, including a lack of focus, irritability, and depression.