Overview – What is it?
Low testosterone is the underproduction or lack of production of testosterone in men. Testosterone is the hormone that is produced in the testicles and which helps in male development such as deepening of the voice, building of muscles and bone mass, as well as sexual function like sex drive and sperm production. Low levels of testosterone can be due to a number of factors such as hormonal disorder, obesity and certain conditions such as diabetes.
Some of its symptoms are changes in sleep patterns, and sexual changes such as low sex drive. The occurrence of low testosterone can be diagnosed through physical examination, blood tests and imaging tests such as MRI.
It can be treated using hormone replacement therapy and by treating underlying factors such as diabetes.
To prevent yourself from suffering from low testosterone, you can practise a healthy lifestyle by eating healthy and not smoking or using illegal drugs, and by getting treatment for conditions that can lead to low testosterone such as diabetes.
Causes – What causes it?
As a man ages, the testosterone levels decrease, however, for some men, this decrease in the level of testosterone can be due to other factors such as:
- Injury or failure of organs that produce testosterone, such as the testes, and other organs of the male reproductive system such as the scrotum. Having undescended testicles can also cause low testosterone.
- Problems with the pituitary gland (which regulates testosterone) such as tumours in the pituitary gland or hypothalamus, and inflammation of the pituitary gland due to conditions like sarcoidosis, can cause low testosterone.
- Certain conditions such as diabetes, renal disease and hypertension can increase the risk of low testosterone levels.
- Some treatments like chemo and radiation therapy can also increase the risk of low testosterone levels.
Other factors that can increase the risk of low testosterone include:
- Smoking and abuse of other drugs,
- Excessive alcohol intake, and
Symptoms – What do you feel?
The most common symptom of low testosterone levels in men is erectile dysfunction (the inability to have an erection or having an erection that does not last long enough for intercourse). Other symptoms of this reproductive male problem are:
- Low or reduced sex drive,
- Loss or reduction of facial, armpit and pubic hair,
- Reduced occurrence, or total lack of, orgasm during sex,
- Enlargement or discomfort of breasts,
- Strength reduction,
- Sleep problems,
- Memory problems,
- Reduction in the size of the testes,
- Experiencing hot flashes or sweating, and
Other signs that may be realised after tests are conducted include:
- Sperm reduction or absence,
- Osteoporosis, and
- Increased BMI (body mass index).
Diagnosis – How do you diagnose it?
- Physical examination: The diagnosis of low testosterone usually starts in a similar way to the diagnosis of other conditions; by having an initial consultation, during which the doctor finds out the man’s symptoms, his medical history and by doing a physical exam. The physical exam enables the doctor to check:
- the amount of body hair,
- the size of the penis, scrotum, testes and breasts,
- whether the patient has any vision problem, and
- whether there are any lumps in the scrotum and testes.
- Blood tests: This is done to determine the testosterone level, the normal level of testosterone being in the range between 300 ng/dl to 1,000 ng/dl. The level of testosterone fluctuates during the day, being highest in the morning.
- Imaging tests: These are carried out to check for any abnormalities in the male reproductive organs such as tumours in the testicles or the gland that controls production of testosterone (the pituitary gland). These can be done using MRI (magnetic resonance imaging) or CT (computerised tomography) scans.
Treatment – How do you treat it?
The treatment of low testosterone levels depends on its cause. Treatment can be carried out through:
- Treating the underlying cause, such as diabetes and hypertension, that can lead to low levels of testosterone,
- Hormone or testosterone replacement therapy which can be done through:
- Tablets that stick to the gums,
- Gel or patches that are applied to the skin, and
- Pellets that are inserted under the skin.
- Lifestyle changes such as not smoking, reducing alcohol intake, exercising and losing weight can also help in improving testosterone levels in men.
Prevention – How do you prevent it?
A man can prevent himself from having low testosterone levels by:
- Getting treatment for conditions like hypertension, diabetes and pituitary gland problems which if not treated, can lead to a decrease in levels of testosterone,
- Protecting the reproductive organs from injury by, for example, wearing protective gear when playing sports like rugby and hockey,
- Living a healthy lifestyle by:
- Eating a well-balanced, healthy diet rich in fruits and vegetables
- Maintaining a healthy body weight
- Exercising regularly
- Avoiding excessive alcohol intake
- Not smoking or abusing drugs
- Managing stress