Low Testosterone

Overview

Reduced production of the male sex hormone testosterone is a condition called male hypogonadism. The hormone is essential to normal male development during puberty and to the production of sperm. The condition can affect men from birth or appear later in life due to injury, infection, or other causes.

The effects and potential treatments for male hypogonadism will vary depending on the patient’s age and the underlying cause. Some cases of low testosterone can be treated using testosterone replacement therapy.

Primary male hypogonadism is the result of an issue with the testicles. This can result from numerous causes, including injury. Secondary male hypogonadism is the result of problems with the hypothalamus or pituitary gland. These play a crucial role in signaling the production of testosterone by the testicles. The two conditions are not mutually exclusive. Other factors can include inherited traits, injury, and infection.

Symptoms

A variety of different symptoms can occur at various stages of development, including during fetal development. During puberty, symptoms include a lack of normal development, such as body and facial hair growth and the deepening of the voice. In adult men, symptoms can include decreased energy and libido, along with depression.

Diagnosis

Early diagnosis for boys approaching puberty is critical to allow for the effective implementation of measures to ensure proper growth during puberty. Early diagnosis is also beneficial in adult men, where treatment can prevent further complications like osteoporosis.

For boys, the physician will conduct a physical examination to determine if indicators such as muscle mass development, pubic hair, and testicle size are in line with the norms at that age. A blood test can be used to determine testosterone levels, and several tests may be required at different times to account for expected fluctuations.

If testosterone levels are low, the physician must determine the underlying cause. Hormone tests, pituitary imaging, semen analysis, and potentially a testicular biopsy reveal whether the condition is primary or secondary male hypogonadism.

Treatment

The treatment for low testosterone will vary based on the patient’s age and the cause of their condition. In older men, reduced testosterone can be a natural effect of aging, and treatment may be unwarranted.

In Adult Men

The most common treatment for low testosterone in adult men is using a testosterone replacement to restore levels to normal. This approach can mitigate many of the symptoms of low testosterone, including decreased energy and sexual desire, loss of muscle mass, and loss of bone density.

Testosterone replacements can come in many forms. There are gels, injections, patches, nasal gel, and implantable pellets replaced under the skin within three to six months. There are no adequate oral testosterone replacements, as slow-release is an essential feature. Oral testosterone supplements have also been known to cause serious liver problems.

In Boys

Treatment can vary depending on the underlying cause, but most cases of low testosterone in boys are treated with testosterone injections. These injections stimulate the natural onset of puberty and are generally required for no more than six months.

FAQ’s