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Low Testosterone or Testosterone Deficiency (Hypogonadism)

Low Testosterone or Testosterone Deficiency (Hypogonadism)

January 21, 2019 testosterone
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Low testosterone is a medical condition, also known as “hypogonadism,” that is caused by a testosterone deficiency.

Testosterone is the most important male hormone. It affects everything in men, from sperm production to libido.

Testosterone deficiency is when your body is not producing enough testosterone. Testosterone deficiency, also known as “hypogonadism,” can happen at any stage of life, particularly when it develops from injury, infection, or some other disease condition.

However, testosterone deficiency is more prevalent among men and women over 40. This is because the most common cause of testosterone deficiency is the steady decline in testosterone that occurs as men and women age. Doctors refer to this condition as an “age-related testosterone deficiency.”

What Is Testosterone Deficiency?

Testosterone is a critical hormone for both men and women. Testosterone is generally recognized as a “male hormone.” It controls all of the physical features we associate with “maleness” – larger muscles, facial hair, deeper voice, etc. However, women make and need testosterone, too but in much smaller amounts than in men.

In both men and women, testosterone is a very critical hormone for your overall health and vitality. Testosterone influences your ability to build muscle. It strengthens your bones, regulates your ability to burn fat, and is critical to sexual arousal and function in both men and women.

Testosterone Deficiency Syndrome, also known as “Hypogonadism,” is a condition in which your body does not produce sufficient testosterone. The conditions may simply be referred to as having a “testosterone deficiency” or “low testosterone.”

How Common Is Testosterone Deficiency?

Men are more likely to develop testosterone deficiency as they get older. According to the Journal of the American Medical Association, testosterone deficiency is common, affecting approximately 7% of men in their 50s, and increases with age.

It is also more common in men who are overweight and men who are in poor general health with long-term health conditions.

One large study in Europe found that testosterone deficiency affected about 2 in 100 men aged 40 to 79 years. Testosterone deficiency affected about 5 in 100 men aged 70 to 79 years.

A testosterone deficiency occurs when, for whatever reason, your body is not making enough testosterone.

Causes of Testosterone Deficiency

Low Testosterone in MenThere can be a number of causes of testosterone deficiencies, such as injury to or disease of the testes or pituitary glands, certain cancers, or genetic conditions. Some medications can also lead to a testosterone deficiency, as can stress, obesity, or alcohol abuse.

However, the most common cause of a testosterone deficiency is simply the natural drop in testosterone levels as you age.

A testosterone deficiency can be caused by an inherited (congenital) trait or something that happens later in life (acquired), such as an injury or an infection.

Several factors can contribute to an acquired testosterone deficiency. Not getting enough exercise, doing the wrong kinds of exercise, a poor diet, and metabolic conditions such as diabetes can lead to low testosterone. However, the most likely cause of testosterone deficiency is the normal drop in testosterone levels that occur as you age.

While there can be many reasons for testosterone deficiency, the condition primarily affects older men. This is because once a man is over 30, the level of testosterone in his blood starts to drop significantly. This type of age-related testosterone deficiency in men is similar to menopause in women. It is, therefore, sometimes referred to as “andropause.”

However, unlike menopause, which happens at a specific time in a woman’s life, andropause in men develops more slowly over time. Once a man is over 40, his testosterone level will drop by as much as 2% per year. By age 70, the average man’s testosterone production is about half of what it was in his 20s.

Testosterone levels are measured in nanograms per deciliter (ng/dL). Typically, the normal range is 300 to 1,000 ng/dL. Anything below 300 ng/dL is considered low testosterone.

Doctors who treat low testosterone recognize two types of testosterone deficiencies: primary and secondary testosterone deficiency. Often primary and secondary testosterone deficiency occur together.

Primary Testosterone Deficiency

When you have a primary testosterone deficiency, that means that you don’t have enough testosterone due to a problem in the organs that make testosterone. In men, that is the testes, and in women, that is the ovaries or the adrenal glands. In a primary testosterone deficiency, the source of testosterone production in your body is still receiving the message from the brain to produce testosterone, but the organs are unable to produce the hormone.

Secondary Testosterone Deficiency

In a secondary testosterone deficiency, there is a problem in the areas of the brain that signal the sex organs to make or release testosterone. This type of testosterone deficiency means that you have a problem in the hypothalamus or the pituitary gland — the parts of the brain that tell the testicles to produce testosterone.

The hypothalamus produces gonadotropin-releasing hormone, which signals the pituitary gland to make follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Luteinizing hormone then signals the testes to produce testosterone.

Testosterone deficiencies can be primary or secondary.

Testing for Testosterone Deficiency

Testosterone DeficiencyThe only way to determine if you have a testosterone deficiency is to have your testosterone levels tested. This is usually done with a simple blood test. In addition to having your testosterone level tested, your doctors will take a complete medical history and do a thorough medical exam before offering a diagnosis of low testosterone.

Any doctor can perform a blood test for low testosterone. However, if you suspect that you have a testosterone deficiency, it is best to be tested by a doctor who specializes in age-related hormone imbalances in men and women.

Your tests will be used to determine your testosterone level. In general, the normal range in males is about 270-1070 ng/dL with an average level of 679 ng/dL. In most men, testosterone levels continue to rise from childhood through adolescence. Testosterone levels peak at about age 20, and then it slowly declines.

There is no special preparation needed for the test doctors use to see if you qualify for testosterone replacement therapy. Doctors usually do prefer to draw your blood sample in the morning.

Testosterone Deficiency Treatment

If you are diagnosed with a testosterone deficiency, the only effective treatment is testosterone replacement therapy. Testosterone replacement therapy raises the body’s testosterone levels through regular administration of testosterone. Testosterone therapy is only available with a doctor’s prescription.

Testosterone replacement therapy can be given in a number of forms, such as creams, topical gels, skin patches, subdermal pellets, or injections. Our doctors have found that intramuscular testosterone injections to be the most effective form of testosterone replacement. Testosterone injections are usually prescribed for a period of six months.

After your first six months of testosterone replacement, you will be evaluated to determine if continued therapy is needed.

What Can I Expect After Treatment for Testosterone Deficiency?

Studies have shown that testosterone replacement therapy provides a wide range of benefits for men and women with testosterone deficiencies. Such benefits include improved libido, mood, cognition, muscle mass, bone density, and red blood cell production. Some of the other benefits of testosterone replacement include:

  • Increased energy and vitality
  • Increased ability to build lean muscle
  • Weight loss, particularly stubborn belly fat
  • Improved ability to focus and other cognitive improvements
  • Increased strength
  • Improve sleep
  • Healthier skin, hair, and nails
  • Stronger bones

In addition, testosterone replacement therapy may reduce the risk of diabetes and some cancers, as well as lower your risk of stroke or heart attack.

You will not experience all of these results of testosterone therapy overnight. It takes time for testosterone injections to reverse all eliminate the symptoms of age-related testosterone deficiency. Your prescription for testosterone therapy will be designed for your body to react to the increases in testosterone slowly over time. The life-changing results of testosterone therapy will impact four major areas of your life:

  1. Physical strength
  2. Sexual performance
  3. Mental acuity
  4. Emotional wellbeing

Your results of testosterone therapy will benefit you in each of these areas of life.

Since testosterone therapy is prescribed on a very individualized basis, results will vary. However, many patients say they start to see improvements in strength and energy in as little as two weeks of being on testosterone replacement.

Testosterone deficiency, or low testosterone, can be effectively treated with testosterone replacement therapy.

Now that you know a bit more about low testosterone and testosterone deficiencies, why not contact us today and learn about the many life-changing benefits that can be achieved with testosterone replacement therapy.

FAQ

Written by Author - Authors/Doctors Authors/Doctors - Medically reviewed by   Reviewers Reviewers - Updated on August 5, 2021

  1. Abram McBride, MD, Culley C. Carson III, MD, Robert M Coward, MD
  2. Nasimeh Yazdani, MD, Stacy Matthews Branch, DVM, PhD
  3. Bruno Lunenfeld, MD, PhD, G. Mskhalaya, MD, Dr. Michael Zitzmann, MD, PhD, FRSM, FECSM, Stefan Arver, Dr. Abraham Morgentaler, MD, Svetlana Kalinchenko, MD, PhD, Yuliya Tishova, MD, PhD
  4. Joshua A. Halpern, MD, MS; Robert E. Brannigan, MD