Do I Have Low Testosterone?

Both men and women produce testosterone, but for males the hormone plays a star role in puberty when it enables the development of hair growth, libido, muscle mass, bone strength and, most importantly, sperm production. A natural decline in male testosterone occurs after age 30 and begins to drop 1 to 2 percent a year around age 40. 

This isn’t alarming unless testosterone levels drop too far, resulting in a diagnosis of low testosterone, or Low-T. Why is a bigger drop concerning? Because testosterone is crucial not only for fertility but also for sexual drive, cognitive ability, muscle growth, bone stability and mood. Older men tend to naturally have lower testosterone, but a few will experience more noticeable, bothersome symptoms. In these cases, patients should visit their doctors and get screened, because Low-T could aggravate underlying medical conditions.

How Do I Know if I Have Low-T?

Men aged 50 and over should know the signs of Low-T, which include: 

• Changes in sexual desire/libido

• Depression and anxiety

• Reduced muscle mass

• Weakened bones

• Hair loss

• Loss of energy 

• Weight gain

• Anemia

• Hot flashes

• Difficulty sleeping

• Difficulty with memory and concentration

Because testosterone levels are affected by a man’s overall health, a doctor will perform a physical exam to determine if you’re overweight, have diabetes or thyroid problems and whether taking certain medications such as steroids could alter your hormonal levels. In addition, your doctor will order lab tests. Low blood testosterone (Low-T) is identified as less than 300 nanograms per deciliter (ng/dL) on two tests obtained in the morning, according to the American Urology Association.

It’s important to note that changes in testosterone usually affect sex drive, rather than erectile dysfunction (ED). This decline in libido is not a quick drop but largely occurs over time. Many men mistakenly think getting their testosterone replaced is going to improve the quality of their erections, but unfortunately this is not always the case. 

Lifestyle Changes to Improve Testosterone Levels

The safest way to remedy Low-T is through lifestyle changes. Obesity can cause a decline in testosterone and an increase in estrogen. Research has shown in multiple studies that losing weight and at the same time increasing your overall muscle mass can cause a natural increase in testosterone. With your doctor, you might discuss how to:

• Maintain a nutritious, balanced diet

• Exercise

• Decrease stress factors

• Decrease alcohol consumption and smoking

• Improve sleep

What About Testosterone Replacement Therapy (TRT)?

There are several ways to replace testosterone, if medical treatment is warranted. However, these come with risks. For younger men who are still in their fertility years, it’s crucial to understand that replacing testosterone can cause infertility. If fertility is not an issue, then testosterone can be replaced with topical gels, long- or short-acting injections, nasal gels and pellet therapy. Each method has its risks and benefits. 

Some studies have linked excessive testosterone replacement with cardiovascular disease, and there also are links between testosterone and increasing your red blood cells, which could put you at risk for blood clots and other disorders. When a patient has started TRT, they must get routine symptom checks and lab work to ensure there are no increased risks for future problems.