As men grow older, sometimes they start to experience uncomfortable physical changes that they chalk up to aging. Sure, you’ve gained some weight, but things have been stressful at work, and you haven’t had time to work out. Your sex drive has diminished, but doesn’t that happen to everyone with age? Maybe you’re even increasingly irritated or feeling down for no reason.
But what if there is a reason? What if all these symptoms combine together with one cause: low levels of testosterone?
What Is Testosterone?
Testosterone is the primary male sex hormone. As such, it is responsible for the changes that boys experience in puberty as they become men. Testosterone builds muscles, helps men grow facial hair and even plays a role in burning fat.
And, of course, testosterone plays an important role in sexual development and function. A male fetus develops sex organs thanks to testosterone during gestation, and testosterone hits again in a big way at puberty. The male hormone rises consistently from the beginning of adolescence until about age 30 — at which point, it starts to decline slowly, dropping a little bit each year.
Why Do Testosterone Levels Change?
The normal level of testosterone has a pretty wide range. According to the American Urology Association, 300 and 1,000 nanograms per deciliter is considered normal. But the actual levels of testosterone in men’s blood drops about 1% per year beginning in the 30s — and if your normal was at the lower end of that spectrum, you can hit clinically low levels of testosterone pretty quickly.
In fact, about 40% of men demonstrate low testosterone in their 40s — and the numbers creep up over the decades. Compounding this are factors other than age. Other factors that can result in low testosterone numbers, also known as testosterone deficiency, are wide-ranging. They can include:
- Hormonal imbalances
- Excessive exercise levels
- Metabolic syndrome (a combination of high blood sugar, high blood pressure, high cholesterol and belly fat)
- AIDS or HIV
- Injuries to the testicles
- Radiation and chemotherapy (as treatments for cancer)
- Removal of the testicles (often following cancer)
- Male hypogonadism (failure of the testes to work properly)
- Taking steroid drugs, either prescribed or not
- Malnutrition
- Obesity
- Diabetes
- Klinefelter Syndrome and other rare genetic syndromes
The range of conditions that can trigger low testosterone production is clearly very wide. Interestingly, some of the lifestyle factors cited above can be key to the onset of low testosterone. Men with diabetes are twice as likely to experience low testosterone as other men, and overweight men are five times more likely.
In rare cases, testosterone levels may be unhealthy because they’re abnormally high. Using anabolic steroids can causes levels to spike, and tumors on the adrenal glands or the testicles can also spur unusually high testosterone levels.
Signs of Low Testosterone
Low testosterone affects almost every part of a man’s body, from the heart to the bones to the hair — and of course, sexual function. Low testosterone has been shown to increase the risk of heart disease, and it can be a significant factor in osteoporosis, a disease involving loss of bone density.
In addition, low testosterone affects a man’s mood, often triggering emotional symptoms. These mental health changes aren’t always attributed to low testosterone, making them difficult to treat at times. Take a look at the variety of symptoms that could indicate testosterone deficiency, some of which may be surprising to many men.
Physical Symptoms of Low Testosterone
Many men experience physical symptoms across their whole body as a result of testosterone deficiency. They have trouble building and maintain muscle, compared to their youth, and they notice a drop in their athletic performance and stamina. Paired with this is difficulty burning fat, which (not surprisingly) often results in overall weight gain. In addition, many men experience a general loss of energy, which they often attribute to aging.
More specific symptoms show up in the cardiovascular and skeletal systems. Osteoporosis, though often seen as a disease of elderly women, can hit men whose testosterone levels are subnormal, often resulting in broken bones. Heart disease and diabetes also go hand in hand with low testosterone. And, of course, decreased beard growth and loss of body hair are well-known as signs of testosterone deficiency.
Mental and Emotional Symptoms of Low Testosterone
It’s easy to miss some of the signs of testosterone deficiency, because they affect your moods and general sense of well-being. It’s all too easy to assume that you’re feeling a bit down because of the stress you’re experiencing at work or in your relationship, not realizing that there’s actually a physical, hormonal cause for the symptoms.
While experiencing these symptoms on their own doesn’t necessarily point a finger at low testosterone, men who deal with them on an ongoing basis and who also have some of the physical and especially the sexual symptoms of testosterone deficiency should definitely see a doctor for testing.
Low testosterone can create a sort of brain fog that manifests in the inability to maintain focus or concentration. Paired with this symptom are often memory lapses, irritability without cause, and an overall loss of motivation. In addition, many men with low testosterone levels report experiencing insomnia. Depression is another frequent mood symptom of testosterone deficiency, caused by the hormone levels in the brain.
Sexual Symptoms of Low Testosterone
The sexually related symptoms of low testosterone are the key signs that something is off with your hormone levels. If you see a change in your sexual performance, there’s a good chance that testosterone deficiency could be at play. Low testosterone shows up not only through erectile dysfunction but also through a loss of libido and low sex drive. It also often results in decreased fertility.
Any man who experiences these sexual symptoms in combination with any of the physical or mental symptoms listed above should have his testosterone levels tested.
How to Treat Testosterone Deficiency
If you suspect that low testosterone levels are behind the way you’ve been feeling and the symptoms you’re experiencing, it’s time for some blood tests. Your doctor is likely to ask that you take these tests early in the morning, when men’s testosterone levels are typically at their highest.
If your blood work confirms a diagnosis of testosterone deficiency, the good news is that you have plenty of treatment options available. Should you start on those treatments, you won’t be alone — in fact, the rate of men undergoing testosterone replacement therapy has tripled over the last 20 years or so. If your tests don’t confirm low testosterone, you shouldn’t seek testosterone replacement therapy.
Once you receive a diagnosis of low testosterone, your physician is likely to prescribe testosterone replacement therapy. While many versions of replacement therapy are available, one of the most practical and effective is via testosterone injections.
Testosterone Injections
Testosterone injections are one of the most effective and simple methods of testosterone replacement therapy. These shots go directly into a muscle — typically the gluteal muscles in the buttocks — with testosterone then absorbed into the bloodstream. Since you need repeated shots, ranging from once a week to once a month, it’s often easiest to make arrangements to give yourself the shots in the privacy of your own home.
Other Types of Testosterone Replacement Therapy
While testosterone injections are one of the simplest, cleanest forms of replacement therapy, other options are also available. These include:
- Testosterone patches. These are similar to nicotine patches. Once applied to dry skin, they release measured doses of testosterone through the skin into your blood. They’re moderately easy to use without any mess.
- Oral testosterone. This type of testosterone replacement therapy is also a sort of testosterone patch — only it’s placed along your upper gum rather than on your skin. It releases testosterone slowly over a 12-hour period. Some men experience headaches and gum irritation with this form of treatment.
- Testosterone gels. This form of therapy is similar to the testosterone patch, but without the patch itself. Instead, you rub the gel used in the patches on your arms. Testosterone gel must be reapplied every four days or so, and it’s a good idea to cover it with a dressing. You can overdose on testosterone gel easily if you misapply it, and it’s important to make sure no one else in your household touches it and absorbs testosterone into their bloodstream.
- Intranasal testosterone. This form of treatment also uses a type of testosterone gel. However, instead of rubbing it on your skin, you pump it into your nostrils. This form of delivery must be done three times a day.
- Testosterone pellets. These small pellets are placed under the skin (usually the skin of the buttocks) by a doctor, who will cut a small slit to place the pellets in the fatty tissue. These pellets release testosterone slowly over a period of three to six months, with the pellets dissolving slowly.
Your doctor can help you choose the right type of testosterone replacement therapy. Check with your health insurance company to see what options are available to you.
Testosterone replacement therapy is considered very safe. However, in rare cases, it brings some side effects with it, including a possible risk of stroke and heart disease, depending on your pre-existing conditions. Your doctor may want to check you for any signs of heart disease before you begin testosterone treatment.
Should You Seek Treatment for Testosterone Deficiency?
Have you been experiencing erectile dysfunction or low sex drive combined with weight gain, loss of energy, depression, or any of the other physical, mental, and emotional symptoms detailed above? If you have, it may be time for some testing. Having your hormone levels checked could answer some big questions for you and get you on the path to health and vitality again.
At Texas Men’s Health Group, we respect your privacy, offering HIPPA-compliant telemedicine options to save you the hassle of coming in to the office often. We can even deliver testosterone injections to your home and train you to use them, so you can handle your treatment discreetly on your own. Get started today by making an appointment to talk to one of our physicians.