Testosterone deficiencies affect nearly 30% of men, especially those at or after the age of 40. While a decrease in testosterone is usually thought of as only afflicting older men, testosterone deficiencies can affect any male, including boys.
With a range of side effects and possible treatments, it is essential for individuals, especially men, to be aware of the signs and symptoms of lowered testosterone.
Table of Contents
- What is Testosterone?
- Low Testosterone in Men
- Low Testosterone in Women
- Signs and Symptoms of Low Testosterone
- Causes of Low Testosterone
- Health Effects of Low Testosterone
- Treatment of Low Testosterone
- What Are Normal Levels of Testosterone?
- Is it Normal to Lose Testosterone as You Get Older?
- Does Testosterone Therapy Work?
- What Tests Will Be Done for Testosterone?
- Can You Be Too Old to Get Testosterone Treatment?
- Is Testosterone Treatment a Lifelong Process?
- Can I Get Too Much Testosterone?
- Are Men with Diabetes More Likely to Have Low Testosterone?
- If I Have Low Sex Drive Does That Mean I Have Low Testosterone?
What is Testosterone?
Testosterone is a hormone made through Leydig cells that is found primarily in men, but it can also be found in women.
It is most commonly known as the critical factor in the development of secondary sexual characteristics in men, such as body hair and voice changes.
In women, testosterone is found in the ovaries and assists in regulating menstruation and ovulation.
For a complete overview of what testosterone is and how it works, read our previous article, “Everything You Need to Know About Testosterone.”
Low Testosterone in Men
Clinicians generally agree that low testosterone in men results from the failure or inability of the testes to produce normal levels of testosterone.
Often, this inability to produce, or a reduction in ability, is caused by one or several problems in the hypothalamus, pituitary glands, and gonadal glands of the endocrine system.
Clinicians are more recently studying areas of the brain where the production processes of testosterone are regulated.
This area of the brain may work in conjunction with the testes to produce testosterone and hormones ineffectively.
It is natural for men’s testosterone levels to decrease as they age. Levels of testosterone begin to fall increasingly after the age of 40. Nearly half of men have “low” levels of testosterone by the age of 45.
For many men, this slow reduction in hormone levels does not cause any detrimental side-effects or interfere with the quality of life.
However, some men may find that their lowering testosterone levels during the aging process lead to loss of muscle mass, loss of bone density, depression, and a decrease in sexual drive or pleasure.
When are Testosterone Levels Considered Low?
Scientists and doctors have not entirely agreed upon a number that distinguishes when testosterone levels are low, primarily since normal testosterone levels and thresholds differ between individuals.
The Endocrine Society notes that the lowest testosterone levels for men that are still within normal range rest at 300 ng/dL. Therefore, testosterone levels that are less than 300 ng/dL are considered too low and abnormal (<300 ng/dL).
The American Association of Clinical Endocrinologists suggests that 200 ng/dL is perhaps the lowest number to be considered normal.
As a general standard, testosterone levels between 200-300 ng/dL are considered in the lower limits and may be regarded as for treatments that increase testosterone levels.
Low Testosterone in Women
While women do not produce nearly as much testosterone as men, testosterone regulates many drives of the female body.
Testosterone influences the sexual drive in the female body, the production of blood cells, and the regulation of menstruation and ovulation, fertility, and fat distribution.
Since testosterone regulates the sex drive, women with lowered levels of testosterone may experience a decrease in libido, a decrease in sexual intensity during intercourse, and a reduction in fertility.
Just like men, women also experience a decrease in hormonal levels around the age of 40. At this time, usually during menopause, both testosterone and estrogen totals decrease by nearly half.
Signs and Symptoms of Low Testosterone
There are many different specific and non-specific signs of testosterone deficiency in men. Signs and symptoms may differ between individuals, and they can vary in age.
Specific and direct signs of lowered testosterone in men can include the following:
- Diminished sexual drives
- Low/loss of bone densities
- Shrinking testes (or reduction in size)
- Loss of body hair
- Erectile dysfunction
- Difficulty in orgasm / reduced intensity
- Reduced sensation in the genital area
- Slow development of tissue or fat in the chest (breast) region
- lowered sperm count
- Lowered strength
- Changes in skin
One of the more serious symptoms of low testosterone is decreased bone density.
The bones become weaker, frail, and thinner. The slow loss of density makes these men more susceptible to bone fractures and breaks.
There are also less direct signs of lowered testosterone. These symptoms may be harder to see or recognize, but they could be signs of reduced testosterone.
- Depression, or depressed moods
- Mood swings
- Lack of energy
- Inability to sleep
- Sleep disturbances
- Increased fatigue or sleepiness
- Inability to concentrate
- Poor memory
- Weight gain/increase in body fat
- Reduction in work performance
Signs and Symptoms in Boys
Testosterone is present in the male body even before puberty occurs. This hormone is essential to the development of the male body, so signs and symptoms may be present in boys with lowered testosterone levels.
Boys who have lowered levels of testosterone may grow, but their frames are not filled out with muscle mass, muscle density, or bone density. This makes some boys look lanky and characteristically effeminate.
Boys who are not changing their voice or body hair may have lowered levels of testosterone that should be tested.
Signs and Symptoms in Women
Women can experience some of the same symptoms of men, but since testosterone regulates different bodily processes, women do experience some various symptoms of testosterone deficiency.
- Diminished sexual drives
- Low/loss of bone densities
- Difficulty in orgasm / reduced intensity
- Increased fatigue or sleepiness
- Inability to concentrate
- Poor memory
- Lowered strength
- Irregular Menstruation / Ovulation
- Blood disorders/anemia
Causes of Low Testosterone
Lowered testosterone or reduced testosterone production can be a result of causes both internal and external to the body.
Externally, injuries may be done to the body that affects or stop testosterone production. For instance, trauma done to the testicles can disrupt the production of testosterone in the testes. Similarly, castration also may act as injury, stopping the production of testosterone.
Health concerns can also affect testosterone levels of production. Infection may cause damage to the testicles, stopping the production of hormones.
Drugs and prescription medications, such as opiates, can cause imbalances in testosterone production.
Health disorders and diseases can significantly affect testosterone levels, especially the pituitary and glandular disorders. Diabetes can hinder testosterone production, as well as diseases of the liver, kidney, and brain.
A key factor in low testosterone or hormone production is genetics. The ability to produce hormones is part of genetic sequencing, so abnormal hormone production can be passed down through generations. Genetic diseases, such as Prader-Willi Syndrome, can significantly hinder testosterone levels.
Causes in Women
There are two primary causes of low testosterone in women. The first is the menopause. The menopausal process severely cuts the amount of testosterone in the body, which is minimal before this change.
Scientists now believe that genetics may affect a woman’s ability to produce compounds necessary for testosterone to form. Therefore, genetics in women may prohibit the production of needed enzymes.
Like men, trauma to the ovaries can affect the production of testosterone, especially if the ovaries were removed or malformed.
Medications may disrupt the production as well, especially if a woman is taking estrogen or birth control.
Health Effects of Low Testosterone
Testosterone, like the, may affect other hormones in the body, regulates bodily processes and development. Therefore, any hormonal imbalance hinders healthy bodily functions and normal development.
Lower levels of testosterone can contribute to the following health conditions:
- cardiovascular diseases
- inflammatory arthritis
- bone fractures
- lung diseases
- renal disease
- swelling and tenderness in breast tissues
- Changes in metabolic rates
Treatment of Low Testosterone
For those who experience lowered levels of testosterone or testosterone deficiency, there are several different options to boost hormone levels or hormone production.
Some forms include injections, gels, patches, nose pumps, mouth tablets, and pills.
The Difference Between Testosterone Replacement Therapy and Testosterone Boosters
There is a significant difference between testosterone replacement therapy (TRT) and testosterone boosters.
Boosters are supplements with chemicals or ingredients that convince the body to produce more testosterone. Boosters may or may not include testosterone.
The purpose of testosterone boosters is to persuade different regulators of the body, such as the brain, to produce more testosterone.
Boosters can include Tribulus, which is an ingredient that convinces the brain to create and send luteinizing hormones to the testicles. The testicles then attempt to produce more testosterone.
Eurycoma is an herbal substance found in many boosters. This herb stimulates the Leydig cells, which are the primary producers of testosterone in the testes. It also makes testosterone less chemically bound to proteins, allowing the testosterone to be absorbed quicker into muscles.
Aside from stimulating testosterone production, individuals utilize boosters to increase muscle mass and build strength quickly.
Boosters can be easily obtained, but many are questioned by the FDA because of their ineffectiveness in stimulating testosterone production and due to their misuse by athletes or bodybuilders.
A study done in 2014 (Corona) shows that testosterone supplements (or boosters) can help men who medically show lowered levels of testosterone but may not be sufficient for men who do not have biologically lower levels of testosterone.
Testosterone Replacement Therapy (TRT), on the other hand, is a medical treatment for lowered testosterone levels. TRT more often contains testosterone explicitly, and it also excites testosterone production. TRT restores medically low testosterone levels.
TRT can also contain steroids, which is why it must be administered by a medical professional.
TRT and boosters can be delivered through various forms; however, keep in mind that boosters generally use natural ingredients to encourage the body to produce more testosterone.
Injections are shots of either medically prescribed testosterone or chemical stimulants that are usually given every 2-5 weeks.
This number can change based on your body type and testosterone levels. This form of testosterone boosting can be painful, but it is perhaps the least inexpensive method.
Some methods involve applying a gel to the inside of the nose or spraying testosterone up the nose. This method can be uncomfortable. It is also not as reliable as other methods.
The levels of testosterone in the body can fluctuate significantly between doses rather than remain stable. In the end, the fluctuations may render the enhancers and the method of delivery useless to the body. Therefore, this method is not as popular or as reliable as others.
Patches are conventional methods of delivery since they appear less intimidating and less painful than other methods. With this delivery system, a patch is placed on the skin, usually the arm or another place with thin skin.
The testosterone stimulants carried in the patch is absorbed through the skin and is then released into the bloodstream.
Patches can be an annoyance because they usually must be applied to the skin every day. This also makes them relatively expensive.
Those who have sensitive skin may not be able to use the patches. Some patches have been known to irritate the skin, cause rashes, form blisters, and cause uncomfortable itching.
Mouth tablets are gelatin, or gel-based, capsules that are placed on the gums. Usually, the tablet is placed above the incisors, but some tablets can be placed behind molars.
After placing the tablet against the gums, it dissolves and slowly releases testosterone boosters, which make their way to the bloodstream.
The mouth tablets can be challenging to use at first. However, other activities, such as eating and drinking, can be done while the tablet is in place.
There can be some side effects when using tablets. Some users have found that the tablets irritate the mouth and gums, cause bad breath, render the gums tender, create a bitter taste in the mouth or throat, and cause headaches.
While there are some testosterone pills on the market, these are not recommended and rarely offered by doctors.
Testosterone pills have been clinically proven to cause damage to the liver. This is because most pills are more testosterone than testosterone stimulants.
The other methods of delivery mentioned bypass the liver and move directly into the bloodstream. Therefore, they are much safer than testosterone pills. Testosterone pills should be avoided.
Pairing Treatment with Lifestyle
Treatments should always be coupled with a healthy lifestyle, which includes exercise, healthy eating habits, smoking avoidance, and avoidance of excessive drinking.
These healthy habits both speed up metabolic processes and promote lean muscle, but they also improve and promote the production of testosterone in both the adrenal glands and testes.
Those Who Should NOT Get Treatment
While men with lowered levels of testosterone may immediately seek hormonal supplements of hormonal therapy, getting treatment is not possible for some individuals.
Those with severe pre-existing conditions may not be able to receive testosterone treatments.
Those with prostate or breast cancer will not be able to receive treatment. The same applies to those with heart diseases, sleeping disorders, and blood diseases.
Those with autoimmune disorders may also not be eligible for testosterone therapies or supplements.
Tracking Your Testosterone
Regardless of gender, you must track any changes in your body that signal a reduction in testosterone.
Aside from affecting sexual pleasure, testosterone hormonally regulates and influences several processes in the human body. This means it should be considered seriously.
For those with hormone deficiencies, there are options to treat the symptoms and increase your quality of life.
Understand that you are not alone, and testosterone deficiency is common among men and women.
It is your job to observe your own body and know when it is time to seek help and maintain your health.
What Are Normal Levels of Testosterone?
Normal levels differ between individuals. The average for men is between 300 and 1000 ng/dL. For women, the average range is 8 to 60 ng/dL.
In both men and women, the number decreases as one gets older.
Is it Normal to Lose Testosterone as You Get Older?
Yes. This is very normal. Men begin to reduce levels around the age of 40 significantly. Women’s levels cut in half during menopause.
Does Testosterone Therapy Work?
Yes. Doctors treat many patients with testosterone therapy delivered through various methods. It is best to work with your doctor to decide on the correct amount for your body and your needs.
What Tests Will Be Done for Testosterone?
There are several tests available to determine testosterone levels. There are blood, breath, urine, and serum tests. More often than not, the doctor will begin with an interview, asking about your history and symptoms.
The doctor may log your physical features and then order a lab test if he/she suspects there is a testosterone deficiency.
Can You Be Too Old to Get Testosterone Treatment?
There is no age limit to testosterone treatment. The only limitations are health limitations, such as cancers and some diseases. However, age rarely plays a factor in testosterone treatment or therapy.
Testosterone boosters are accessible to nearly everyone.
Is Testosterone Treatment a Lifelong Process?
In many cases, testosterone treatment does require a long-term, sometimes life-long commitment. Since the body is not producing testosterone, treatment is necessary to replenish testosterone.
When treatments are discontinued, the symptoms of testosterone deficiency return. Therefore, treatment is usually lifelong.
Can I Get Too Much Testosterone?
Yes. While the threshold may be high, men can receive too much testosterone. When this happens, the male body sometimes coverts the hormone into estrogen.
Too much testosterone is a serious concern for women, as it can lead to PCOS, unwanted body hair, and changes in voice.
Are Men with Diabetes More Likely to Have Low Testosterone?
Yes. Men with diabetes tend to be at risk for lower testosterone. At the same time, men with lower testosterone are at higher risk of developing diabetes.
The hormone testosterone helps the body process insulin to combat sugar levels in the blood. If testosterone is low, then the body is less adept at producing insulin and processing blood sugar.
If I Have Low Sex Drive Does That Mean I Have Low Testosterone?
Having a low sex drive does not necessarily mean you have lowered levels of testosterone. Many factors play into sexual drive and desire. Some of these factors are psychological.
Depression can lower sexual drive, along with stress. Others may find themselves too busy.
It is best to examine your own life to see if other causes are first impacting your sexual drives.
Corona, G., Isidori, A., Buvat, J., Aversa, A., et al. (2014). “Testosterone supplementation and sexual function: A meta-analysis study.” The Journal of Sexual Medicine, 119(6), 1577-92.
Hoberman, J. M., & Yesalis, C. E. (1995). “The history of synthetic testosterone.” Scientific American, 272(2), 76-81.
Miner, M., Barking, J., & Rosenberg, M. (2014). “Testosterone deficiency: Myth, facts, and controversy.” Canadian Journal of Urology, 21(2), 39-54.
Tsametis, C., & Isidori, A. (2018 Sept). “Testosterone replacement therapy: For whom, when, and how?” Metabolism-Clinical and Experimental, 86, p. 69-78.