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Low testosterone in men

Low testosterone in men

Published on: 06/20/24 9:28 PM

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How common is low testosterone in men?

Depending on what figures you read, between 20-40% of men will experience low testosterone (T) levels at some point in their lives. Symptoms of low testosterone can be quite general (like tiredness or weight gain) and overlap with many other health conditions. Because of this, low testosterone is often not considered or diagnosed in many men that go to see their doctor with possible symptoms, so we can’t be sure of exactly how many men are affected by low T.

What causes low testosterone?

It’s common for testosterone in men to steadily decline from the mid-30s onwards but only by small amounts, around 1% per year for example. This is not in the same way as a female menopause, which is a much more dramatic decline in several hormone levels.

Some men may have particularly low T levels – or a heightened sensitivity to lower levels – and can develop symptoms of low testosterone, often when in their 40s or 50s.

This is what is generally referred to when you hear talk of the male menopause or ‘man-opause’. The medical term used nowadays for this type of low testosterone is ‘Androgen Deficiency in the Aging Male’ or the handy abbreviation, ADAM.

And it’s important to mention there are other causes of low testosterone apart from age related, including: injury to the testicles, cancer treatments, stress, alcohol abuse, kidney or liver disease, obesity or due to certain medications.

What are the signs of low testosterone?

Here are some common signs and symptoms of low testosterone – and it’s always worth remembering that many of these symptoms can be due to other health conditions too.

  1. Low sex drive – testosterone plays a key role in your libido. It’s normal for your sex drive to decrease a bit with age but if you have low testosterone, it will be a more significant drop in sexual desire and arousal.
  2. Difficulty getting and keeping an erection – there are many reasons why you can get problems with erections (known as erectile dysfunction) such as some heart conditions, diabetes, thyroid disorders, high blood pressure or cholesterol, as well as depression and anxiety, so this symptom would need to be investigated carefully before assuming it’s related to low testosterone levels.
  3. Fatigue and tiredness – it’s common to feel wiped out even if you’re sleeping well, or you may experience problems getting off to sleep or staying asleep and feel very tired as a result.
  4. Increased body fat – this may be due to an imbalance between estrogen and testosterone (men have estrogen too). You may notice more fat over your pecs and feel you’re developing man boobs. This is called gynaecomastia and is a recognised symptom of low testosterone.
  5. Memory and mood changes – testosterone helps your mental agility and skills like concentration, memory and speed of thinking. You might be finding it harder to focus and remember things. You may also notice mood swings, find it harder to regular your emotions, feel irritable or low and depressed.
  6. Hair loss – balding is a natural part of aging for most men and it’s often hereditary but with low testosterone, there can be additional hair loss including loss of hair on the face and body.
  7. Hot flushes – you may feel sudden sensations of warmth spread over your body and perhaps sweating or reddening of the skin. You might get night sweats where the sweating is more pronounced, and you may feel cold rather than hot at these times.

These are just some of the symptoms of low testosterone, there are other signs that may be less noticeable and accumulate over time like loss of bone tissue, causing weaker bones as you get older and a risk of breaking them more easily. There’s also a loss of muscle mass and definition, and low testosterone can also increase your risk of anaemia.

How can I check if I have low testosterone?

It’s relatively straightforward to diagnose low testosterone from a simple blood test but it won’t necessarily provide answers to what is causing your low T levels.

A normal range of testosterone in men is 300 – 1000ng/dL (nanograms per decilitre) and a score of less than 300 would be considered low.

At Summerhill Health, the ADAM screening tool is used before an appointment, which is just 10 quick questions about everyday life, covering things like your energy levels, your work and sports performance, and your sex drive.

Following a consultation with Dr Natalie Summerhill, where you can talk in full about how you’ve been feeling and what symptoms you’ve noticed, you will then be offered a blood test. A series of measures will be checked in your blood including a full blood count, your levels of total and free testosterone (how much there is in total and how much active or available testosterone there is), luteinizing hormone, FSH (follicle stimulating hormone) and blood prolactin levels.

Dr Natalie will then discuss your results with you and you can decide next steps with her support and guidance.

How do you treat low testosterone in men?

If a blood test has confirmed you have low testosterone and ADAM is suggested as the most likely cause, Dr Natalie will discuss the possibility of trialling testosterone replacement therapy with you. This is a gel that you rub into your skin on a daily basis and the hormone is absorbed into the bloodstream through your skin.

She will explain the potential benefits of the treatment and discuss possible side effects or any associated risks. There have not been large scale clinical trials on using testosterone therapy for ADAM long term, but many men do experience benefits to their sex drive and function, their mood and energy levels and their improvements to muscle mass and fat distribution.

Book a consultation with Dr Natalie to explore your testosterone levels further.

For more information about testosterone therapy, read our follow up blog here.

Dr Summerhill is a GP and Menopause Specialist. She qualified from Guy’s, King’s and St Thomas’s (GKT) School of Medical Education in London in 2007. She qualified as a GP from the Royal College of General Practitioners (RCGP) in 2015 and has undertaken specialist training in women’s health having achieved diplomas from the Royal College of Obstetricians and Gynaecologists (DRCOG) as well as the Faculty of Sexual and Reproductive Health (DFSRH). She has the Letter of Competence from the FSRH for both coils and implants. Dr Summerhill has undertaken extensive training in menopause management and holds an Advanced Menopause Specialist certificate with the Faculty of Sexual and Reproductive Healthcare.