What to know about Low Testosterone? Definition, Causes, Effects and Treatment

Low testosterone, or hypogonadism, occurs when the body fails to produce sufficient testosterone, the hormone vital for male development and various bodily functions. 

The main causes of low testosterone are aging, medical conditions like diabetes and obesity, injuries to the testes, hormonal disorders, and certain medications. 

The effects of low testosterone include decreased libido and interest in sex, difficulty achieving and maintaining erections, feeling tired and lacking energy, decreased muscle mass and strength, reduced bone density, depression, irritability, mood swings, and balding and loss of body and facial hair.

Hormone replacement therapy (HRT) is the primary treatment, which aims to restore normal hormones and alleviate symptoms.

What Is Low Testosterone?

Testosterone is the chief male hormone responsible for regulating sex differentiation, developing male sex characteristics, spermatogenesis, and fertility, according to Nasser and Leslie (2023) in their paper Physiology, Testosterone.

Li et al. in their Increased risk of testosterone deficiency is associated with the systemic immune-inflammation index: a population-based cohort study highlight- “Testosterone deficiency (TD) was defined as a serum testosterone level ≤ 300ng/dl.”

Testosterone influences muscle mass, bone density, red blood cell production, and sexual function. Quantities are between 300 to 1,000 ng/dL, and low testosterone is diagnosed when it falls below 300 ng/dL.

According to findings presented at the 2020 American Urological Association Virtual Experience, testosterone levels in adolescent and young adult men (AYA) have declined by 20%-25% from 1999 to 2016.

West Palm Beach boasts a growing population of over 111,000 residents, averaging nearly 40 years old, as The Palm Beach County Health Needs Assessment reported, emphasizing the critical need for ample hormonal treatment facilities and staff.

Low Estrogen vs. Testosterone Imbalance (Low T)

Low Estrogen

Estrogen, predominantly a female hormone, is essential for reproductive health, bone density, and regulating the menstrual cycle. Low estrogen occasions diverse health issues, viz:

  • Hot Flashes and Night Sweats: Sudden feelings of heat, accompanied by sweating.
  • Irregular Menstrual Cycles: Changes in cycle length and flow.
  • Bone Density Loss: Augmented risk of osteoporosis.
  • Mood Swings and Depression: Emotional instability and depressive symptoms.
  • Vaginal Dryness: Spawning discomfort during intercourse.
  • Fatigue: Persistent tiredness and lack of energy.

Testosterone Imbalance (Low T)

Testosterone, principally a male hormone, is crucial in muscle mass, bone density, and sex drive. Low testosterone outcomes are:

  • Reduced Sex Drive: Lower libido and sexual performance.
  • Erectile Dysfunction: Difficulty in achieving or maintaining an erection.
  • Decreased Muscle Mass: Loss of strength and muscle tone.
  • Increased Body Fat: Particularly around the abdomen.
  • Fatigue: Persistent tiredness and diminished energy.
  • Mood Changes: Increased irritability, depression, and difficulty concentrating.

Comparison and Distinction

Gender Prevalence: 

Low estrogen in women, especially during menopause, while Low T mainly is in men, particularly as they age.


Both conditions produce fatigue and mood changes, but they also have unique symptoms, such as hot flashes for low estrogen and erectile dysfunction for Low T.

Health Implications: 

Low estrogen markedly impacts bone density and menstrual cycles, whereas Low T muscle mass, fat distribution, and sexual health.

The two conditions engender disruptions in sex hormones but different genders with distinct symptoms.

What Are the Causes of Low Testosterone?

The causes of low testosterone are aging, medical conditions like diabetes and obesity, injuries to the testes, hormonal disorders, and certain medications. The following are the 8 key factors that contribute to sparse testosterone as sparked by Li et al. (2023) in Increased risk of testosterone deficiency is associated with the systemic immune-inflammation index: a population-based cohort study:

  • Aging: Testosterone decreases by approximately 1% per year after age 30.
  • Medical Conditions: Diabetes, obesity, and metabolic syndrome correlate with poor testosterone capacity.
  • Injuries or Infections: Damage to the testes from trauma or infections impairs testosterone production.
  • Hormonal Disorders: Problems with the hypothalamus or pituitary gland, which controls testosterone production, trigger faint testosterone.
  • Medications: The use of opioids, steroids, and certain hormones lowers testosterone.
  • Stress: Chronic stress elevates cortisol, which negatively provokes testosterone production.
  • Genetic Disorders: Conditions like Klinefelter syndrome and hemochromatosis impair testosterone production.
  • Lifestyle Factors: Poor diet, lack of exercise, and excessive alcohol consumption contribute to inefficient testosterone.

What Are the Effects of Low Testosterone?

The predominant effects of low testosterone are decreased libido and interest in sex, erectile dysfunction, feeling tired and lacking energy, reduced muscle mass and strength, weakened bone density, depression, irritability, mood swings, balding, and loss of body and facial hair as extolled by Li et al. (2023) in Increased risk of testosterone deficiency is associated with the systemic immune-inflammation index: a population-based cohort study. Below is the aftermath of the onset of paltry testosterone:

  • Sexual Dysfunction: Low testosterone leads to reduced libido, erectile dysfunction, and infertility. This impacts intimate relationships and overall quality of life.
  • Decreased Muscle Mass and Strength: Testosterone plays a crucial role in muscle development. Its reduction results in muscle atrophy and diminished physical strength, making everyday activities more challenging.
  • Increased Body Fat: Men with below-average testosterone frequently experience an upsurge in body fat, particularly around the abdomen. This shift in body composition increases the risk of metabolic disorders.
  • Bone Density Loss: Testosterone is essential for bone health. Insufficiency contributes to decreased bone density, increasing the risk of osteoporosis and fractures.
  • Cognitive Impairments: Low testosterone manipulates cognitive functions, causing problems with memory, concentration, and mental clarity.
  • Mood Changes: Psychological effects include depression, irritability, and anxiety. These mood swings severely muddle daily life and relationships.
  • Fatigue and Decreased Energy: Chronic limited energy and fatigue are common, impacting productivity and overall well-being.
  • Cardiovascular Health: Low testosterone is associated with an increased risk of cardiovascular diseases, including heart attacks and strokes.
  • Hair Loss: Reduced testosterone leads to a decrease in facial and body hair growth.
  • Hot Flashes: Similar to menopausal women, men with low testosterone experience hot flashes, characterized by sudden feelings of warmth and excessive sweating.

What Is the Treatment for Low Testosterone?

The foremost treatment regime for testosterone insufficiency is TRT, which is backed by a collection of other methods listed below for restoring hormones and alleviating symptoms. Treatment options are as explained in Harvard Health Publishing’s Treating Low Testosterone Levels (2019):

  1. Testosterone Replacement Therapy (TRT)

TRT involves using synthetic testosterone to restore normal levels in the body. It is administered through injections, patches, gels, or implants. In their 2020 research What Is a Hormone?, Luboslav Stárka and Michaela Dušková argue that Starling’s 1905 definition of a hormone—“a substance produced by glands with internal secretion, which serves to carry signals through the blood to target organs”—is outdated.

TRT provides rapid relief from symptoms like low energy and decreased libido. Plus, there are distinct methods to choose from, so you do find what works best for you.

It’s a commitment—you’ll need to continue using it to maintain benefits. Side effects like acne, sleep apnea, and increased red blood cell count are possible, so regular monitoring is critical.

You’ll follow a prescribed schedule for the rest of your life, with regular check-ups to ensure everything’s on track.

Symptoms get better within a few weeks, but it’ll require several months to feel the full benefits.

Interested in a Testosterone Replacement Therapy in West Palm Beach? Reach out to us! 

  1. Bioidentical Hormones

These hormones are identical to the ones your body produces, custom-made for your needs. They’re natural and personalized to fit your body’s requirements, offering a more customized approach to hormone therapy. There’s still limited long-term research on their effects. Compounded formulations vary, which spawns inconsistent dosing. You’ll take them regularly as prescribed, adjust doses as needed, and check in with your doctor periodically. Improvement in symptoms is seen within weeks to months, depending on how your body responds.

  1. Peptides & Human Growth Hormone (HGH)

These therapies stimulate your body to produce hormones naturally, aiming to restore overall hormonal balance. They encourage your body’s hormone production, contributing to a comprehensive sense of well-being. They are costly and have side effects like joint pain and insulin resistance. It’s administered through injections over a specific period, with regular health assessments to monitor progress. It’ll require several months to notice considerable effects on testosterone levels and related symptoms.

  1. Lifestyle Changes

This involves making healthier choices, such as diet improvements, regular exercise, weight management, and getting enough sleep to naturally boost testosterone. There are no side effects here—just overall better health and well-being.

To see results, you must commit to and be consistent. Changes won’t happen overnight. It’s all about making these changes a part of your everyday routine.

You’ll likely see positive changes over several months to a year as your lifestyle adjustments take effect.

  1. Clomiphene Citrate

Clomiphene citrate helps stimulate testosterone production by acting on the pituitary gland.

It’s taken orally, making it convenient compared to other treatments. It stimulates your body’s natural testosterone production.

Potential side effects like visual disturbances and mood swings can occur. It’s also not FDA-approved specifically for testosterone deficiency. Taken in cycles as prescribed, with regular monitoring to ensure it’s working effectively.

Symptoms diminish within a few weeks to months, depending on your response.

  1. Human Chorionic Gonadotropin (hCG)

hCG therapy stimulates your testes to produce more testosterone, used in combination with other treatments.

It supports natural testosterone production and assists in maintaining fertility in men.

Nevertheless, it requires injections, and there’s a risk of side effects like headaches and mood swings.

It’s administered via injections alongside other therapies, with ongoing medical supervision to monitor progress.

Effects on testosterone levels and related symptoms are noticeable within a few weeks to months.

  1. Aromatase Inhibitors

These medications reduce the conversion of testosterone to estrogen, helping to increase testosterone levels.

They’re taken orally, which is convenient. Aromatase inhibitors effectively lower estrogen levels. The side effects include bone loss and joint pain. There’s also a risk of suppressing estrogen too much.

It is taken as prescribed, with regular hormone level checks to ensure effectiveness and safety. You will notice improvements within a few weeks to months as testosterone levels adjust.

  1. Herbal Supplements

Herbal supplements like fenugreek and ashwagandha claim to naturally boost testosterone levels. 

They’re made from natural ingredients and are available over the counter.

Scientific evidence supporting their effectiveness is limited, and they interact with other medications negatively.

It is taken as directed on the product label, requiring consistent use over several months to see results.

Positive effects are gradual and may take several months to become noticeable.

  1. Male Hormone Test (Testosterone Test)

The male hormone test, or testosterone test, measures testosterone levels in your blood as elaborated by the 2020 American Urological Association Virtual Experience that noted testosterone levels in adolescent and young adult men (AYA) have declined by 20%-25% from 1999 to 2016

You’ll provide a blood sample, usually in the morning when testosterone levels are highest. The sample is then sent to a lab for analysis.

This test helps diagnose conditions related to testosterone imbalance, like low testosterone (hypogonadism), which can cause symptoms such as decreased libido, erectile dysfunction, fatigue, and mood changes. It’s also used to monitor testosterone levels during treatments like TRT.

How Does Low Testosterone Affect Your Weight?

Low testosterone sparks weight gain by augmenting body fat and reducing muscle mass. 

Testosterone regulates metabolism, fat distribution, and inadequate metabolic changes that promote fat accumulation, especially around the abdomen. 

This condition, known as central adiposity, accelerates the risk of obesity-related health issues such as cardiovascular disease and type 2 diabetes. 

The affected organ, in this case, is the adipose tissue, where fat accumulation occurs.

How Does Low Testosterone Impact Your Gut Health? 

Low testosterone adversely acts upon gut health by disrupting the balance of gut bacteria and exacerbating the risk of gastrointestinal issues such as bloating, constipation, and diarrhea. 

Testosterone receptors are present in the gastrointestinal tract, indicating its role in maintaining gut function. 

Shah et al.’s (2024) Evaluation of the Incidence of Low Testosterone Levels in Young Male Adults with Moderate to severe obesity: a Single-Centre Study from India suggests that low testosterone alters gut microbiota composition and function, potentially contributing to digestive problems and inflammation. 

Additionally, hormonal imbalances compromise the integrity of the intestinal barrier, hence increased permeability and susceptibility to gut-related disorders. 

The affected organ, in this case, is the gastrointestinal tract, including the stomach and intestines.

How Does Low Testosterone Affect Mental Health?

Low testosterone has considerable implications for mental health, given that it undulates neurotransmitter function and brain activity, influencing mood, cognition, and emotional well-being. 

Reduced testosterone is associated with symptoms of depression, such as persistent sadness, loss of interest in activities, and feelings of worthlessness. 

Also, low testosterone contributes to anxiety symptoms to cover excessive worry, restlessness, and irritability. These mental health effects influence the quality of life and overall functioning. 

The affected organ is the brain, where neurotransmitter activity and mood regulation occur.

How Does Low Testosterone Affect Anxiety?

Low testosterone exacerbates anxiety symptoms and aggravates the risk of developing anxiety disorders. 

Testosterone determines various physiological processes in stress response and emotional regulation, and lower testosterone intensity disrupts these mechanisms, thus heightening anxiety. 

Suboptimal testosterone is linked to an uptick in susceptibility to stress and maladaptive coping strategies with the onset of anxiety symptoms such as nervousness, tension, and irrational fears. 

Hormonal imbalances drive neurotransmitter activity and brain function, further exacerbating anxiety-related symptoms. 

The organ in question is the brain, where anxiety-related processes and emotional responses are calibrated.

How Does Low Testosterone Affect Depression?

Degraded testosterone increases the risk of depression and the development of depressive symptoms. 

Testosterone modulates mood, motivation, and emotional well-being, and sub-levels interrupt these processes, causing persistent sadness, loss of interest, and feelings of hopelessness. 

Subdued testosterone is common in men with depression, and testosterone replacement therapy ameliorates mood and alleviates depressive symptoms in some individuals. 

The affected organ, in this case, is also the brain, where neurotransmitter activity and mood normalization occur.

How Does Low Testosterone Affect Energy and Causes Fatigue?

Minimal testosterone cuts energy and surges fatigue, impacting overall vitality and well-being. 

Testosterone coordinates metabolism, energy production, and muscle function, and curtailed production impairs physical stamina and endurance. 

Lessened testosterone interferes with sleep patterns, further inducing feelings of fatigue and lethargy. 

Individuals with slashed testosterone experience lowered motivation, difficulty concentrating, and overall undermined stamina, which harms daily functioning. 

The affected organ is the skeletal muscle tissue, where testosterone harmonizes energy metabolism and muscle strength.

Is low testosterone genetic?

Yes, low testosterone has a genetic component, with genetic factors influencing hormone production and metabolism.

Why is low testosterone more common among seniors?

Low testosterone is more common among seniors due to natural age-related changes in hormone production and metabolism. As men age, their testosterone amounts gradually shrink, precipitating symptoms of hormonal imbalance.

How does one have their blood tested if they receive hormone replacement therapy or Testosterone Replacement Therapy?

The frequency of blood tests for individuals receiving hormone replacement therapy or Testosterone Replacement Therapy is every 3 to 6 months initially. Once hormones stabilize, annual tests are recommended to monitor intensities and make necessary adjustments to the treatment plan.

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