What Causes Low Testosterone? (Male Hypogonadism)

Primary hypogonadism, or "primary testicular failure," occurs when the testes don't make enough testosterone. It could be genetic or due to an accident or illness.

Medical conditions that cause primary hypogonadism include:

Undescended testicles

Testicles form in the abdomen before birth and should move down to the scrotum. Sometimes they don't, which the Cleveland Clinic notes can fix itself [3].

But if not, it can cause testicle malfunction and lower testosterone.

Klinefelter Syndrome

Typically, males have one X and one Y chromosome. Klinefelter syndrome brings an extra X, leading to abnormal testicle development and reduced testosterone [4].

Hemochromatosis

Excess iron in the blood can harm the testicles or pituitary gland, messing with testosterone levels.

Physical Injury to the Testicles

Injuring both testicles can slash testosterone production and lead to hypogonadism.

Mumps Orchitis

I recall a client whose mumps infection in adulthood led to impaired testicular function and reduced testosterone.

Cancer Treatment

Chemotherapy or radiation might hinder testosterone and sperm production. While usually temporary, the National Cancer Institute warns of potential permanent infertility [5].

Secondary hypogonadism stems from damage to the hypothalamus or pituitary gland in the brain, which governs testicular hormone production.

Medical conditions that cause secondary hypogonadism include:

Pituitary Disorders

A 2010 study published in the Journal of Pharmaceutical Technology and Research indicates that pituitary gland abnormalities can block hormone release to the testicles, reducing testosterone production [6].

Kallmann Syndrome

Abnormal hypothalamus function in Kallmann syndrome can cut down on testosterone production.

Inflammatory Diseases

Conditions like tuberculosis affect the pituitary gland and hypothalamus, lowering testosterone.

HIV/Aids

HIV/AIDS hits the hypothalamus, pituitary, and testes, dropping T levels.

Normal Aging

Aging can lead to late-onset hypogonadism, especially in men with type 2 diabetes or obesity, marked by a steady testosterone drop, as noted by the Cleveland Clinic [7].

Obesity

My experience has taught me that significant weight gain is a common factor disrupting hormone production, including testosterone.

Medications

Opioids and steroids can mess with the pituitary and hypothalamus, impacting testosterone production, per a study in the Journal of Clinical Medicine [8].

Concurrent Illness

Severe stress from illness or surgery can temporarily shut down the reproductive system.

Hypogonadism symptoms vary with age, emerging during fetal development, puberty, or adulthood.

If the body doesn’t produce enough testosterone during fetal development, it may result in the impaired growth of external sexual organs:

• Underdeveloped male genitals
• Female genitals
• Ambiguous genitals (neither male nor female)

If hypogonadism happens during puberty, it can hamper average growth and cause problems with:

• Voice deepening
• Muscle development
• Growth of body and facial hair
• Development of the penis and testicles
• Enlarged breasts (gynecomastia)
• Overly long limbs

Hypogonadism in adult males can affect specific masculine physical characteristics and hinder normal reproductive function.

Early signs and symptoms to look out for might include:

• Low-sex drive
• Low energy levels
• Depression
• Bad mood, memory, and cognitive functions

You can fix low testosterone levels by making specific lifestyle changes or undergoing testosterone replacement therapy.

Lifestyle Changes

In my practice, I've guided many clients to increase physical activity and optimize their diet, significantly improving their testosterone levels.

Also if your condition doesn't require medical intervention, you can opt for some high-quality testosterone boosters to naturally ramp up your body's hormone production.

Testosterone Replacement Therapy (TRT)

Based on my experience working alongside medical professionals, TRT is a common prescription for male hypogonadism.

“Treatment can consist of different formulations of testosterone, including topical gels or patches, injections into the muscle or skin, nasal gels, long-acting pellet implants, and other options.”

- Sriram Eleswarapu, MD, Ph.D., Urology Specialist 

TRT tackles low T symptoms like low libido, muscle mass, and energy. It aids teenagers in normal masculine development.