Men’s testosterone levels decrease about 1-2% every year, but this decline is expected after the age of 30.
However, if the testicles don’t produce enough testosterone, this condition is known as male hypogonadism. It can happen at any age and should be treated.
After hundreds of hours researching hypogonadism, drawing from both studies and my experience as a health and performance coach, I confirmed my findings with a urologist to ensure accuracy.
Read on to discover what causes low T and how you can treat it.
What Is the Number One Cause of Low Testosterone?
The number one cause of low testosterone is not easy to determine, as different factors can bring about the condition.
You can develop hypogonadism if you experience an accident, illness, damage to the hypothalamus or the pituitary gland, or if you were born with certain medical conditions.
Between 19% and 35% of older men have hypogonadism, but it’s not just them who can experience it .
According to the Boston University School of Medicine, low T affects around 4 to 5 million men in the United States .
It can affect young men, children, and teenagers as well.
Common Causes of Hypogonadism
There are two main types: primary and secondary hypogonadism.
Let's dive into what causes them.
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:
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 .
But if not, it can cause testicle malfunction and lower testosterone.
Typically, males have one X and one Y chromosome. Klinefelter syndrome brings an extra X, leading to abnormal testicle development and reduced testosterone .
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.
I recall a client whose mumps infection in adulthood led to impaired testicular function and reduced testosterone.
Chemotherapy or radiation might hinder testosterone and sperm production. While usually temporary, the National Cancer Institute warns of potential permanent infertility .
Related Article: Foods That Lower Testosterone?
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:
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 .
Abnormal hypothalamus function in Kallmann syndrome can cut down on testosterone production.
Conditions like tuberculosis affect the pituitary gland and hypothalamus, lowering testosterone.
HIV/AIDS hits the hypothalamus, pituitary, and testes, dropping T levels.
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 .
My experience has taught me that significant weight gain is a common factor disrupting hormone production, including testosterone.
Opioids and steroids can mess with the pituitary and hypothalamus, impacting testosterone production, per a study in the Journal of Clinical Medicine .
Severe stress from illness or surgery can temporarily shut down the reproductive system.
Symptoms of Testosterone Deficiency Syndrome
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
- Bad mood, memory, and cognitive functions
How Do You Fix Low Testosterone?
You can fix low testosterone levels by making specific lifestyle changes or undergoing testosterone replacement therapy.
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.
However, TRT methods like transdermal applications and injections have side effects that need careful consideration.
TRT's potential side effects are:
- Breast enlargement or tenderness
- Skin irritation
- Sleep apnea
- Swelling in the ankles caused by fluid retention
- Smaller testicles
- Difficulty urinating
- Decreased sperm count
Notably, TRT isn't for everyone, especially men with early prostate cancer, due to concerns that testosterone might spur cancer growth .
That's why anyone considering this treatment plan is recommended to undergo prostate screening first.
Does Sleep Apnea Cause Low Testosterone?
Yes, sleep apnea can cause low testosterone, since most daily testosterone production occurs during sleep. Studies have proven that both the duration and quality of sleep influence testosterone levels.
Can Low Testosterone Cause Joint Pain?
Yes, low testosterone can cause joint pain. Low levels of this hormone can directly contribute to joint pain and arthritis and indirectly through weight gain, which can further impact bone cartilage and joint health.
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