Prolonged exposure to high levels of cortisol, the primary stress hormone, can disrupt the hypothalamic-pituitary-gonadal (HPG) axis, which is responsible for regulating testosterone synthesis6. Obesity and excess body fat have been strongly linked to low testosterone levels. At UAB, men who require testosterone replacement therapy can access a full range of services through the Men’s Health Clinic, which offers various treatment options including injections, gels or creams, subcutaneous pellets, and oral medications. With proper evaluation and treatment, most men can achieve significant improvement in their symptoms and overall wellbeing, regardless of the underlying cause of their hormone deficiency. For men experiencing signs and symptoms of testosterone deficiency, seeking comprehensive medical evaluation represents the crucial first step. Low testosterone can lead to decreased sex drive, erectile dysfunction, and ejaculatory dysfunction, and can potentially contribute to infertility. Androgen insensitivity syndrome is when there’s a resistance to the effects of androgens, including testosterone, leading to feminization and infertility. Low testosterone can have a significant impact on your quality of life, leading to physical, emotional, and sexual health issues. It also contributes to sexual function, bone health, and overall well-being in both men and women. Your doctor may also want to measure your iron levels to check for haemochromatosis. It's best to have the blood test early in the morning while you are fasting. They may then refer you to an endocrinologist — a doctor who specialises in hormones. CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help. Use the BMI Calculator to find out if your weight and waist size are in a healthy range. Pathological hypogonadism involves abnormally low levels with significant symptoms or disease, while age-related decline may lack noticeable symptoms. Natural aging represents the most common cause of declining testosterone levels, affecting virtually all men as they age. Some long-term users develop permanent hypogonadism requiring lifelong testosterone replacement therapy. For men experiencing signs and symptoms of testosterone deficiency, seeking comprehensive medical evaluation represents the crucial first step.This iron overload damages testosterone-producing cells over time, causing progressive hormone deficiency.Men with this genetic condition have an extra X chromosome (47,XXY or mosaic variations), causing abnormal testicular development.Men with low testosterone may experience fatigue, lethargy, decreased physical performance, and exercise intolerance.Men working in hot environments—such as foundries, commercial kitchens, or outdoor construction—may experience temporary or chronic testosterone reductions. Excess prolactin, whether from prolactin-producing pituitary tumors (prolactinomas) or certain medications, inhibits GnRH release from the hypothalamus. These growths may compress normal pituitary tissue, reducing the gland’s ability to produce LH and FSH. These tests help determine if the issue lies in the testicles or the brain-pituitary axis. Pubertal cancer patients face especially high risks because their reproductive systems are still developing. Mumps orchitis, inflammation caused by the mumps virus, poses the greatest infectious risk, especially during or after puberty. Chronic Diseases Many psychiatric medications also affect testosterone levels, adding complexity. Treatment with continuous positive airway pressure (CPAP) often partially restores testosterone levels. Sleep, stress, and testosterone production have a critical but often overlooked relationship. Since the liver metabolizes hormones and produces hormone-transporting proteins, impaired liver function affects hormone availability throughout the body. » Discover what your progesterone levels mean InsideTracker Ultimate + Membership plan helps you understand, measure, and balance your hormones in addition to other biomarkers. Prolonged elevation also has several medical implications for a woman later in life, which you should take care of by consulting a physician. Fertility treatments and estrogen-containing contraceptives may also cause the increase. InsideTracker displays estradiol blood test results using the reference ranges provided. Estradiol upregulates LDL receptors, which improves the body’s ability to clear LDL particles from the bloodstream. Optimize your ApoB levels and get science-backed recommendations to improve your heart health. The process contributes to a decline and subsequent low levels of the hormone when compared to premenopause. Low testosterone has been linked to increased body fat, particularly around the abdomen, leading to an increased risk of metabolic disorders like type 2 diabetes. Minimizing exposure to these substances through lifestyle changes and environmental regulations can help to protect testosterone levels. Exposure to environmental toxins like phthalates, bisphenol A, and heavy metals can disrupt the endocrine system and interfere with testosterone production, metabolism, and action 9,10,13,14. Certain rare genetic disorders, such as Klinefelter syndrome and androgen insensitivity syndrome, can lead to low testosterone production or impaired testosterone action8. Gradual Decline of Testosterone Levels Hyperprolactinemia—elevated prolactin levels—is one of the most treatable causes of secondary hypogonadism. Even small tumors can disrupt hormonal balance if they produce excess prolactin or other hormones that interfere with reproductive function. LH targets Leydig cells to produce testosterone, while FSH supports sperm production. The hypothalamus releases gonadotropin releasing hormone (GnRH), which stimulates the pituitary gland to produce luteinizing hormone (LH) and follicle stimulating hormone (FSH). Testicular cancer itself can impair hormone production, especially if both testicles are involved or both must be surgically removed. As listed above (see Causes and Risk Factors of Low T), many conditions, such as obesity or heart failure, relate to or potentially contribute to low T. The American College of Physicians updated its clinical practice guidelines in 2020 to counsel that TRT should only be prescribed to men for sexual dysfunction. Sometimes the cause of low testosterone in a man is unknown, and many men have several different causes. Depending on the cause and age when low T first appears, symptoms can differ. We are a government-funded service, providing quality, approved health information and advice These synthetic compounds interfere with hormone production, metabolism, or action throughout the body. Endocrine-disrupting chemicals (EDCs) pose a significant environmental threat to testosterone production. Environmental exposures represent an increasingly recognized category of testosterone-disrupting factors, raising concerns about population-wide effects on male reproductive health. “Diagnosing low testosterone involves assessing symptoms and confirming with a blood test measuring total testosterone.” Adam S. Baumgarten, M.D., assistant professor in the University of Alabama at Birmingham Department of Urology, shares insights on the causes, symptoms and treatment options for low testosterone in men. Low testosterone, or hypogonadism, in men can often go unnoticed without an understanding of the symptoms and causes. Depression and psychiatric disorders often coexist with low testosterone in complex ways. This disruption can last even during time off work, suggesting lasting effects on hormonal function. Men working night shifts, frequently changing schedules, or experiencing chronic jet lag may have persistent suppression of testosterone peaks. Liver cirrhosis and chronic liver disease also disrupt testosterone metabolism and availability. Men undergoing dialysis frequently have severe hypogonadism, contributing to muscle wasting, bone disease, and reduced quality of life. Anabolic steroids, often misused for performance enhancement, can lead to the suppression of natural testosterone production and cause long-term hypogonadism. Glucocorticoids, used to treat inflammatory conditions, can also inhibit testosterone production. Certain medications, including opioids, glucocorticoids, and some antidepressants, as well as anabolic steroids, can interfere with testosterone production or its action 7,8. Though rare, it highlights GnRH’s critical role in male development and reproduction. This genetic condition causes absent or deficient GnRH production, leading to failed puberty and permanent hypogonadism if untreated. Men with hyperprolactinemia may also experience sexual dysfunction, breast enlargement (gynecomastia), and rarely, milk production (galactorrhea). TRT replaces testosterone to restore normal levels and relieve symptoms of hypogonadism.In males, most testosterone is made by the testes.Testosterone levels start declining after age 30-40, dropping about 1% per year.Men with hypogonadism may notice a reduction in muscle mass, particularly in the upper body, and may find it more difficult to build and maintain muscle through exercise.Hypergonadotropic hypogonadism can be caused by genetic disorders, testicular injury, or other factors affecting testicular function.But at each stage, the hormone can fall outside of that range.The U.S. Food and Drug Administration (FDA) removed the black box warning on testosterone products, reflecting updated evidence.The trend is now affecting the state-funded National Health Service, since many seek free treatment there. Decreased Bone Density and Osteoporosis Risk TRT replaces testosterone to restore normal levels and relieve symptoms of hypogonadism. These tests can help to identify tumors, structural issues, or other conditions that may be contributing to low testosterone levels. Low testosterone levels can be accompanied by high levels of FSH and LH, a condition known as hypergonadotropic hypogonadism 3. Low testosterone levels may increase the risk of depression, anxiety, and irritability. During the postmenopausal years, a woman’s body stops converting a weaker form of estrogen—estrone—to estradiol. So, optimizing the hormone's values throughout perimenopausal years is critical for overall health as you age. Improving the levels can reduce the severity of menopausal symptoms you may be experiencing. Comprehensive Evaluation Consistently high levels can increase the risk for clinical conditions post-menopause. Those with low estradiol levels are also at a higher risk for low bone mineral density and cardiovascular disease compared to those with optimal. On the other hand, high estradiol levels come with heavier or more frequent periods, worsening premenstrual syndrome (PMS) symptoms, fatigue, and low libido. This hormone plays a crucial role in the development of female sex characteristics—like breasts—and in regulating the menstrual cycle and reproduction. » Measure your estradiol levels with a blood analysis Low Testosterone: Symptoms, causes & treatments Healthy Male Over time, low testosterone can contribute to a range of serious health problems. What would it mean for your life to finally have a personalized, safe, and effective testosterone replacement therapy plan tailored just for you? Still have questions about the causes of low testosterone and how to effectively address testosterone deficiency? A thorough assessment can distinguish between primary and secondary hypogonadism, identify potentially reversible causes, and guide appropriate treatment decisions. Perhaps most importantly, recognizing when symptoms warrant medical evaluation ensures that treatable causes receive appropriate attention. Primary hypogonadism (also called testicular failure) results from problems directly affecting the testicles. The American Urology Association defines low testosterone as levels below 300 ng/dL. It helps you identify risk factors and know when to seek medical evaluation. Conversely, if levels are too low, the gland can speed up their release. “Lifestyle adjustments like improving sleep, reducing stress, losing weight, and increasing physical activity can naturally boost testosterone, particularly in borderline or age-related cases,” Baumgarten noted. “These may include reduced muscle mass, decreased bone density with a higher risk of fractures, increased chances of developing diabetes and cardiovascular disease, infertility, and depression,” Baumgarten said. Because of this, a thorough evaluation is essential to ensure an accurate diagnosis and appropriate treatment plan. In some cases, imaging tests such as magnetic resonance imaging (MRI) or computed tomography (CT) scans, may be used to assess the pituitary gland or testes for abnormalities. Maintaining a balanced diet rich in these nutrients can help to support healthy testosterone levels. Zinc is essential for the proper function of the HPG axis and testosterone synthesis, while selenium acts as an antioxidant and supports testicular health. Klinefelter syndrome is when males are born with an extra X chromosome, resulting in decreased testosterone production and various developmental issues. Chronic conditions like HIV/AIDS, COPD, and chronic liver or kidney disease can contribute to low testosterone levels 6,7. Secondary hypogonadism occurs when problems with the hypothalamus or pituitary gland disrupt the hormonal cascade controlling testosterone production in the testicles. But some clinics prescribe it to men with normal levels and risking side-effects including infertility and thickened blood that carries cardiovascular risks, doctors warn. TRT is needed by those with true deficiency, known as hypogonadism, including men who never went through puberty or had testicular cancer. If the patient’s results show that their testosterone levels are below 15 nmol/L, TRT will be recommended, and a treatment plan will be developed. Australian men who are considering hormone therapy to correct low testosterone symptoms are encouraged to read the guide to learn about the resources available to them. Consult your physician for any health concerns.Treatments for low testosterone include testosterone replacement therapy (TRT), lifestyle modifications, medications, and supplements.To maintain healthy testosterone levels naturally, focus on a balanced diet, regular exercise, and reducing stress.Most testosterone is produced by the testes, but the levels are regulated by a feedback loop between the hypothalamus and pituitary gland.Side effects of testosterone replacement therapy may also include acne, breast enlargement, and sleep apnea, which should be carefully monitored during treatment.Acquired testicular problems develop during life due to injury, infection, or other external factors.This hormone is essential for the development and maintenance of male characteristics, such as facial and body hair, muscle mass, and a deeper voice.Adam S. Baumgarten, M.D., MBA, assistant professor in the UAB Department of Urology, shares insights on the causes, symptoms, and treatment options for low testosterone in men.Testicular torsion happens when the spermatic cord twists, cutting off blood supply to the testicle. Michelle Darian is a registered dietitian with two master’s degrees in nutrition and public health. As the diagnosis of hypogonadism is not always straightforward, careful clinical and biochemical assessment is essential prior to prescribing. Men are increasingly seeking testosterone measurement for a variety of reasons and GPs are thus faced with a burgeoning number of ‘low testosterone’ results needing to be actioned. Visceral adipose tissue (belly fat) contains high levels of aromatase, an enzyme that converts testosterone to estrogen.The choice of treatment depends on the underlying cause, your symptoms and preferences, and potential risks and benefits.Regular follow-up and laboratory monitoring are essential for men taking hormone replacement therapy to detect potential side effects and ensure treatment efficacy.Doctors use common laboratory tests to measure total testosterone and hormone levels like FSH and LH.Factors like elevated testosterone levels, excess body fat, stress, and alcohol intake may increase estradiol in postmenopausal women.Testosterone may cause erythrocytosis,6 which can increase the risk of cardiovascular events, so haematocrit should be checked before initiation and annually during therapy.Men with obesity and insulin resistance may have very low SHBG levels; hence normal FT despite having a low total testosterone.The chronic immune activation and inflammation in these conditions suppress the hypothalamic-pituitary-gonadal axis. If you have fertility problems because of low testosterone levels, speak to your doctors about fertility treatments and other options. Some females with low testosterone levels might have loss of libido. Males with low testosterone levels can have many different symptoms. Healthy older males may have lower testosterone levels due to the ageing process itself. Types of Hypogonadism Currently, estradiol is only included in the Ultimate Plan. This effect contrasts the association observed between estradiol and hs-CRP in premenopausal women. It secretes estradiol, promoting inflammation. Estradiol is delicately connected to many processes in the body. Moreover, long-term use may cause persistent hypogonadism that requires months to recover after stopping. The effects can begin within days of starting opioid therapy and may persist for months after discontinuation. Major depression suppresses the hypothalamic-pituitary-gonadal axis through neurochemical mechanisms. Learn who's most at risk, how long the condition may last, and the possible side effects of hormone therapy. Learn about symptoms of low testosterone or androgen deficiency. Pathology Tests Explained also has more information on blood tests, including testosterone tests. You may have a greater drop in your testosterone levels if you have long-term medical conditions or if you are living with obesity. When treating hypogonadism, or low testosterone, male hormone replacement therapy (MHRT) is the primary course of action. When released into the bloodstream, these hormones travel to the testicles and trigger the testosterone production. It is important to note that several other medical conditions can mimic the symptoms of low testosterone, including depression, sleep apnea, hypothyroidism, and anemia, among others. Even small tumors can disproportionately affect hypothalamic nuclei controlling reproductive hormones. Craniopharyngiomas, meningiomas, and other suprasellar masses pose particular reproductive risks. Brain tumors near the hypothalamus can compress or infiltrate this critical region, disrupting GnRH production and release. The U.S. Food and Drug Administration (FDA) removed the black box warning on testosterone products, reflecting updated evidence. Importantly, prostate cancer is no longer an absolute contraindication to treatment. The approach to treating low testosterone depends heavily on identifying and addressing underlying causes. Opioid medications represent perhaps the most significant medication-related cause of testosterone deficiency. Understanding these medication-induced causes is crucial because they represent potentially reversible factors in testosterone deficiency. Meanwhile, testosterone deficiency can contribute to mood disorders, creating a challenging cycle. It improves sexual activity, hypogonadal symptoms, and sexual desire, but not erectile function 11. TRT also can improve anemia in men with hypogonadism and reduces anemia risk in those without anemia 10. Treatments for low testosterone include testosterone replacement therapy (TRT), lifestyle modifications, medications, and supplements. Healthcare providers will assess body composition, muscle mass, hair distribution, and testicular size and consistency. A physical exam can help to identify signs of hypogonadism and rule out other potential causes of symptoms. Lifestyle modifications can help to improve testosterone levels and reduce symptoms of hypogonadism. This enlargement may be due to an increase in gonadotropin levels, particularly follicle-stimulating hormone (FSH), in response to decreased testosterone production. These illnesses can cause systemic inflammation, disrupt hormone production, and lead to malnutrition, all of which can negatively impact testosterone levels. Chronic stress can lead to a decrease in the production of luteinizing hormone (LH) by the pituitary gland, which in turn reduces testosterone production by the testes. Inflammatory and demyelinating diseases sometimes affect hypothalamic function when involving the central nervous system. Some men have immediate hormonal dysfunction; others develop problems months or years later. Motor vehicle accidents, sports concussions, military blasts, and other head traumas damage the connections between hypothalamus and pituitary. Traumatic brain injury can cause immediate and long-term hypothalamic-pituitary axis disruption. Your body needs to maintain normal levels of testosterone for it to function properly. Male hypogonadism means the testicles don't make enough of the male sex hormone testosterone. Make a medical appointment if you have symptoms of male hypogonadism. Even less severe calorie restriction can reduce testosterone, especially when combined with excessive exercise or rapid weight loss. Excessive endurance exercise, however, can suppress testosterone in some men. Regular physical activity, especially resistance training, boosts testosterone through multiple mechanisms. Men who eat many processed foods, refined carbs, and added sugars usually have lower testosterone than those on balanced, whole-food diets. High-glycemic foods cause rapid spikes in blood sugar and insulin, which interfere with hormonal signaling. Low levels can lead to decreased bone mass and an increased risk of osteoporosis and fractures 6. Testosterone plays a role in regulating mood and emotional well-being, and hypogonadism can lead to changes in mental health 5,6,7. Men with hypogonadism may notice a reduction in muscle mass, particularly in the upper body, and may find it more difficult to build and maintain muscle through exercise. It has a profound impact on reproductive health and regulating menstruation. I'm a data-driven editor with a passion for empowering individuals through clear, informative health content. She has worked for over five years at InsideTracker to communicate the science of nutrition and build healthy, sustainable habits based on data. Clinicians face challenges distinguishing normal aging from pathological hypogonadism. This natural process, called andropause or late onset hypogonadism, occurs more gradually than menopause in women. Testosterone levels start declining after age 30-40, dropping about 1% per year. Undescended testicles (cryptorchidism) is another significant congenital risk factor. Men with this genetic condition have an extra X chromosome (47,XXY or mosaic variations), causing abnormal testicular development. Klinefelter Syndrome is the most common congenital cause of low testosterone. There are many reasons that you may have low testosterone levels. In females, testosterone is made by the ovaries and converted to female sex hormones. Testosterone is a sex hormone that helps develop the male reproductive system including the penis, testes and prostate. But some clinics prescribe it to men with normal levels and risking side-effects including infertility and thickened blood that carries cardiovascular risks, doctors warn.The hormone estradiol is one of three primary forms of estrogen.Additionally, obesity can lead to insulin resistance and chronic inflammation, which may further suppress testosterone production.If you need urgent medical help, call triple zero immediatelySH is caused by impaired hypothalamo-pituitary function (see Supplementary Box S1) and, hence, serum ferritin and pituitary hormone profile (serum prolactin, cortisol, and thyroid hormones) plus imaging is warranted.If there is an underlying cause for your low testosterone, it should be treated. Normal ones differ based on menopausal status, menstrual cycle phase, hormonal contraceptive use, and menopausal hormone therapy (MHT). Estradiol blood levels in your chart show up against a reference range with many variables. It gives insights into your levels, how they impact your health, and how to optimize them. It contributes to healthy sexual function, but it circulates in much smaller quantities. Testosterone may cause erythrocytosis,6 which can increase the risk of cardiovascular events, so haematocrit should be checked before initiation and annually during therapy. The first step in establishing aetiology is measuring serum luteinising hormone (LH) and follicle stimulating hormone (FSH) levels (Supplementary Figure S1 and Supplementary Box S1). Conversely, men with high SHBG levels may have low FT despite normal total testosterone. Men with obesity and insulin resistance may have very low SHBG levels; hence normal FT despite having a low total testosterone. Disorders affecting the pituitary gland, such as pituitary tumors or hypopituitarism, can lead to low testosterone levels 3,6.Estradiol is delicately connected to many processes in the body.With proper evaluation and treatment, most men can achieve significant improvement in their symptoms and overall wellbeing, regardless of the underlying cause of their hormone deficiency.Excessive alcohol consumption damages testosterone production through several mechanisms.Testosterone secretion has diurnal variation and is suppressed post-prandially, so serum testosterone and sex-hormone binding globulin (SHBG) should be measured between 7.00 am–11.00 am following an overnight fast.This natural process, called andropause or late onset hypogonadism, occurs more gradually than menopause in women.Finding the cause of hypogonadism is an important first step to getting the right treatment. Male hypogonadism is a condition in which the body doesn't make enough of the hormone testosterone or enough sperm or both. A urologist can help diagnose low testosterone levels, which are often determined with a blood test, which should be taken around 8 a.m. Thus, anything that impacts the testes, hypothalamus, or pituitary gland has the potential to cause low testosterone or "hypogonadism," which can cause sexual dysfunction and physical changes. In some cases, healthcare providers may prescribe medications or supplements to increase testosterone levels. Studies have shown that TRT can increase testosterone levels, leading to improvements in muscle mass, bone density, sexual function, mood, and quality of life 1,2,3. Low testosterone affects millions of men worldwide, yet many remain unaware of the diverse factors disrupting their hormone production. "I've seen the advertising that up to one in four or one in five men before the age of 40 have testosterone deficiency -- that is just absolutely not true," she told AFP. LONDON -- Social media claims by clinics promoting testosterone treatment for men to improve their physique and mood are driving large numbers to pay for unnecessary medication that can have serious side effects, doctors say. Premenopausal women with decreased estradiol levels may have irregular or infrequent periods, difficulty sleeping, mood swings, and low libido. Let’s dive into what estradiol levels mean for pre-, peri-and postmenopausal women. Those altered levels can also have different impacts on the body. These options stimulate endogenous testosterone without impairing sperm counts.Many psychiatric medications also affect testosterone levels, adding complexity.From genetic conditions present at birth to daily lifestyle choices, causes of low testosterone span a wide range of medical, environmental, and behavioral influences.Moreover, long-term use may cause persistent hypogonadism that requires months to recover after stopping.These tests help determine if the issue lies in the testicles or the brain-pituitary axis.Low testosterone can have a significant impact on your quality of life, leading to physical, emotional, and sexual health issues.Testosterone helps maintain male secondary sexual characteristics, sperm production, and overall reproductive health. Our suggested algorithm in Supplementary Figure S1 provides a pragmatic approach to low testosterone, taking into account the best evidence and practice within the NHS. Some of these men will then seek NHS prescriptions for testosterone, or referral to a specialist by their GP. Although testosterone, along with other androgens, is a banned substance under doping regulations for sport, its use by non-professional athletes — or even men who wish to achieve a more sculpted musculature — seems to be increasingly pervasive. Recognizing when testosterone deficiency requires medical attention involves understanding both concerning symptoms and risk factors that warrant professional evaluation. Corticosteroids, whether used for inflammatory conditions, autoimmune diseases, or other medical purposes, can rapidly and severely suppress testosterone production. Long-term use of narcotic pain medications can suppress testosterone production so dramatically that many patients develop severe hypogonadism requiring testosterone replacement therapy. Many chronic medical conditions impact testosterone production via systemic inflammation, metabolic disruption, and hormonal signaling interference. The hypothalamus controls the entire reproductive hormone cascade, so hypothalamic dysfunction greatly disrupts testosterone production. » Find out how to balance your hormones for weight loss But at each stage, the hormone can fall outside of that range. » Learn how to balance testosterone and estrogen It also impacts the cardiovascular system—the heart and blood vessels—and the musculoskeletal system—bones, ligaments, cartilage, and tendons. Remember that testosterone deficiency is a medical condition, not an inevitable consequence of aging. With proper evaluation, individualized treatment plans, and regular monitoring, TRT is a safe and effective option for men with clinically significant testosterone deficiency. Consequently, men actively trying to conceive should avoid starting testosterone replacement therapy due to its effects on sperm production. TRT can suppress natural sperm production by reducing the body’s testosterone synthesis through feedback mechanisms. The diagnosis typically includes blood tests, physical examination, medical history, and sometimes imaging tests. Diagnosing low testosterone involves a comprehensive evaluation of symptoms, causes, and diagnostic tests. In this condition, the testes are unable to produce sufficient testosterone despite increased stimulation from the pituitary gland. However, more research is needed to fully understand the relationship between testosterone and cognitive health. Some studies suggest an association between low testosterone and cognitive impairment, including difficulties with memory, concentration, and problem-solving 8,9,10,11. Micronutrient deficiencies severely impact hormone production, especially zinc and vitamin D. Unlike genetic or medical causes, these lifestyle factors often represent modifiable risks. Modern lifestyle choices increasingly contribute to testosterone deficiency, especially in younger and middle-aged men. Often, alternative treatments or dose modifications help minimize testosterone-related side effects while maintaining therapeutic benefits. This opioid-induced hypogonadism affects not only pain management patients but also individuals using these medications for other conditions or recreational purposes. While some causes like genetic conditions or cancer treatments may not be preventable, many factors contributing to testosterone deficiency remain within our control. Heat exposure affects testosterone production by disrupting testicular temperature regulation. The decision to treat age-related testosterone decline with hormone therapy remains controversial, as experts debate its risks and benefits. Therefore, doctors consider both symptoms and blood tests when evaluating testosterone deficiency. About 40% of men over 45 have testosterone levels below normal, and up to 50% of men in their 80s show laboratory evidence of hypogonadism. This suppression reduces LH and FSH production, ultimately lowering testosterone levels. The pituitary gland regulates hormonal function throughout the body, making pituitary disorders a significant cause of secondary hypogonadism. Most testicular cancers are highly curable, but survivors often need ongoing testosterone deficiency monitoring and may require replacement therapy. Medical Conditions Causing Low Testosterone Talk to your healthcare provider about the risks and benefits of taking TRT.This vital hormone is mainly produced by Leydig cells within the testicles, and the pituitary gland and hypothalamus carefully regulate its production.Cancer treatments, while life-saving, significantly affect testosterone and sperm production.Prolonged elevation also has several medical implications for a woman later in life, which you should take care of by consulting a physician.Getting diabetes or other health conditions under control and losing weight can improve testosterone levels.Sometimes your body can't make enough testosterone.Testosterone is a sex hormone that helps develop the male reproductive system including the penis, testes and prostate.Overtraining syndrome, common in endurance athletes, raises cortisol levels that suppress the hypothalamic-pituitary-gonadal axis.Remember that testosterone deficiency is a medical condition, not an inevitable consequence of aging. However, some men may experience more significant declines in testosterone levels, leading to symptoms of hypogonadism. Several other medical conditions can mimic the symptoms of low testosterone, including depression, sleep apnea, hypothyroidism and anemia, among others. Therefore, the American Urology Association recommends testosterone therapy only for men with testosterone levels below 300 ng/dL and related symptoms. Opioids, commonly prescribed for pain management, can suppress the HPG axis and reduce testosterone levels. Damage to the pituitary gland or having a tumor can disrupt the production of LH, leading to low testosterone. Varicocele, a condition that causes enlarged veins in the scrotum, can lead to decreased testosterone production and infertility. Injuries or conditions affecting the testes, such as trauma, varicocele, or testicular cancer, can impair the ability of the testes to produce testosterone3,5. Extreme weight loss or eating disorders severely impair hormone production pathways, including testosterone synthesis. Although steroid use may raise testosterone levels during use, natural production often remains suppressed for months or years after stopping. Weight lifting and other resistance exercises stimulate testosterone release and help maintain lean body mass, which correlates positively with hormone levels. Exercise patterns and body composition strongly influence testosterone levels, though the relationships can be complex. Men's hormone levels can fluctuate for lifestyle reasons but many are being prescribed testosterone replacement therapy (TRT) without medical need despite the health risks, doctors in the UK and Australia told AFP. TRT Australia’s guide says that online TRT treatments usually start with a preliminary screening to identify whether symptoms like fatigue and mood changes are related to low testosterone levels and whether TRT is medically appropriate. To keep treatment options open to men who may otherwise have limited accessibility to specialised care, many reputable hormone therapy services, including TRT Australia, offer comprehensive telehealth programmes that can help with medical evaluations, monitoring, and prescriptions. The medical condition, which is known as male hypogonadism, can cause many symptoms that can impact quality of life, including persistent low energy levels, loss of lean muscle mass, and depression or irritability. Your healthcare provider will ask about symptoms such as decreased libido, erectile dysfunction, fatigue, muscle loss, and mood changes. Hypergonadotropic hypogonadism can be caused by genetic disorders, testicular injury, or other factors affecting testicular function. Testosterone stimulates erythropoiesis, the production of red blood cells, and hypogonadism can contribute to the development of anemia. Testosterone may play a role in maintaining cognitive function, and low levels have been linked to an increased risk of age-related cognitive decline and dementia. Over recent years, there has been a surge in testosterone prescriptions for men with sexual dysfunction or putative age-related decline in testosterone,2 possibly reflecting pharmaceutical promotion, or sharing of misleading information on the internet. As described above, diet, stress management, and several other nonmedical approaches may be effective in staving off low testosterone issues. In the past, low T was typically treated with testosterone replacement therapy (TRT). Get the details about low testosterone, from its symptoms and causes to how it's diagnosed and treated. Testicular torsion happens when the spermatic cord twists, cutting off blood supply to the testicle. The severity of deficiency often depends on injury extent and whether both testicles are involved. Sports injuries, accidents, workplace incidents, or surgery can damage hormone-producing structures. Acquired testicular problems develop during life due to injury, infection, or other external factors. Most people don't know where their heart health status stands until it's too late. It can also negatively impact bone mineral density, increasing osteoporosis and cardiovascular disease risk. » Explore science-backed ways to increase your testosterone Drastic shifts in estradiol during menopause lead to irregularities in the menstrual cycle, such as shorter or longer times between periods. Testosterone plays a crucial role in men’s health, influencing everything from energy levels and mood to muscle mass, bone density, and sexual function. The choice of treatment depends on the underlying cause, your symptoms and preferences, and potential risks and benefits. Blood tests are the primary diagnostic tool for confirming low testosterone levels. They will also consider your age, medications, chronic illnesses, and lifestyle factors that may contribute to low testosterone levels. While some men experience natural age-related decline, others face significant testosterone deficiency due to medical conditions, medications, or lifestyle factors. "Feeling tired, unfocused, or taking longer to recover after workouts? It could be time to check your testosterone levels," reads one ad for Harley Street TRT provider. Studies in the United States and Europe have shown testosterone levels declining for decades, which scientists link to lifestyle and environmental factors. For this reason, testosterone replacement therapy (TRT) is often recommended to individuals whose symptoms are caused by hormone deficiencies, as long as it is medically appropriate. Factors like elevated testosterone levels, excess body fat, stress, and alcohol intake may increase estradiol in postmenopausal women. Other things being equal (haematocrit, bone density, and symptoms), treatment aims to achieve testosterone levels in the reference range (mid-range for gel; low end at trough for injectables). In men with verified hypogonadism, testosterone therapy maintains secondary sexual characteristics, improves psychological and sexual function, bone and muscle health, and reduces anaemia and frailty. 10 healthspan category scores that look at every major system in your body The insights are based on biological sex, so if you use gender-affirming hormone therapy, select the option that aligns with it. That's why InsideTracker recommends monitoring this hormone and working with a healthcare provider for support. For lab values outside a given optimal zone, a person may see food, supplements, and physical activity recommendations that can positively impact estradiol levels. Still, it takes the analysis further by creating optimal zones based on menopausal status and exogenous hormone use for females. Testosterone levels can vary greatly depending on your sex, age and health. In males, most testosterone is made by the testes. Males and females both naturally produce testosterone, though males produce far more than females. If any of these risk factors are in your family health history, tell a member of your healthcare team. Finding the cause of hypogonadism is an important first step to getting the right treatment. In this condition, the testicles cannot produce adequate testosterone despite normal brain signals. Usually, two total testosterone measurements below 300 ng/dL confirm the diagnosis. This comprehensive guide explores all major categories of low testosterone causes. Unlike men with infertility and erectile dysfunction, for whom there are established UK guidelines,4,5 there is no single UK consensus on how to approach male hypogonadism. SH is caused by impaired hypothalamo-pituitary function (see Supplementary Box S1) and, hence, serum ferritin and pituitary hormone profile (serum prolactin, cortisol, and thyroid hormones) plus imaging is warranted. Secondary (or central) hypogonadism (SH) is characterised by low testosterone with low-to-normal LH and FSH levels. Clinical features of hypogonadism are not limited to sexual symptoms — reduced libido, erectile dysfunction (ED), and loss of waking erections. Blood Tests The pituitary gland produces LH, which stimulates testosterone production in the testes. Disorders affecting the pituitary gland, such as pituitary tumors or hypopituitarism, can lead to low testosterone levels 3,6. Testicular cancer and its treatment, including chemotherapy and radiation, can also damage the testes and cause a drop in testosterone. Managing stress through techniques such as meditation, exercise, and therapy can help reduce the impact of stress on testosterone levels. Cancer treatments, while life-saving, significantly affect testosterone and sperm production. Autoimmune conditions rarely attack testicular tissue directly, but when they do, they destroy hormone-producing cells gradually. About 10-30% of post-pubertal males with mumps develop orchitis, and roughly 10% of those cases lead to testicular atrophy and hormone reduction. Even after surgery, severe torsion can cause testicular atrophy and lowered hormone production on that side. Low testosterone is when the body can't make enough testosterone to work. Its production is stimulated and controlled by luteinising hormone (LH), which is m Testosterone is a steroid hormone (androgen) made by the testes in males. Visit Healthy Male for more information about male reproductive and sexual health