Signs and Symptoms of Low Testosterone

Low testosterone, or low-T, is when the testicles don't produce enough of the hormone testosterone. Testosterone is important for bone health, muscle health, and sexual function. As a result, common symptoms of low testosterone include bone loss, muscle mass loss, and low sex drive.

Testosterone levels naturally decrease with age, usually between 30 and 40 years old. If you have age-related low testosterone, your levels decrease gradually. Health conditions, medications, and injuries can cause your testosterone to lower faster or earlier than usual. While some men might not experience any symptoms of low testosterone, other can have a wide range of symptoms. 

Low Sex Drive 

Men with low testosterone often experience a low sex drive. If your sex drive has gotten lower, you might be having fewer sexual thoughts. Sights, words, and touch may also be less sexually stimulating for you. Your loss of interest in sex might lead you to have sex less often.

Since lower testosterone is a natural part of aging, it is normal to be less interested in sex as you get older. However, a complete lack of interest in sex is not typically considered normal.

Decreased Semen Volume 

Testosterone helps the seminal vesicles and prostate create and secrete semen—the reproductive fluid that contains sperm. If you have low testosterone, these organs won't be able to make as much fluid, causing you to ejaculate less semen.

The research is unclear on whether low testosterone levels impact sperm count enough to cause infertility. But while a lower semen volume might not directly cause fertility issues, it may lower your chance of getting a partner pregnant.

Erectile Dysfunction

Erectile dysfunction is a condition that makes it hard for you to get and keep an erection. Testosterone is essential for sexual function. Insufficient testosterone can make it difficult to maintain an erect penis.

However, low testosterone alone is not usually the primary cause of erectile dysfunction. Erectile dysfunction is a condition with various causes related to not only hormone production, but also nervous system regulation and blood circulation.

Body and Facial Hair Loss

Testosterone helps men develop features like thicker body hair and facial hair. If you have low testosterone, you may notice armpit hair, pubic hair, and chest hair start to thin. Low testosterone can also cause slow beard growth. However, hair loss on your head is typically related to genetics and male pattern baldness, not low testosterone levels. 

Fatigue

Chronic fatigue and loss of energy are common side effects of low testosterone. Fatigue may be mild or intense. Even if you get enough sleep, your low energy levels won't improve if you have low testosterone.

The exact reason low testosterone causes low energy levels isn't fully understood. For some people, the fatigue may be related to anemia. Anemia is a condition where your body has low levels of red blood cells, and fatigue is a common symptom. Low testosterone has been linked to a decrease in red blood cell production and anemia. 

Loss of Muscle Mass

Testosterone helps stimulate protein synthesis responsible for growing muscles. Men with low testosterone often lose muscle mass, making the muscles feel weak and appear less defined. Also called muscle wasting, muscle loss can contribute to low energy, too. 

Increased Breast Tissue

People of every sex have estrogen and testosterone, but women have more estrogen for fertility and breast growth. For men, producing too little testosterone can make estrogen levels too high. This imbalance can cause gynecomastia, a condition where men develop larger breasts due to higher estrogen levels and low testosterone levels. 

Gynecomastia is more common in men over 60 since that age group is more likely to have low testosterone levels and increased body fat (another factor that may contribute to developing gynecomastia).

People with prostate cancer whose treatment includes testosterone blockers, a class of medication known as antiandrogens, often develop gynecomastia as a side effect of their decreased testosterone. 

Loss of Bone Density

Testosterone is essential for maintaining bone mineral density, which is how much calcium and minerals are in your bones. Without the proper bone mineral density, your bones are more likely to break. Research finds that men with low testosterone are at greater risk for fractures and osteoporosis, a bone disease caused by low bone mineral density that can lead to weakened bones and fractures. 

Depression

Research shows older men with low testosterone often develop depression and anxiety. However, the link between depressive symptoms and low testosterone isn't well understood. Multiple conditions can contribute to depression, so it's difficult to tell if low testosterone alone is the reason for the depression. That being said, studies have found that older men who took testosterone replacement therapy to treat low testosterone also had improvements in their depression.

Symptoms in Women 

Women's testosterone levels also decrease with age, but low testosterone is an unlikely problem for women. More commonly, high levels of testosterone are the concern. In fact, there are no official guidelines defining the measurement of low testosterone levels in women.

Women still need a certain level of testosterone for sex drive, muscle growth, and bone health. As a result, women with lower testosterone levels may deal with side effects similar to men, like loss of muscle mass or bone density and low sex drive. However, research hasn't proven these side effects are directly related to low testosterone.

Symptoms in Children 

Low testosterone is not common in children, but it is possible. If boys experience low testosterone before or during puberty, they can have symptoms like: 

• Slow growth rate, causing disproportionate arms and legs relative to the body
• Reduced pubic hair
• Slow testicle and penis growth that can ultimately limit their size  
• Less voice deepening
• Muscles weakness  
• Below average endurance

When to See a Healthcare Provider 

If you notice any symptoms of low testosterone that affect your health, mood, or sex life, see a healthcare provider. While you may feel embarrassed about sexual function issues, seeing a healthcare provider can help you find the right treatment.  

If your healthcare provider suspects you have low testosterone, they will do a testosterone levels test. This blood test involves inserting a needle into a vein to collect a sample of your blood. The sample is then sent to a lab to measure the testosterone in your blood.

There are different forms of testosterone levels you can measure, but tests typically measure total testosterone. These tests measure testosterone attached to proteins and free testosterone—testosterone not bound to active proteins in your tissues.

A Quick Review

Lower testosterone levels are a normal part of male aging. Some people may not have symptoms as the body gradually creates less testosterone. But depending on when, how quickly, or how much levels drop, low testosterone can cause symptoms like decreased libido, energy, and muscle strength. If you suspect you have low testosterone, see a healthcare provider.