Last Updated December 20th, 2021
- Between 4 and 5 million adults in the United States have low testosterone levels.
- The American Urological Association states that 2 out of 10 men aged 60-70 have low testosterone. This number increases to 3 in a sample of 10 men in their 70s and 80s.
What is testosterone?
Sometimes the word ‘testosterone’ is used with a negative connotation (esp. in testosterone-fuelled) when used to describe the brawn and the aggressiveness of men. But as a man, if you have experienced symptoms of low testosterone, then you would know how much of a shortfall it can be to not have enough of it.
So are you missing the T-factor? Noticed a shortage of hair on your chest or feel that you don’t really need to shave? Do you feel that your sex drive is affected, or not what it used to be? The culprit could be the principal hormone responsible for changes in your body’s physical appearance and sex drive—testosterone. And if you think you are one of just a few who are affected, then think again.
Testosterone levels are measured by a blood test. Only about half of the testosterone that is circulating in the blood is available to the cells and is called free testosterone. The other half is tightly bound to a carrier molecule—sex hormone-binding globulin, which is abbreviated as SHBG. A test of free testosterone is a better indicator of low testosterone levels than a test of the total testosterone.
Testosterone in Men
Testosterone is a hormone produced by the testes that aids in the development of sex organs and the sperm itself. In addition to these, it also affects a man’s physical appearance and energy levels. It even helps build muscle and bone mass and regulates red blood cell production. The normal testosterone range for males is between 270 and 1070 ng/dL. The average level of testosterone in the human male is 670 ng/dL.
The testosterone level generally peaks at 20 and then gradually reduces with age. Anything below or higher than the normal range is considered to be unhealthy for the body.
Testosterone in Women
The ovaries produce both testosterone and estrogen. But relatively small quantities of it are released into the blood by the ovaries. It is therefore present in women at much lower levels. For females aged 17–18, for instance, the normal testosterone level is between 20 and 75. High testosterone levels can affect the physical appearance and sex drive of women. It can also lead to other health issues such as irregular menstrual cycles and changes in mood. In severe cases, it could also lead to the absence of periods, and to obesity and infertility.
What causes low testosterone?
Some men suffer from a testosterone deficiency that is called hypogonadism. Hypogonadism is a condition in males when the testes do not secrete enough testosterone. Hypogonadism is of two types:
- Primary hypogonadism is when the testes do not secrete enough testosterone, despite normal functioning of the hypothalamus and the pituitary gland. This can be the result of an acquired trait that causes testicular failure. It can also be caused by accident or illness like physical injury, radiation during chemotherapy, or mumps infection, leading to testicular damage.
- Secondary hypogonadism is when the testes do not secrete enough testosterone because of damage to the hypothalamus or pituitary gland. Some probable causes of secondary hypogonadism are medications such as opioids that affect the function of the hypothalamus and pituitary gland. Age and obesity are other culprits that affect hormone production and response in the body. Severe mental or physical illness can also cause the reproductive system to shut down.
- Mixed hypogonadism is a result of the dual effect of reduced secretion from the testes and a malfunctioning of the pituitary gland and the hypothalamus. This kind of hypogonadism is common in adults undergoing glucocorticoid (a class of corticosteroids) hormone therapy.
Signs of low testosterone in men
Low sex drive
According to the NHS, UK, the falling levels of testosterone in men can lead to a low sex drive (libido). Though the sex drive does fall in men with age, it is more drastic in the case of men who have lower testosterone levels.
The inability of a man to get or maintain an erection suitable for sex is called erectile dysfunction. Again, a lower testosterone level is not the only cause for erectile dysfunction. In addition, people with normal testosterone levels may respond to drugs such as Viagra and Levitra, as they help increase the blood supply to the penis and thus help overcome erectile dysfunction. However, people with low testosterone levels may need TRT (Testosterone Replacement Therapy) also to respond to these drugs.
Low semen volume
Semen is the milky fluid that aids in the motility of the sperm. The lower level of testosterone will also lead to a reduction in the volume of semen that is ejaculated. An adequate semen volume is necessary to ensure the transportation of the sperm into the female reproductive tract and lead to fertilization. So a lower semen volume lowers the chances of pregnancy also, as much does a lower sperm count. The average volume of semen ejaculated by a healthy male is about 2.5 ml. The lower level of testosterone is one of the causes for lower semen volume.
Reduction in testicular size
Men may observe a reduction in the size of their testicles, which is unrelated to lower temperatures. The scrotum also generally feels softer than it usually is.
Men with low levels of testosterone can experience hair loss on the chest, other parts of the body, and head, though balding can be a result of hereditary factors as well. Dihydrotestosterone (DHT) is produced from testosterone by the action of an enzyme called 5-alpha reductase.It is found in the skin, prostate, and hair follicles.
The production of DHT and the sensitivity of the hair follicles to the level of DHT are factors that affect hair loss. It can also be made from DHEA (Dehydroepiandrosterone), a hormone that is more common in women. DHT also acts on the prostate. Without DHT, the prostate doesn’t develop normally. Too much DHT can lead to prostate enlargement.
Men with a low level of testosterone have reported fatigue and low energy levels. This means that you will feel tired despite getting enough sleep. In addition, sometimes you are not motivated enough to do exercise. Greater physical activity was shown to be associated with reduced odds of low or low normal testosterone levels in non-obese men. This was, however, not the case with obese men.
Lack of Sleep
Low testosterone levels can lead to sleep disorders. Men with low testosterone levels are particularly prone to sleep apnea, a disorder in which the subject has difficulty breathing. Doses of testosterone are known to improve sleep quality. Testosterone levels can be lowered as a result of sleep apnea also.
Loss of muscle mass
Testosterone levels affect muscle mass in the body. So, people with lower levels of testosterone may observe that they have lesser muscle mass in their body. But a lower muscle mass does not imply reduced function or strength of muscles in general.
Loss of bone volume
Osteoporosis (the thinning of bones) is a condition generally observed in women. Testosterone helps increase bone volume and strengthens bones. Therefore, its deficiency in men can lead to lower bone volume, hence reduced strength, making them vulnerable to fractures.
Changes in Mood
Since testosterone can affect so many physical processes in the body, it can also cause changes in mood and influence mental capacity. Men with low testosterone are more prone to irritability, mood swings, lack of focus, depression, etc. TRT has been shown to improve the negative mood states associated with depression and self-esteem.
Self-help for low testosterone
There are some ways to increase testosterone levels naturally. Some of them are:
- Regular exercise and lifting weights. In obese men, regular physical activity was found to be more beneficial than a weight loss program for maintaining higher levels of testosterone.
- Eat a balanced diet. Overeating or constant dieting can disrupt testosterone levels. Eating enough protein maintains the testosterone levels and also leads to fat loss, which again increases your testosterone level. Again, some other studies have shown that a balanced diet is also helpful for maintaining your testosterone levels.
- Minimize stress and cortisol levels. Stress and cortisol levels have a seesaw effect on testosterone. As they increase, the testosterone goes down. Stress and high cortisol can also increase food intake, leading to obesity, which can further affect testosterone levels. Focus on a balanced diet. Add laughter and good sleep to the mix. This will reduce stress in your life.
- Get plenty of sun and vitamin D. Vitamin D has been shown by studies to have several benefits, one of which is its function as a testosterone booster. To boost your testosterone levels with vitamin D, take at least 3000 IU of vitamin D3 supplement daily
- Take mineral supplements such as zinc. Studies have shown that zinc, when administered to athletes, helps boost their testosterone levels. It can also help people who are deficient in testosterone. There may be other micronutrients and minerals that also help, but sufficient research is not available on them.
- Get plenty of high-quality, restful sleep. A study on people who slept less than 4 hours at night showed that they had borderline-deficient testosterone levels. Research suggests that around 7–10 hours of sleep per night maintains normal testosterone levels.
- Take natural testosterone boosters. A herb called ashwagandha is known to increase testosterone levels by 17% and sperm count by 167% in infertile men. In healthy men, it increased testosterone levels by 15%. It also helped lower cortisol levels by 25%, which should also aid in increasing testosterone levels. Another herb that helps boost testosterone is ginger. It is known to increase testosterone levels by 17% in infertile men.
- Avoid exposure to estrogen-like chemicals. These include BPA, parabens, and other chemicals found in some plastics. These estrogen-like chemicals can affect your testosterone levels.
- Avoid alcohol and drugs. The excessive consumption of alcohol and drug abuse can also lead to lower testosterone levels in men.
Treatment for low testosterone
If the preventive remedies do not help your testosterone levels or if you suffer from testosterone deficiency such as hypogonadism, treatment may be necessary. The diagnosis of hypogonadism is done through physical exams and blood tests. Since low testosterone has an underlying cause, the doctor may do further tests to identify the underlying cause. A probable course of action is TRT. TRT can be done in three ways:
- By applying patches that contain testosterone to the skin. They can, however, cause skin rashes and may need to be applied more than once a day.
- Through testosterone injections. They are given 2 to 10 weeks apart. Though it is expensive, it may not provide long-lasting benefits. Your testosterone levels could go low again between doses.
- Through the use of gels that contain testosterone. Gels must be rubbed on the skin daily. Do not let others touch the areas of application as they too may absorb the testosterone from your skin. Nasal gels that are available now reduce this risk of accidental exposure.
- Through the application of buccal patches. These are applied to your gums twice daily. The use of buccal patches, however, can cause irritation of the gums or gum disease.
Benefits of TRT
TRT has the following benefits:
- Improves sexual activity
- Increases muscle mass
- Boosts energy levels
- Improves red blood cell production
- Restores a positive mood
Side effects of TRT
Side effects of TRT include:
- Acne and oily skin
- Increased risk of blood clots
- Increased risk of heart attack and stroke
- Lower sperm count
- Enlargement of the breasts
- Shrinkage of the testicles
Conditions made worse by TRT
Conditions made worse by TRT are:
- Congestive heart failure
- Severe symptoms of the lower urinary tract such as an increase in urination due to an enlarged prostate.
- Obstructive sleep apnea.
- Increased red blood cell count
When must you call 911?
Patients undergoing TRT must call 911 if they notice any of the following symptoms:
- Chest Pain
- Shortness of breath or other breathing problems
- Slurred speech
- Weakness in one side of the body
Low testosterone: Many ways to solve the problem
As you might have gathered from this article, low testosterone is not merely a cause for embarrassment. It leads to serious conditions like loss of libido, erectile dysfunction, negative mood changes, etc. Also, research shows a link between low testosterone (particularly hypogonadism) and obesity and risk of heart disease as well.
But if a man takes care of his health by reducing stress, getting enough sleep, and having a balanced diet, rich in vitamins and minerals, he can easily boost his testosterone. Nature is also kind in this regard. The herb ashwagandha has been shown to increase testosterone levels by a reasonable margin in infertile men.
So, if you are a man and worry about your testosterone levels, do not. There are tried and tested measures to increase them naturally that have been mentioned in this article.
Help Others Be Fit