Testosterone is the key sex hormone within men’s health and dictates predominant features in a mans appearance i.e. the sex organs, in addition to regulating the sex drive. Even physiological features such as muscle mass and bone density in men, requires adequate levels of testosterone to build sufficiently.
It is a common fact that testosterone levels in men do decrease as men age, this is natural. However, some men can experience low testosterone and testosterone deficiency earlier on within their younger years, and this can come with signs and symptoms that affect the quality of life overall. The NHS states that normal levels of testosterone in the blood will range between 10-30 nmol/L . Anything lower could be a sign of low testosterone hormone levels in males.
What happens when a man’s testosterone is low?
In males, testosterone levels will drop by an average 2% every single year once they surpass the age of 30, however knowing if you have low testosterone levels, can be particularly hard to spot usually. The best thing to do if you feel that you have some kind of testosterone deficiency in your body, is to see a doctor and be administered a blood test, to check the presence of testosterone in your blood levels. The blood test will need to be medically reviewed and quantitatively analysed, alongside any symptoms of low testosterone that you have. The following signs and symptoms of low testosterone that a doctor will take into consideration are listed below.
Having a low sex drive
Sexual dysfunction is a key symptom and indicator to a males testosterone deficiency. Sex drive does decline naturally as men age, yet if you are having little to no libido in the earlier years where fertility should be at its peak, that should definitely be an indicator. Having low T levels will often occur quite suddenly in some cases, meaning signs and symptoms will become more known and frequent in everyday life and living quality. 
How does low testosterone affect a man sexually?
Erectile dysfunction can link with issues of low libido and low testosterone, due to the fact that testosterone is key to maintaining an erection and the mood and energy levels needed to sustain a healthy sex drive. Testosterone is actually key to stimulating the testicles and the penile tissues, when it comes to producing the nitric oxide that results in an erection.  Therefore, if you are noticing that it is becoming increasingly difficult to sustain an erection and actually have the mood for a healthy sex life, it may be time to actually pay a visit to your local doctor and medical clinic.
Should erectile dysfunction be the only symptom of what you believe to be low testosterone, it may be a likelihood that you are not suffering from low testosterone, but other health related issues. Research performed by the endocrine society and American Urology Association, actually identified that treatment options in aid of improving hormone levels and sexual function did not always work. The reason for this was due to health problems linked to lifestyle habits and metabolic stresses. Other factors which can lead to erectile dysfunction include:
- Heavy drinking and alcohol use
- Smoking and abuse of drugs
- High cholesterol
- High blood pressure
- Thyroid issues
- Mental health factors such as anxiety and depression
For this reason, testosterone therapy is not the be all and end all to improving sexual function. There can be other factors that can be at play within your health overall, and often making changes to your lifestyle and life habits can provide better interventions, than testosterone replacement initiatives. There has been a link between prostate cancer and testosterone replacement therapy, meaning a doctor will be very careful in recommending testosterone therapy just to treat sexual dysfunction and sex drive .
Low sperm count and sperm production
Semen is the fluid that comes out of the testicles when a male ejaculates. The fluid is key for fertility and offspring, when fertilising the egg within the uterus of a woman. Testosterone will allow for the stimulation of sperm production. Should a male have a lower volume of semen upon ejaculation, this can indicate issues of fertility directly linked to low testosterone concentration within the blood plasma.
Over the course of a male’s life, the testosterone level in terms of concentration should be sufficient to allow a male to engage in the production of offspring. Fertility may not be on your mind in the present day, yet it is good to remain conscious and aware of where your health lies in relation to your testosterone levels. It is a key sex hormone in males after all, and fertility is not the only issue that becomes a symptom of hypogonadism. It is vital for all functions of health, as you will see from reading further within this article.
Testosterone is key for the development of the sex organs, such as the testicles. Low testosterone levels contribute to a smaller than average testicle size, especially if men have hypogonadism during the key stages of puberty. This is not always the most common of signs and symptoms, as it can be related to other health issues too. However, should this be one of the many symptoms experienced, linking to low T levels, it can then be easily diagnosed correlating to hypogonadism.
FYI, there have been links between testosterone therapy and testicle shrinkage as a side effect to the treatment. While this is not always a common side effect, it can happen to a minority who wish to proceed with testosterone treatment.
It should not be a surprise that hair loss is directly one of the main symptoms of low testosterone, as it is key for hair growth in both men and women. Balding is a natural sign of male aging so of course, if you are balding before the onset of aging, that is a huge sign you should check out the T levels within your bloodstream.
While the human body holds onto many variants of testosterone i.e. free testosterone and SHBG (sex hormone-binding globulin), the Dihydrotestosterone (DHT) is pinnacle for hair growth. DHT is made within the body due to the 5-alpha reductase enzyme and can be found within the skin, prostate and hair follicles all over the body.  It may also be sourced from DHEA, which has become a popular testosterone booster supplement within the industry to treat testosterone deficiency.
As mentioned previously, DHT is found within the prostate so, should there be lower concentration of the DHT variant, it can affect the prostate function and development in men massively. If on the opposite side of the scales, and there is a surplus of DHT, male prostate can become enlarged- also known as prostatic hypertrophy.
Fatigue and low energy levels
Testosterone deficiency in men can lead to extreme fatigue and a lower energy overall. Mood swings will also be extremely common, and the first direct sign to irregular hormone function. This will also correlate massively with sleeping patterns too. It has been reported that men with low testosterone can find it really difficult to get the recommended 8 hours of sleep a day, due to being unable to consistently stay asleep for long durations. Doctors will always correlate sleep apnea, as a condition prevalent to males with low testosterone i.e. hypogonadism.
A study by Gary Wittert showcased plasma testosterone display in males, with varying concentration levels of the sex hormone. In 3 hour sleep studies, males who had low testosterone had poorer sleep quality overall. The same sleep quality was reflected in those who abused testosterone replacement doses. Sleep abnormalities were present in both those with high and low testosterone concentration levels present. Yet, those who took testosterone replacement therapy as an intervention scheme saw improved sleeping quality; however, it was important that doses were not in excess. 
Muscle mass deterioration
Muscle mass is linked to adequate testosterone level concentration within the blood plasma. It is essential for men and women, when they wish to build and sustain muscle. Should men have low T levels, it may result in a condition of lessened strength and unequal distribution between body fat and muscle mass. Within a 156 male clinical study, testosterone and a placebo were used to form a comparative study with those suffering from low testosterone levels. The study subjects that examined testosterone supplementation, saw an increased effect on their muscle strength. Testosterone treatment correlated and was consistent as an improvement for the ratio between body fat and muscle distribution.  It would therefore be a good initiative for men who wish to maintain their muscle as they age, by taking a testosterone booster, as testosterone in men can decline exponentially with the onset of natural ageing.
Body fat increase
Low T levels will also have an effect on the fat ratio present within the body, and it is believed that this is due to the imbalance between the estrogen and testosterone levels in men. Health information has long told us, how in-proportionate ratios between these sex hormones can cause havoc to a males body. Estrogen is of course, a female predominant sex hormone, however it does exist in men too. When a male has a large ratio of estrogen, the estrogen substitutes such as estradiol, can block the free testosterone within the blood from doing its job. This can therefore be converted into direct weight gain on the waistline, the abdomen; in addition to the breast tissue and chest area, giving rise to the feature commonly known as ‘man boobs’. 
Lower bone mass
Bone mass production is directly correlated towards the level of testosterone in the body. Often Osteoporosis is a condition associated in women when they hit menopause, due to the rapid decline of testosterone levels. However, men can also experience this illness too, as low testosterone levels will cause bone mass deterioration. Testosterone is key to strengthen bones and produce the minerals for building bone in the long term. Symptoms of bone mass decline will be noticeable through easy fractures and breakages. Older men and women are susceptible to fractures naturally, however if those who are younger are noticing prevalence in breakages, that should raise concern for testosterone regulation and overall well being.
Lower memory capacity
Lowered cognitive function is expected with low T levels in men and women. Why? Because the T hormone contributes to the memory and brain’s capability. A study performed by the Endocrine Society showcased how testosterone is key for memory and brain function. Through the use of spatial memory testing, and a 100mg testosterone dosage given twice a week, men aged from 52 to 79, saw improved memory abilities. While women have been scientifically recommended to take testosterone in aid of reducing the risk of Alzheimer disease plaques forming on the brain. The same concept applies to men, should they not have enough of the predominant sex hormone in their bodies. The T hormone has been shown to affect memory and fight memory disorder illnesses significantly. 
Abnormal blood tests
Blood work quantitatively proves low testosterone levels within men, as we have mentioned above. However, low T levels in blood plasma not only leads to the health issues listed, it can aggravate other symptoms such as anaemia. The Journal of the American Medical Association picked up on how testosterone therapy eased symptoms of low T levels, in addition to alleviating aggressive anaemia symptoms such as dizziness, cramping, sleep apnea, irregular heart rates and improved concentration and focus. 
How do you fix low testosterone?
To fix low T levels within men, there are many initiatives that can be suggested by a doctor. Testosterone therapy is often the last of the delivery methods used to combat hypogonadism. Treatment of lifestyle factors will often be addressed first, and changes suggested accordingly. For example, obesity in men is a metabolic stress that links to lower T hormone presence within the body. Should a male fall under the obesity risk category, that would be one of the first obvious changes to integrate- a weight loss programme.
If men suffer from hypogonadism during the key pre-puberty stages, there is a chance that more aggressive treatment options need to be considered. The reason being is that low T hormones can directly result in the underdevelopment of key chromosomes, leading to a genetic anomaly such as Klinefelter syndrome. Men who have this condition will be unable to produce sufficient levels of sperm and therefore find their fertility affected significantly without treatment introduced.
How can I test my testosterone levels at home?
Testosterone testing kits are available to those that wish to regularly manage and take charge of their own testosterone levels within their body. Such tracking technologies will just require a saliva sample, or a blood test at the peak of testosterone production i.e. during the morning time. These samples can then be sent off directly to a laboratory, where your results can be received via a phone call, or a mobile app, to explain and elaborate on your data results.
- Feintuch, S., 2019. Low Sex Drive: Common Causes and Treatment. [online] Healthline. Available at: https://www.healthline.com/health/low-testosterone/conditions-that-cause-low-libido#low-t [Accessed 31 May 2021].
- Fletcher, J., 2020. What are the symptoms of low testosterone?. [online] Medicalnewstoday.com. Available at: https://www.medicalnewstoday.com/articles/322647#twelve-signs-and-symptoms [Accessed 31 May 2021].
- Case-Lo, C., 2018. Hair Loss and Testosterone. [online] Healthline. Available at: https://www.healthline.com/health/hair-loss-and-testosterone#baldness [Accessed 31 May 2021].
- Wittert, G., 2014. The relationship between sleep disorders and testosterone in men. Asian Journal of Andrology, 16(2), p.262.
- Huo, S., Scialli, A., McGarvey, S., Hill, E., Tügertimur, B., Hogenmiller, A., Hirsch, A. and Fugh-Berman, A., 2016. Treatment of Men for “Low Testosterone”: A Systematic Review. PLOS ONE, 11(9), p.e0162480.
- Harding Medical Institute. 2016. Estrogen in Men. [online] Available at: https://hardingmedicalinstitute.com/estrogen-in-men/ [Accessed 31 May 2021].
- Rathbun, J., 1998. Can testosterone improve memory in men? Study provides initial findings. [online] UW News. Available at: https://www.washington.edu/news/1998/06/25/can-testosterone-improve-memory-in-men-study-provides-initial-findings/ [Accessed 31 May 2021].