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6 Signs Your Testosterone May Be Lower Than You Think
Men's Health · Testosterone
Testosterone levels in men start declining around their mid-30s. This natural decline can be exacerbated by other causes of decline, which include prescription medications, stress, obesity, and social interaction.
Because testosterone levels often decline gradually, you may not even realize that low testosterone could be contributing to the way you’re feeling. Your doctor may run tests to look for other possible causes of your symptoms, and you may find some relief with treatment. But if your symptoms don’t completely go away, low testosterone could be playing a role you haven’t considered.
Symptoms alone don’t tell the whole picture. Many diseases have similar or overlapping symptoms, such as diabetes and thyroid dysfunction. Blood tests that include testosterone levels can give a clear picture of what’s going on, which can lead to appropriate treatment. (1,2)
Low Testosterone or Something Else?
Each of the six signs of low testosterone below has a hormonal explanation — and at least one non-hormonal one. Knowing both sides is what helps you and your provider get to the real cause.
1. Low Mood, Irritability, and Disrupted Sleep
Low testosterone can be associated with depressed mood, irritability, difficulty concentrating, and brain fog.
Possible Causes
- When testosterone is genuinely low, changes in androgen signaling may contribute to mood and well-being changes. However, low mood and irritability are not specific to testosterone deficiency. Stress, depression, chronic illness, medications, and poor sleep can also cause these symptoms. Sleep is particularly complicated because sleep disorders themselves are associated with low testosterone, meaning the relationship can work in both directions. (1)
2. Low Libido
A reduction in sexual desire (libido) is one of the more recognized symptoms of testosterone deficiency. Testosterone plays an important role in normal male sexual function.
Possible Causes
- Low testosterone can contribute to reduced sexual desire, but low libido can also result from relationship difficulties, psychological stress, depression, certain medications, chronic disease, and other hormonal conditions.
Get tested for testosterone levels and explore other reasons you may not be interested in sex with your care provider. (1)
3. Feeling Tired All the Time
Reduced energy and fatigue are symptoms associated with testosterone deficiency; however, they can also stem from many other illnesses and diseases.
Possible Causes
- Low testosterone may contribute to reduced energy, but persistent tiredness can have many possible explanations. Sleep disorders, obesity, chronic diseases, poor nutrition, depression, medications, and other hormonal problems can lead to fatigue but also contribute to low testosterone levels. (1)
4. Loss of Muscle Strength
Testosterone contributes to the development and maintenance of muscle mass and strength. Low testosterone levels can be associated with reduced lean muscle mass and reduced physical performance.
Possible Causes
- Testosterone deficiency can reduce the body’s ability to maintain muscle tissue. Other factors that contribute to declining muscle strength are aging, inactivity, inadequate protein or calorie intake, illness, neurological conditions, and other hormonal disorders. (2)
5. Lack of Motivation and Confidence
Testosterone deficiency can result in reduced motivation, irritability, depressed mood, and difficulty concentrating.
Possible Causes
- Low testosterone levels may contribute to changes in mood, motivation, and sense of well-being. That said, lack of motivation or confidence is not specific to testosterone. Depression, anxiety, chronic stress, poor sleep, relationship problems, illness, diabetes or thyroid dysfunction, and other psychological or physical factors can mimic low testosterone levels. (1)
6. Changes in Body Composition
Low testosterone is associated with changes in body composition, particularly reduced muscle mass and increased body fat. Testosterone helps maintain muscle and other body tissues; low testosterone can lead to muscle loss.
Possible Causes
- Low testosterone contributes to reduced lean muscle mass and changes in fat distribution. At the same time, excess body fat has itself been associated with lower testosterone. Other causes of changing body composition include aging, reduced physical activity, diet, metabolic disease, and other medical conditions. (1)
Testosterone Replacement or Testosterone Support?
If your practitioner has identified the cause of your symptoms as low testosterone levels, there are two options that can help restore your testosterone levels: testosterone replacement or testosterone support.
Testosterone Replacement
Testosterone replacement involves an injection into the muscle that releases testosterone into the bloodstream. It is designed to lead to stable hormone levels and is indicated when the testes are unable to produce testosterone (called primary hypogonadism) due to damage or age. Injections are administered every 1–4 weeks, depending on the formula and your practitioner’s discretion.
Testosterone Support: Enclomiphene
Enclomiphene is a prescription oral tablet indicated for secondary hypogonadism. It increases hormones that stimulate testosterone production, and it maintains sperm concentration and production, unlike testosterone replacement therapy. It may not be effective for primary hypogonadism; however, your practitioner can determine this.
Side Effects to Discuss With Your Practitioner
- Testosterone replacement: increased red blood cell production, potentially leading to the formation of blood clots, stimulation of growth of existing prostate cancer, and enlarged breasts. However, more research is needed. (3)
- Enclomiphene: mild headaches, mild mood swings, or irritability. (4)
Use under the guidance of your healthcare practitioner if you have a history of prostate or breast cancer or heart disease, or if you are trying to conceive.
Get the Whole Picture
Low mood, low libido, fatigue, lost strength, flagging motivation, and a changing waistline can all be signs your testosterone is lower than you think — but every one of them has other possible causes, too. The most important step is a blood test that includes testosterone levels. Once you and your practitioner know what’s really behind your symptoms, you can choose the right path, whether that is replacement, support, or addressing another underlying cause.
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References
- Anawalt BD, Matsumoto AM. Aging and androgens: Physiology and clinical implications. Rev Endocr Metab Disord. 2022 Dec;23(6):1123-1137. doi: 10.1007/s11154-022-09765-2. PMID: 36459352; PMCID: PMC10370404.
- Jansen HI, Boelen A, Heijboer AC, Bruinstroop E, Fliers E. Hypothyroidism: The difficulty in attributing symptoms to their underlying cause. Front Endocrinol (Lausanne). 2023 Feb 6;14:1130661. doi: 10.3389/fendo.2023.1130661. PMID: 36814580; PMCID: PMC9939761.
- Shoskes JJ, Wilson MK, Spinner ML. Pharmacology of testosterone replacement therapy preparations. Transl Androl Urol. 2016 Dec;5(6):834-843. doi: 10.21037/tau.2016.07.10. PMID: 28078214; PMCID: PMC5182226.
- Wiehle R, Cunningham GR, Pitteloud N, Wike J, Hsu K, Fontenot GK, Rosner M, Dwyer A, Podolski J. Testosterone Restoration by Enclomiphene Citrate in Men with Secondary Hypogonadism: Pharmacodynamics and Pharmacokinetics. BJU Int. 2013 Jul 12;112(8):1188–200. doi: 10.1111/bju.12363. PMID: 23875626; PMCID: PMC4155868.
Author
This article is not intended to diagnose or treat any disease. Consult with your healthcare practitioner for your healthcare needs.
