Low Testosterone Symptoms in Men & Young Males — Causes, Diagnosis & Treatment Guide

The testosterone hormone produces the male features such as a low voice, muscularity, body hair, and facial hair. It also promotes the formation of red blood cells, improves mood, strengthens bones, and supports cognitive function. Testosterone is also essential for the proper functioning of the male reproductive system.

By the time a boy gets to early adulthood, testosterone is highest and declines with age. A gradual decline of about 1% per year, beginning around age 30–40, is common.

This can create signs and symptoms as men get older (50 years and older). Testosterone plays a vital role in sexual drive changes, depression or anxiety, reduced muscle mass, loss of energy, weight gain, anaemia and hot flashes.

Low testosterone (male hypogonadism) is a disease which prevents your testicles from producing testosterone (the male sex hormone) in adequate amounts.

Low testosterone in men is characterised by the fact that the body fails to produce the required amount of male hormone. This state may cause several physical, emotional, and psychological symptoms. In this blog, we will discuss Male Hypogonadism, its causes, symptoms, and treatments.

Testosterone deficiency syndrome is another clinical diagnosis for this condition, describing low testosterone levels and associated symptoms.

To know your testosterone, you should not simply look at a single number on a lab report. The definition of a normal testosterone level depends upon your age, biological sex, and, most importantly, whether you have any symptoms or not.

Low blood testosterone is identified through these lab tests, which help determine if your levels fall below the clinical threshold for deficiency.

In the case of men, muscle mass, bone density, libido, and mood rely on having enough testosterone in the body. Peaks are usually found in late adolescence and early adulthood and then tend to decrease at a rate of approximately 1% per year after the age of 30 or 40.

• Total Testosterone: The normal values are 300-1,000 ng/dL (nanograms per deciliter).

• Unit Remark: In most countries (such as the UK/Canada), this herein is nmol/L. It is approximately 10-35 nmol/L.

The "normal" range shifts downward as you reach age 50. A level that is average for a 60-year-old might be flagged as low for a 20-year-old.

In case of a drastic decrease in your testosterone production, you can have a variety of symptoms. A significant decrease in sexual desire and changes in erectile function are common symptoms of low testosterone. Symptoms of low testosterone are usually not that obvious and can include the following:

Testosterone is important in your sex drive or libido. Some individuals may suffer a loss of sex drive due to their old age, which occurs naturally, though individuals with low testosterone are likely to experience an even more significant loss.

Risk factors that can contribute to low sex drive include chronic illnesses, obesity, certain medications, excessive alcohol use, and stress.

Studies suggest that approximately 20–30% of men with erectile dysfunction also have low testosterone. Testosterone replacement therapy may improve erectile function when low testosterone is a contributing factor, but it is not effective for erectile dysfunction caused by vascular or neurological conditions alone.

Note: In young men who wish to preserve fertility, testosterone replacement therapy is usually avoided because it can suppress natural testosterone and sperm production. Alternative treatments such as clomiphene citrate or hCG may be considered.

Testosterone helps in maintaining energy. It instructs brain receptors to make nitric oxide, which keeps you charged and excited. Low testosterone in men causes low energy and makes them feel drowsy.

There are studies which posit that low T correlates with muscle mass reduction. Nevertheless, the research on the impact of low T on muscle strength and functioning is inconclusive.

Testosterone can contribute greatly to moods, quality of life, and self-perception. Low T has been linked with mood change and emotions such as:

• Stress

• Irritability

• Low self-esteem

• Anxiety

• Dissatisfaction with life (dysphoria)

• Depression

• Poor Muscle Gain: Young males with low testosterone struggle to build muscle. Testosterone plays a key role in protein synthesis and muscle development. Testosterone deficiency results in reduced strength and slow physical progress.

• Delayed Puberty Signs: Low testosterone may delay normal puberty signs such as voice deepening, facial and body hair growth, and genital development.

• Fatigue: Young males with low testosterone may experience persistent tiredness, reduced stamina, and difficulty maintaining daily activity levels.

• Poor Concentration: Testosterone supports cognitive function, focus, and mental clarity. Low T can lead to brain fog, difficulty concentrating, forgetfulness, and reduced academic or work performance.

Levels of testosterone in adult males that are below 200 nanograms per deciliter (ng/dL) are generally considered to be dangerously low (hypogonadism). Although some sources declare levels below 250-264 ng/dL, when combined with other symptoms, to be considered low indeed.

Diagnosis is performed by blood tests, usually in the morning, and the comparison of the results with obvious symptoms, where physicians consider having numbers considerably lower and clinical manifestations.

Hypogonadism is classified into two main categories: primary and secondary hypogonadism. Primary hypogonadism originates from problems in the testes, and secondary hypogonadism, which results from issues in the hypothalamus or pituitary gland.

As men age, testosterone levels naturally decline. Late-onset hypogonadism occurs when age-related testosterone decline is accompanied by clinical symptoms and confirmed low hormone levels.

Note: Medical guidelines (Endocrine Society) state that testosterone should be tested between 7 am and 10 am because levels fluctuate throughout the day.

• Physiologic risk: Extremely low testosterone (particularly chronic levels less than 200 ng/dl) is more probably associated with low libido, erectile dysfunction, less muscle mass/strength, poor bone density (high fracture risk), anaemia, mood swings, and infertility. These symptoms can result from issues with hormone production in the testicles or in the brain (pituitary gland or hypothalamus). The sequelae occur more frequently according to the levels and prolonged duration.

• Clinical action: Re-check: An early-morning total testosterone (fasting) test, LH, and FSH levels determine whether it is primary (testicular) or secondary (hypothalamic/pituitary) hypogonadism. This testing helps determine how the body controls hormone production. It also gives an insight into whether sex hormone-binding globulin (SHBG) or free testosterone requires measurement in case of SHBG conditions (obesity, age, liver disease). See endocrinology/urology with significantly low values, or in the case of fertility/structural pituitary disease.

• Ageing: Testosterone levels naturally reduce with age. It declines typically by about 1–2% per year after the age of 30. This gradual drop can lead to reduced energy, muscle mass, and libido over time.

• Genetics: Genetic factors can influence how much testosterone the body produces and how efficiently it is used. Some men are genetically predisposed to lower hormone levels due to genetic conditions.

• Stress: Chronic stress increases cortisol levels, which can suppress testosterone production. Long-term mental or emotional stress can significantly disrupt hormonal balance in young males.

• Poor Lifestyle: Irregular lifestyle, lack of physical activity, excessive screen time, and unhealthy eating habits negatively affect hormone production. These factors reduce the natural testosterone production.

• Obesity: Excess body fat converts testosterone into estrogen. It leads to lower available testosterone levels.

• Nutritional Deficiencies: Low levels of key nutrients like zinc, vitamin D, magnesium, and healthy fats can lower testosterone production.

• Varicocele: Varicocele is an enlargement of the veins in the scrotum. It can raise testicular temperature and impair testosterone production.

• Certain Medical Conditions: Conditions such as hypogonadism, thyroid disorders, pituitary dysfunction, and chronic illnesses can reduce testosterone levels.

• Sedentary Lifestyle: Lack of regular physical activity causes reduced muscle mass and increased fat accumulation. Both of these negatively impact testosterone levels.

• Alcohol and Smoking: Excessive alcohol consumption and smoking damage testosterone-producing cells.

• Sleeplessness: Poor sleep or chronic sleep deprivation lowers testosterone production. Consistently sleeping less than 6 hours can significantly reduce testosterone levels.

Fasting Morning Blood Test

• Testosterone is a diurnal hormone with a peak in the early mornings.

• The blood is to be drawn following an overnight fast, preferably between 7 -11 AM.

• Later testing in the day may give a false indication that testosterone is low.

Repeat Testing for Accuracy

• The amount of testosterone changes daily.

• Physicians must have two distinct low morning readings to establish a deficiency.

• Repeat testing will help to decrease false positives due to stress, illness, or poor sleep.

A panel of hormonal blood tests is carried out to ascertain the deficiency of testosterone and determine whether the issue is in the testes or the brain.

• It checks the overall level of the concentration of testosterone in the blood, the bound and unbound hormone.

• This is the initial and most crucial screening examination.

• Early in the morning (approximately 7-11 AM) when testosterone levels are at their peak, blood samples are taken.

• The lower limit of the laboratory reference range (usually less than 300 ng/dl) causes suspicion of deficiency.

• Determines the biologically active, non-protein-bound testosterone.

• Especially handy when the level of total testosterone is marginal or in cases when the level of SHBG is abnormal.

• Helps provide information on the symptoms of men with normal total testosterone and low active hormone.

• Calculated free testosterone (using total testosterone and SHBG) is generally preferred over many direct assays due to better accuracy.

A test is advisable when you are experiencing symptoms that might indicate low testosterone levels, which include:

• Poor libido or erectile dysfunction.

• Constant fatigue or loss of energy.

• Loss of body muscle or gain of fat.

• Major depression, irritability, or inability to concentrate.

• Infertility or loss of body hair.

• Loss in bone strength or fractures without any explanation.

Healthy testosterone levels are maintained through consistent daily habits. Although some of them might need medical intervention, most men are capable of maintaining optimal levels of testosterone by means of nutrition, exercise, sleep hygiene and stress management.

In some cases, testosterone supplementation, testosterone treatment, or certain medications may be necessary under medical supervision to address low testosterone symptoms.

A nutritious and well-balanced diet is very important in enhancing the production of testosterone. Cholesterol is converted to testosterone, and thus, a very low-fat diet can hurt hormones. Hormonal balance is achieved by including healthy fats like nuts, seeds, olive oil, ghee, avocados, and fatty fish.

One of the most effective natural means to control testosterone is regular physical activity. Resistance training, especially compound exercises such as squats, deadlifts, bench presses and pull-ups, will increase the release of testosterone and enhance muscle mass. High-intensity interval training (HIIT) also has the potential to contribute to hormonal balance when it is moderated.

Supplements are to be considered as the supportive methods and not the initial treatments. Supplementation of vitamin D could be of benefit to men with such a deficiency, particularly those who have limited exposure to the sun. Ashwagandha may modestly improve testosterone levels in stressed or infertile men, but evidence is limited, and it should not replace medical treatment.

Most testosterone is produced in deep sleep, and hence, sleep is necessary to control the level of testosterone. Sleeping less than 6 hours a night regularly has been associated with huge decreases in levels of testosterone. 7 to 9 hours of good sleep helps to keep the hormone cycles in line with nature. Screen time should be restricted before sleep, and the sleep environment must be dark and cool.

Chronic stress causes cortisol to increase, and this suppresses the production of testosterone. Hormonal imbalance could therefore be brought about by long-term chronic stress, work pressure, and emotional burnout. The regulation of the stress response can be achieved by incorporating stress-reducing activities, including yoga, meditation, a deep breathing exercise, or mindfulness.

Low testosterone may affect males of all ages, including younger men and boys. It impacts bodily health, mental health, sexual performance, and life quality. Though testosterone levels decrease with age, abnormally low testosterone levels among younger men are an indicator of underlying lifestyle, metabolic, or hormonal problems that cannot be overlooked. Testosterone imbalance can be caused by poor nutrition, constant stress, obesity, sleep deprivation, medical conditions, as well as some drugs at any age. However, if you maintain a good diet and lifestyle, it can be treated.