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Low Testosterone

Contact the UPMC Men's Health Center

To make an appointment at the Men's Health Center, call 1-877-641-4636 or fill out our form.

What is Testosterone?

Testosterone is a hormone primarily produced in males, in the testicles. Testosterone is necessary for sexual development and for making sperm.

What is Low Testosterone?

If you have low testosterone, also known as hypogonadism, it means you have a reduced amount of the hormone testosterone in your body. Among other symptoms, low testosterone can affect your desire and ability to have sex.

This condition is common; nearly 40 percent of men ages 45 and older are affected.

Low Testosterone Causes

Potential causes of low testosterone include:

  • Autoimmune disease: Some autoimmune diseases have been linked to low levels of testosterone.
  • Chemotherapy: Low testosterone is a common hormonal issue you may experience when undergoing chemotherapy for cancer.
  • Klinefelter syndrome: Affects testicular growth which can lead to lower production of testosterone.
  • HIV/AIDS: Testosterone deficiency is sometimes seen in patients with HIV/AIDS.
  • Injuries or infection of the testicles: Damage or infection may impact testosterone levels.
  • Medications: A decrease in testosterone levels can be a side effect of some prescription medications.
  • Metabolic disorders: Such as hemochromatosis, causing your body to absorb too much iron, which can lead to erectile dysfunction.

Low Testosterone Risk Factors

After young adulthood, men's testosterone levels start to drop. If you're over 45, you may be at a higher risk of having low levels of testosterone. Risk factors of low testosterone include:

  • Age
  • Alcoholism
  • Stress
  • Weight (obesity or extreme weight loss)

Low Testosterone Symptoms

If you have low testosterone, you may experience some of the following symptoms:

  • Fatigue
  • Low sex drive
  • Depression
  • Erectile dysfunction
  • Low muscle mass
  • Issues with memory or concentration
  • Obesity
  • Hair loss
  • Anemia

Low Testosterone Diagnosis

To diagnose low testosterone, your doctor will conduct a physical examination, consider your medical history and symptoms, and order a blood test to measure your testosterone levels. A blood test is one of the most definite ways to diagnose the condition.

Medical history

Your doctor may ask you questions regarding:

  • Current or past illnesses
  • Genetic conditions in the family (diseases linked to low testosterone)
  • Headaches
  • History of chemotherapy
  • History of head trauma
  • Injury to testicles
  • Loss of smell
  • Sex drive
  • Use of opiates
  • Use of glucocorticoids

Physical examination

A physical exam for low testosterone levels is essential. Your doctor will look at:

  • BMI
  • Body hair (pattern, amount, and location)
  • Presence and size of testicles
  • Size and consistency of the prostate
  • Size of breasts

Testing

In addition to a physical exam, your doctor may order the following tests:

  • Blood test
  • Total testosterone level
  • Luteinizing hormone (LH)
  • Blood prolactin level
  • Blood hemoglobin (Hgb)

Low Testosterone Treatment

Though some men want to start treatment for low testosterone, before confirming their testosterone levels, this isn't advised. If a blood test confirms you have low testosterone, however, there are multiple treatments that can help.

The most common treatments are:

  • Gels and creams: These are applied topically on the skin and last for about four days.
  • Skin patches: Similar to a bandaid, absorbing into the skin. These are left on until the next dose is due.
  • Oral: These are slow-release oral tablets that are placed in your mouth to dissolve.
  • Injection: These are bi-weekly injections of testosterone into your muscle tissue.
  • Pellets: Your doctor will place slow-release pellets under your skin.
  • While receiving testosterone therapy, it is important to have regular appointments with your doctor so they can check your testosterone levels and help manage any negative side effects.

Potential side effects of testosterone therapy may include:

  • Difficulty urinating
  • Skin irritation
  • Breast tenderness
  • Acne
  • Polycythemia (high red blood cell count)

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