What is testosterone deficiency?

Testosterone deficiency, often referred to as hypogonadism, occurs when the body produces insufficient amounts of testosterone—a hormone critical for male health. Testosterone is responsible for regulating a range of functions, including muscle mass, bone density, red blood cell production, and libido. Although testosterone is commonly associated with men, women also produce small amounts of this hormone. Testosterone deficiency can result from various causes, including ageing, medical conditions, or lifestyle factors.

A leading consultant urologist provides a patient-friendly overview of testosterone deficiency, helping you identify potential symptoms and understand its causes and treatment options.

What are the symptoms of testosterone deficiency?

Testosterone deficiency may present with a variety of symptoms, many of which can be subtle or mistaken for other conditions. Common signs include low energy levels, reduced sex drive, and difficulty achieving or maintaining erections. Men may also experience mood changes, such as irritability or depression, and cognitive difficulties like poor concentration or memory issues.

Physical symptoms might include decreased muscle mass, increased body fat, and loss of body hair. In some cases, men may notice a reduction in the size of their testes. If you experience any of these symptoms persistently, it may be worthwhile to consult your doctor.

What causes testosterone deficiency?

There are several reasons why testosterone levels might decrease. Ageing is one of the main factors contributing to testosterone deficiency. Testosterone production typically peaks during adolescence and early adulthood, then gradually declines after the age of 30. While this is a natural part of ageing, some men may experience a more significant drop in testosterone than others, leading to symptoms.

Other potential causes include medical conditions such as type 2 diabetes, obesity, and chronic illnesses like kidney or liver disease. Certain treatments, such as chemotherapy or radiation therapy, can also impair testosterone production. Additionally, injuries to the testicles or disorders affecting the pituitary gland—a small gland in the brain that regulates hormone production—may lead to deficiency.

How is testosterone deficiency diagnosed?

If testosterone deficiency is suspected, your doctor will likely conduct a physical examination and review your symptoms. A blood test is typically required to measure testosterone levels. These tests are often done in the morning when hormone levels are at their highest. Additional tests may be necessary to identify underlying causes or to rule out other conditions that could mimic the symptoms of low testosterone.

What treatments are available?

Treatment for testosterone deficiency often involves testosterone replacement therapy (TRT). This can be administered in various forms, such as injections, gels, patches, or implants. TRT is designed to bring testosterone levels back to a healthy range, helping to reduce symptoms and enhance overall quality of life.

However, TRT may not be suitable for everyone. For example, men with certain medical conditions, such as prostate cancer, should discuss alternative approaches with their doctor. Lifestyle modifications, including weight loss, exercise, and a healthy diet, may also help improve testosterone levels naturally.