How is low testosterone different in men?

Possible features include reduced sexual desire, fewer spontaneous erections, erectile difficulty, low energy, reduced muscle strength, low mood, irritability and difficulty concentrating. Some men notice reduced body hair, smaller testes, breast tenderness or problems with fertility.

These changes have many possible causes, including poor sleep, stress, some medicines, excess weight, illness and conditions affecting the testes or pituitary gland. A single result does not establish the reason for symptoms because testosterone changes during the day and can be temporarily lower when someone is unwell.

A clinician will ask about sexual symptoms, sleep, medicines, fertility plans and relevant health conditions. Testing is usually planned for the morning and may be repeated when a result is low, with additional hormone tests used to explore whether the source is the testes or the brain’s hormone-control centres.

Do not start testosterone from an unregulated source. Treatment decisions should account for fertility goals, prostate assessment, blood health, sleep-related breathing problems and the cause of the deficiency. Addressing sleep, alcohol, activity, nutrition or a contributing medicine may also be part of care.

Arrange a medical review for persistent loss of sexual desire, erection changes, unexplained low energy, fertility concerns or new breast or testicular changes. Seek urgent help for sudden severe testicular pain, a rapidly enlarging testicular swelling, or severe headache with vision changes.

A clinician should review symptoms that began after a new medicine or major illness, because correcting the trigger may be safer than treating a laboratory value alone.

Ask which symptoms could be related to testosterone, when testing should be taken, whether a repeat sample is needed, and what other causes should be checked. If fertility matters to you, say so before discussing treatment because testosterone therapy can reduce sperm production.