Testosterone is the primary male sex hormone, produced mainly in the testicles. It plays a critical role in maintaining muscle and bone mass, regulating libido, supporting mood, and ensuring sustained energy levels. While women also produce testosterone, they do so in much smaller amounts; nevertheless, it remains essential for their overall physiological health.
What is low testosterone?
When testosterone levels fall below the normal range, the condition is known as hypogonadism. If the cause is linked to lifestyle factors or chronic diseases rather than permanent damage to the testes or pituitary gland, it is referred to as functional hypogonadism.
Studies show that testosterone levels naturally decline by approximately 1% per year after the age of 30. While not every man experiences symptoms, clinically significant hypogonadism affects 2–6% of men, rising to up to 20% in men over age 60.
Symptoms of low testesterone
- Fatigue and weakness
- Reduced libido and erectile dysfunction
- Loss of muscle mass, increased fat mass
- Mood swings, depression, anxiety
- Reduced bone density, risk of osteoporosis
- Decreased hair growth and other physical changes
Risk factors
- Aging
- Obesity and metabolic disorders (like type 2 diabetes)
- Chronic illnesses (kidney or liver disease)
- High stress levels and poor sleep quality
- Alcohol consumption, drug use, and certain medications
Functional hypogonadism
Caused by lifestyle and metabolic disorders. Often reversible with weight loss, improved sleep, diabetes management, and reduced alcohol intake.
Role of the family doctor
The family doctor is your first point of contact. They will evaluate your symptoms, order appropriate laboratory tests, and provide a referral to an endocrinologist or urologist if necessary.
Dr. Ruslans Mihailovskis
Diagnostic tests
Diagnosis typically involves blood work, ideally performed in the morning when testosterone levels are at their peak:
- Total Testosterone & Free Testosterone: To assess overall hormone levels.
- LH (Luteinizing Hormone) & FSH (Follicle-Stimulating Hormone): To determine if the issue originates in the brain or the testicles.
- Comprehensive Screening: Glucose, lipid profile, and liver/kidney function tests to rule out metabolic triggers.
- Imaging: Ultrasound or MRI of the pituitary gland or testicles may be indicated in specific cases.
Treatment and prevention
- Functional hypogonadism is often reversible through lifestyle modifications.
- Monitoring: Regular check-ups are essential to monitor prostate health, cardiovascular markers, and blood cell counts.
- Lifestyle Changes: Focused weight loss, regular exercise, improving sleep hygiene, and reducing alcohol and tobacco intake.
- Medical Intervention: Testosterone replacement therapy (TRT), available in gels, patches, or injections, provided under strict medical supervision.
At Republikas laukuma klīnika, we offer professional endocrine and urological consultations, alongside all necessary diagnostic laboratory tests. If you are experiencing symptoms such as unexplained fatigue, low libido, or mood changes, our specialists are here to provide an individualized health assessment.
FAQ
Yes, it is a natural physiological process. Testosterone levels typically decrease by about 1% annually after age 30. However, if this decline is accompanied by significant symptoms like fatigue or erectile dysfunction, it warrants a medical evaluation to distinguish between normal aging and clinical hypogonadism.
Accuracy is key. Since testosterone levels fluctuate throughout the day, the blood sample should be collected in the morning (usually before 11:00 AM). Ensure you follow your doctor’s instructions regarding fasting, as certain metabolic markers may also be checked at the same time.
In cases of functional hypogonadism, yes. Significant improvements in body weight, insulin sensitivity, sleep quality, and stress management can often help the body restore its natural hormonal balance without the need for lifelong hormone replacement therapy.
