“Not tonight, honey. I’m just too tired.”
“I don’t know what’s wrong with me. I just don’t feel like myself.”
“Guess I’m just not as strong as I used to be! Must be my age.”
Guys, have you found yourself saying any of these statements? These could signal a real and important issue for men and people assigned male at birth (AMAB) and your health system.
What is low testosterone (male hypogonadism)?
To find out if you or your loved one may have low testosterone, call us to book an appointment at 302-661-3070.
Men with low testosterone (male hypogonadism) do not make enough of the male hormone called testosterone. This condition occurs when there isn’t enough hormone produced in your testicles. Testosterone regulates a man’s sex drive, bone mass, fat distribution, muscle mass (and strength) and the production of red blood cells and sperm. This hormone is also vital to the healthy functioning of many different parts of the body. The hypothalamus, along with the pituitary gland, controls the amount of testosterone the testicles produce and release.
Hypogonadism may start during fetal development, before puberty or in adulthood, with the signs and symptoms varying based on the timing of its onset. It can lead to problems such as a lower sex drive, weak bones, less muscle mass, less body hair, enlarged breasts and infertility.
What causes low testosterone?
Many things can cause this condition, such as:
- Injury to the testicles, or surgery or radiation treatment in the groin area.
- Certain medicines.
- Having a long-term medical condition, such as kidney or liver disease or obesity.
- Aging.
- Problems related to the pituitary gland or hypothalamus.
- Low testosterone also can be present at birth.
A blood test is usually done to find out if you have low testosterone. If your doctor thinks low testosterone could be related to another medical problem, other tests may be done.
What are the symptoms of low testosterone in men?
The symptoms of low testosterone in men are vague and could represent other diseases that should be addressed. Symptoms of low testosterone in men may include:
- Reduced sex drive.
- Erectile dysfunction or impotence.
- Loss of body hair, armpit and/or pubic hair.
- Decreased muscle mass/strength.
- Swelling/tenderness in the breast tissue or enlarged breasts.
- Depressed mood.
- Fatigue.
- Sleep disturbances and insomnia.
- Fertility problems.
- Increased body fat.
- Anxiety, guilt or shame.
- Relationship problems.
- Lack of inspiration or purpose.
- Very small testicles.
- Hot flashes.
- Loss of height.
- Weakened bones.

Conditions that can result from low testosterone
- Low sperm production.
- Fat distribution.
- Red blood cell production.
- Metabolic syndrome.
- Diabetes.
- Cardiovascular disease.
- Fractures and bone density.
- Neurodegenerative disease.
- Hypothyroidism.
- Migraines.
- Higher mortality rate in men with lower testosterone levels.
- Stress disorder.
Rare conditions may cause low testosterone
It’s important to note that causes of low testosterone can be caused by rare conditions, some of which could have been present since birth. When the body doesn’t produce and receive enough testosterone during fetal development in the mother’s womb, this could result in impaired growth of the external sex organs. Some conditions that may cause male hypogonadism in the womb or at birth can include:
- Absence of testicles at birth (anorchia).
- Cryptochordism (undescended testicles).
- Klinefelter’s syndrome (a genetic condition in which people AMAB are born with at least two X chromosomes in addition to their Y chromosome, and in rare cases, as many as three or four).
- Noonan syndrome (a rare genetic condition causing delayed puberty, undescended testicles or infertility).
- Isolated hypogonadotropic hypogonadism (a condition causing low levels of gonadotropin-releasing hormone from birth).
- Kallmann syndrome (a rare genetic condition that causes loss of nerve cell development in your hypothalamus producing gonadotrophin-releasing hormone. It can also cause a lack of smell, synkinesis of the limbs and micropenis.).
Help is here
At ChristianaCare, we treat all conditions that can cause low testosterone.
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Low testosterone is most often treated with testosterone hormone replacement therapy (HRT) but there are also other courses of action. We will discuss all appropriate options with you.
Schedule an appointment with one of our endocrinology specialists today and learn more about low testosterone, its treatment and its health effects. No one needs to go through this alone. We are here to help.
Prakash Seshadri, M.D., is here to help new and existing patients in endocrinology. Learn more about us online or call us to schedule an appointment at 302-661-3070.