Low Testosterone / Late Onset Hypogonadism Quiz
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Reduced libido
Erectile dysfunction
Shrinking testicles
Hot flashes
Reduced sex drive
No armpit hair
Poor concentration
Enlarged male breasts
Feeling depressed or fatigued
Low energy level
Difficulty maintaining an erection
Low motivation or ambition
Not seeing your symptoms? No worries!
What is Low Testosterone / Late Onset Hypogonadism?
Low testosterone, or late-onset hypogonadism, is a condition characterized by reduced levels of testosterone in aging males, leading to symptoms such as fatigue, reduced libido, depression, and decreased muscle mass.
Typical Symptoms of Low Testosterone / Late Onset Hypogonadism
- Difficulty achieving or maintaining an erection
- Decreased sex drive
- Recent changes in mental state
- Decreased motivation
- Mental stress and physical fatigue
- Intense mood swings
- Fatigue or low energy that varies throughout the day
- Fatigue or low energy that is worse in the morning
Diagnostic Questions for Low Testosterone / Late Onset Hypogonadism
Your doctor may ask these questions to check for this disease:
- Are you worried about your sexual performance because you can't get or keep an erection for sex?
- Have you experienced a decrease in your sex drive?
- Recently, are you more confused than before?
- Have you been experiencing decreased motivation recently?
- Are you experiencing mental stress and physical fatigue?
Treatment of Low Testosterone / Late Onset Hypogonadism
Treatment involves addressing symptoms and restoring testosterone levels, often through testosterone replacement therapy (TRT). Lifestyle modifications, managing underlying conditions, and periodic monitoring are essential to ensure efficacy and minimize risks.
Reviewed By:
Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Apr 15, 2025
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Premature ejaculation
- Decrease in sexual desire
- Impotence
- Confusion
- Delayed ejaculation
- Lack of motivation
- No sexual desire
- Low libido
- Feeling stressed
- No sex drive
- Change in mental status
- Low libido
- Losing erection with new partner
- Sudden loss of erection
- Feeling less ambitious nowadays
See full list
Symptoms Related to Low Testosterone / Late Onset Hypogonadism
Diseases Related to Low Testosterone / Late Onset Hypogonadism
FAQs
Q.
Losing Drive? Why Your Testosterone Is Low & Medically Approved Next Steps
A.
Low testosterone can cause reduced libido and erections, fatigue, loss of muscle, increased belly fat, and low mood, most often from aging but also obesity, sleep apnea, chronic illness, or certain medications. Because many issues can mimic it, proper diagnosis needs symptoms plus repeat morning blood tests and sometimes pituitary evaluation. Medically approved steps include weight loss, resistance training, better sleep, treating conditions like diabetes or sleep apnea, and doctor supervised testosterone therapy with monitoring for risks like reduced fertility and high red blood cell counts; there are several factors to consider that can change your next steps, so see the complete guidance below.
References:
* Krzastek SC, Sharma D, Ziemba-Davis M, Zuniga A, Brannigan RE, Vasan S. Testosterone Deficiency Syndrome: A Review of Diagnosis and Treatment. World J Mens Health. 2021 Jan;39(1):31-38.
* Araujo AB, Dixon JM, Suarez EA, Morgentaler A. Testosterone deficiency in aging men: an evidence-based review. Aging Male. 2021 Dec;24(1):21-36.
* Mulhall JP, Trost TA, Brannigan RE, Kurtz S, Lee NK, Althof SE, Burnett AL, Breyer BN. The Clinical Practice Guideline for Testosterone Deficiency from the American Urological Association. J Urol. 2018 Sep;200(3):517-523.
* Yeap BB, Inder WJ, McLachlan RI. Testosterone replacement therapy in men: current perspectives. Med J Aust. 2020 Aug;213(4):185-191.
* Kovac JR, Pan MM, Smith RP, Lipshultz LI. Male Hypogonadism: Symptoms, Causes, Diagnosis, and Treatment Options. Curr Urol Rep. 2017 Jul;18(7):51.
Q.
Losing Your Edge? Why Your Internal Engine Is Stalling & Medically-Backed Steps
A.
Low testosterone is a common, often overlooked reason your internal engine feels stalled, causing fatigue, lower libido, weaker workouts, brain fog, and mood changes, though sleep loss, stress, thyroid disease, diabetes, and heart issues can cause similar symptoms. Proper diagnosis requires morning blood tests on two separate days and evaluation for underlying causes, and many men can raise levels with better sleep, fat loss, strength training, stress control, adequate vitamin D, zinc and magnesium, and less alcohol, while testosterone therapy may help select patients but can suppress fertility and needs monitoring. There are several factors to consider, including urgent red flags that change next steps, so see the complete, medically-backed guidance below.
References:
* Konopka AR, Harber MP. Lifestyle interventions for improving mitochondrial function in health and disease. FASEB J. 2020 May;34(5):6033-6047. doi: 10.1096/fj.201902996RR. Epub 2020 Mar 19. PMID: 32188220.
* López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. Mitochondrial dysfunction and the aging process. Cell. 2018 Jul 26;174(3):511-522. doi: 10.1016/j.cell.2018.07.014. PMID: 30048126.
* Missailidis C, Annesley SJ, Fisher-Carroll L, Barnden LR, Staines DR, Marshall-Gradisnik SM, Eaton N, Newton JL, Smith PM. Metabolic features of myalgic encephalomyelitis/chronic fatigue syndrome. Curr Rheumatol Rep. 2018 Mar 12;20(5):26. doi: 10.1007/s11926-018-0731-y. PMID: 29530467.
* Milanese C, Di Nunzio M, Lattanzio F, D'Antona G. Exercise and metabolic health in aging. Curr Opin Clin Nutr Metab Care. 2019 Jan;22(1):31-37. doi: 10.1097/MCO.0000000000000529. PMID: 30419163.
* da Cruz Gouveia E, Paes F, Machado S, Nardi AE, Rocha NB. Nutrition, physical activity, and sleep: three pillars of aging well. Int J Environ Res Public Health. 2021 Jun 28;18(13):6903. doi: 10.3390/ijerph18136903. PMID: 34208460; PMCID: PMC8297746.
Q.
Silent Struggle? Why Your Anatomy Is Misfiring + Medically Approved Next Steps
A.
Fatigue, low libido, brain fog, and slower recovery can reflect connected anatomy misfires, often from hormonal imbalance like late-onset low testosterone, and they warrant attention because untreated issues can affect bones, heart, mood, and metabolism. There are several factors to consider, and medically approved next steps include structured symptom checks, a doctor visit with morning labs to confirm and rule out other causes, lifestyle treatment first, and carefully monitored testosterone therapy when appropriate; see the complete guidance below because key details there can change which next step is right for you.
References:
* Riemann BL, Lephart SM. The sensorimotor system, part I: the physiologic basis of functional joint stability. J Athl Train. 2002 Oct-Dec;37(4):460-70. PMID: 12937402; PMCID: PMC164390.
* Cook C, Hegedus EJ. Diagnostic and Treatment Pathways for Musculoskeletal Disorders. Orthop J Sports Med. 2017 Apr 26;5(4):2325967117705191. doi: 10.1177/2325967117705191. PMID: 28480287; PMCID: PMC5410931.
* Hodges PW, Smeets RJ. Interaction between pain, movement, and motor control in musculoskeletal pain disorders: Implications for treatment. Phys Ther. 2015 Feb;95(2):273-87. doi: 10.2522/ptj.20140060. Epub 2014 Aug 21. PMID: 25147253.
* Saragiotto BT, Machado LF, Verhagen AP, van Tulder MW, Koes BW, Rzewuska M, Maher CG. Exercise therapy for patients with nonspecific low back pain: A systematic review and meta-analysis of randomized controlled trials. J Orthop Sports Phys Ther. 2016 May;46(5):372-88. doi: 10.2519/jospt.2016.6473. Epub 2016 Mar 23. PMID: 27008493.
* Huxel Bliven KC, Anderson BE. Core stability training for injury prevention. Sports Health. 2013 Nov;5(6):514-22. doi: 10.1177/1941738113482637. PMID: 24427426; PMCID: PMC3820252.
Q.
Intimacy and Muscle Loss: The Quiet Symptom No One Talks About
A.
Muscle weakness during intimacy can be a quiet but important health signal, ranging from low testosterone to neurological causes like cataplexy triggered by strong emotion or arousal, with sleep problems, medications, stress, and heart issues also possible. There are several factors to consider; red flags such as sudden collapse, excessive daytime sleepiness, chest pain, or rapid decline warrant prompt evaluation, and key details on what to do next are outlined below.
References:
* Lee, J., Jo, S., Kim, H., & Kwon, Y. (2018). Impact of Sarcopenia on Sexual Function and Health-Related Quality of Life in Postmenopausal Women. *Journal of Clinical Densitometry*, *21*(4), 543–550.
* Li, T., Li, M., Ma, Z., Ma, Q., Cui, Y., Chen, J., Li, Y., Song, R., & Zhu, S. (2020). Sarcopenia and Its Association with Sexual Dysfunction in Older Men: A Systematic Review and Meta-Analysis. *The Journal of Sexual Medicine*, *17*(7), 1279–1290.
* Crespo, M., Calero, M., Otero, Á., & Bellón, J. Á. (2020). Frailty and sexual activity in older adults: a systematic review. *Archives of Gerontology and Geriatrics*, *87*, 104000.
* Lin, H.-C., Chen, T.-W., Fang, Y.-F., & Hsieh, M.-H. (2021). The Association Between Frailty and Sexual Dysfunction in Older Women: A Cross-Sectional Study. *Sexual Medicine*, *9*(4), 100399.
* Gruenewald, D. A., & Matsumoto, A. M. (2003). Testosterone and the aging male: a review of the clinical and scientific literature. *Journal of the American Geriatrics Society*, *51*(7), 103–115.
Q.
Baking Soda Trick for Men: What Women 30-45 Must Do Next
A.
There are several factors to consider: the baking soda trick is not proven to boost testosterone, fix erectile dysfunction, or improve fertility, and frequent use can raise sodium and blood pressure, creating risks for people with heart or kidney problems. Instead, women 30 to 45 should start a supportive conversation, focus on evidence-based steps like better sleep, strength training, weight and stress management, use a structured low testosterone symptom check, and arrange a medical evaluation if symptoms persist or seem serious. There are important details that could change your next steps, so see below to understand more.
References:
* Maalouf, N. M., & Sakhaee, K. (2010). Sodium bicarbonate: a review of the medical literature. *Kidney International*, *78*(S117), S11-S17.
* Tourmente, M., & Koppers, A. J. (2010). Sperm motility and fertilization. *Biology of Reproduction*, *83*(5), 724-733.
* Henriksen, T. B., Skjaerven, R., & Kvale, G. (2005). Age and fertility: a study of 4000 pregnancies. *Acta Obstetricia et Gynecologica Scandinavica*, *84*(7), 675-679.
* Navarro, B., & Darszon, A. (2014). pH regulation of sperm capacitation and acrosome reaction. *Current Topics in Developmental Biology*, *108*, 277-302.
* Carr, A. J., Slater, G. J., & Gore, C. J. (2011). Sodium bicarbonate ingestion and its effects on repeated bouts of high-intensity exercise. *Sports Medicine*, *41*(8), 603-617.
Q.
What are some effective ways to stop hot flashes quickly in men?
A.
To stop a hot flash quickly, men can cool down their body with immediate measures like a cold shower or cool compress, and in some cases, medications such as megestrol acetate may be used under a doctor's supervision.
References:
Loprinzi CL, Michalak JC, Quella SK, O'Fallon JR, Hatfield AK, Nelimark RA, Dose AM, Fischer T, Johnson C, Klatt NE, et al. Megestrol acetate for the prevention of hot flashes. N Engl J Med. 1994 Aug 11;331(6):347-52. doi: 10.1056/NEJM199408113310602. PMID: 8028614.
Mohile SG, Mustian K, Bylow K, Hall W, Dale W. Management of complications of androgen deprivation therapy in the older man. Crit Rev Oncol Hematol. 2009 Jun;70(3):235-55. doi: 10.1016/j.critrevonc.2008.09.004. Epub 2008 Oct 25. PMID: 18952456; PMCID: PMC3074615.
Witkowski S, Evard R, Rickson JJ, White Q, Sievert LL. Physical activity and exercise for hot flashes: trigger or treatment? Menopause. 2023 Feb 1;30(2):218-224. doi: 10.1097/GME.0000000000002107. Epub 2022 Nov 7. PMID: 36696647; PMCID: PMC9886316.
Q.
What self-care strategies can help manage erectile dysfunction?
A.
Self-care strategies to help manage erectile dysfunction include lifestyle changes like regular exercise, healthy eating, stress reduction, and avoiding smoking and excessive alcohol. These practices may improve blood flow and overall health, which can support better erectile function.
References:
Maiorino MI, Bellastella G, Esposito K. Lifestyle modifications and erectile dysfunction: what can be expected? Asian J Androl. 2015 Jan-Feb;17(1):5-10. doi: 10.4103/1008-682X.137687. PMID: 25248655; PMCID: PMC4291878.
Gerbild H, Larsen CM, Graugaard C, Areskoug Josefsson K. Physical Activity to Improve Erectile Function: A Systematic Review of Intervention Studies. Sex Med. 2018 Jun;6(2):75-89. doi: 10.1016/j.esxm.2018.02.001. Epub 2018 Apr 13. PMID: 29661646; PMCID: PMC5960035.
Lowy M, Ramanathan V. Erectile dysfunction: causes, assessment and management options. Aust Prescr. 2022 Oct;45(5):159-161. doi: 10.18773/austprescr.2022.051. Epub 2022 Oct 4. PMID: 36382171; PMCID: PMC9584785.
Q.
Why do hot flashes often occur at night, and how can they be managed?
A.
Hot flashes often happen at night because our body’s temperature control becomes more sensitive during sleep, and they can be managed with lifestyle adjustments and sometimes medications.
References:
Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. Available from: [https://www.ncbi.nlm.nih.gov/books/NBK65717/
https://www.ncbi.nlm.nih.gov/books/NBK65717/
Morrow PK, Mattair DN, Hortobagyi GN. Hot flashes: a review of pathophysiology and treatment modalities. Oncologist. 2011;16(11):1658-64. doi: 10.1634/theoncologist.2011-0174. Epub 2011 Oct 31. PMID: 22042786; PMCID: PMC3233302.
Thurston RC, Chang Y, Buysse DJ, Hall MH, Matthews KA. Hot flashes and awakenings among midlife women. Sleep. 2019 Sep 6;42(9):zsz131. doi: 10.1093/sleep/zsz131. PMID: 31152182; PMCID: PMC7368339.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Dudek P, Kozakowski J, Zgliczyński W. Late-onset hypogonadism. Prz Menopauzalny. 2017 Jun;16(2):66-69. doi: 10.5114/pm.2017.68595. Epub 2017 Jun 30. PMID: 28721133; PMCID: PMC5509975.
https://pmc.ncbi.nlm.nih.gov/articles/PMC5509975/Griebling, T.L. Late Onset Hypogonadism, Testosterone Replacement Therapy, and Sexual Health in Elderly Men. Curr Transl Geriatr and Exp Gerontol Rep 2, 76–83 (2013). https://doi.org/10.1007/s13670-013-0042-9
https://link.springer.com/article/10.1007/s13670-013-0042-9Giagulli VA, Castellana M, Lisco G, Triggiani V. Critical evaluation of different available guidelines for late-onset hypogonadism. Andrology. 2020; 8: 1628–1641.
https://onlinelibrary.wiley.com/doi/10.1111/andr.12850