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
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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.
Is it Micropenis? The Medical Reality and Your Essential Next Steps
A.
True micropenis is rare and medically defined as a normally formed penis with a stretched length under about 3.5 inches (9 cm) in adults, so most men who worry about size do not meet this definition. There are several factors to consider, including buried penis, obesity, and hormonal conditions like low testosterone; see the detailed explanation below to understand diagnosis, causes, and what it means for function and fertility. For next steps, get an accurate in-office measurement, ask for hormone testing, and consider urology or endocrinology referral, with mental health support as needed and prompt care for red flags like sudden erectile failure or severe fatigue.
References:
* Hatipoglu, N., & Kurtoglu, S. (2019). Micropenis: Etiology, diagnosis and treatment. *Journal of Clinical Research in Pediatric Endocrinology*, *11*(3), 209.
* Baş, F., & Darendeliler, F. (2020). Management of Micropenis: Current Concepts. *Journal of Clinical Research in Pediatric Endocrinology*, *12*(Suppl 1), 60–67.
* Bin-Abbas, H. A., & Al-Amri, M. (2017). Micropenis: Classification, diagnosis and management. *Saudi Medical Journal*, *38*(11), 1083–1089.
* Boas, M., & Houk, C. P. (2018). Normal penile length measurements in male infants and children: A review of the literature. *Journal of Pediatric Endocrinology & Metabolism*, *31*(1), 1–8.
* Lee, P. A., & Houk, C. P. (2015). The clinical spectrum and management of the small penis. *Current Opinion in Endocrinology, Diabetes, and Obesity*, *22*(6), 492–498.
Q.
Out of Control? Why Your Brain is Hypersexual & Medical Next Steps
A.
Hypersexual urges, especially when thoughts feel intrusive or impairing, can stem from dopamine reward dysregulation, bipolar mania, hormonal shifts, stress-based coping, medication side effects, or less commonly neurological disease. There are several factors to consider, and you can see below to understand more. Next steps include seeing a clinician for medication review, hormone and thyroid testing, and screening for mood disorders, with urgent evaluation warranted for severe mood swings, compulsive risky sex, sudden personality changes, or neurological signs; key details and practical strategies are outlined below.
References:
* Reay, W., et al. (2018). Neurobiological Aspects of Hypersexual Behavior: A Systematic Review. *Current Sexual Health Reports*, 10(2), 65-74.
* Ley, P., et al. (2019). Neurobiological Correlates of Compulsive Sexual Behavior. *Current Sexual Health Reports*, 11(4), 312-321.
* Barth, J. P., et al. (2020). Pharmacological and Psychological Treatment Options for Compulsive Sexual Behavior Disorder: A Review. *Current Psychiatry Reports*, 22(2), 8.
* Gola, M., et al. (2021). The Neurobiology of Compulsive Sexual Behavior: A Narrative Review. *Sexual Medicine Reviews*, 9(4), 515-525.
* Brand, M., et al. (2018). Functional Neuroimaging of Compulsive Sexual Behavior: A Systematic Review. *Sexual Addiction & Compulsivity*, 25(2), 99-122.
Q.
Libido Crashing? Why Maca Root Works and Medically Approved Next Steps
A.
There are several factors to consider. Maca root is one of the better-studied natural options for a crashing libido, with modest benefits for desire, mood, and mild ED after 6 to 12 weeks via non-hormonal pathways, but it is not a replacement for testosterone therapy; dosing, safety, and who should avoid it are detailed below. Medically approved next steps include optimizing sleep, strength training, stress, diet, and alcohol, then a monitored maca trial, and seeking medical evaluation for red flags or persistent symptoms with labs like testosterone, thyroid, prolactin, glucose, and lipids; important nuances that could change your next step are outlined below.
References:
* Dording CM, Schettler K, Rosenbaum JF, Fava M, Jellinek D, Rosenbaum JF, Alpert JE, Fava M. Maca (Lepidium meyenii) for treatment of sexual dysfunction in women with antidepressant-induced sexual dysfunction. CNS Neurosci Ther. 2008 Fall;14(3):182-91. doi: 10.1111/j.1755-5949.2008.00052.x. PMID: 18784609.
* Gonzales GF. Maca (Lepidium meyenii) and male sexual dysfunction. Andrologia. 2012 Nov;44 Suppl 1:178-83. doi: 10.1111/j.1439-0272.2011.01162.x. PMID: 22099419.
* Meissner HO, Reich-Meissner H, Reich-Meissner H, et al. Prospective randomized, placebo-controlled study of Maca (Lepidium meyenii) on sexual desire and mood in postmenopausal women. Maturitas. 2006 Nov 20;55(3):356-62. doi: 10.1016/j.maturitas.2006.07.009. Epub 2006 Oct 2. PMID: 17007998.
* Nappi RE, Nappi C, Nappi F, Nappi M. Update on the pharmacologic treatment of female sexual dysfunction. Ther Adv Urol. 2019 Aug 26;11:1756287219871147. doi: 10.1177/1756287219871147. eCollection 2019. PMID: 31481977.
* McMahon CN, Lakin MM. Current and emerging therapeutic approaches for male sexual dysfunction. J Sex Med. 2018 Jan;15(1):15-28. doi: 10.1016/j.jsm.2017.11.002. Epub 2017 Dec 1. PMID: 29203108.
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.
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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