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 Feb 17, 2025
Following the Medical Content Editorial Policy
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- Premature ejaculation
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- Sudden loss of erection
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See full list
Symptoms Related to Low Testosterone / Late Onset Hypogonadism
Diseases Related to Low Testosterone / Late Onset Hypogonadism
FAQs
Q.
What Is a Dangerously Low Testosterone Level?
A.
There is no clearly defined ‘dangerously low testosterone level’. Low testosterone is generally considered to be well below the normal range for a range defined by biological sex (male vs. female), not gender identity. Often under about 200 ng/dL on repeated morning tests is considered low, especially when combined with significant symptoms.
References:
https://doi.org/10.1210/jcem.86.2.7219
https://doi.org/10.1210/jcem.86.2.7219
https://doi.org/10.1210/jc.2018-00229
Q.
Does Low Testosterone Cause Weight Gain?
A.
Low testosterone is linked with weight gain because it can reduce muscle mass and slow metabolism, but many factors also affect body weight.
References:
Kelly DM, Jones TH. Testosterone and obesity. Obes Rev. 2015 Jul;16(7):581-606. doi: 10.1111/obr.12282. Epub 2015 May 15. PMID: 25982085.
Fernández-García JC, Barrios-Rodríguez R, Asenjo-Plaza M, et al. Metformin, testosterone, or both in men with obesity and low testosterone: A double-blind, parallel-group, randomized controlled trial. Metabolism journal. 2022;136(155290):1-10. doi:10.1002/oby.23695.
Q.
What Kind of Test Is Required to Confirm Low Testosterone?
A.
A blood test that measures your serum testosterone levels—usually taken in the morning—is the main test used to confirm low testosterone.
References:
Rivas AM, Mulkey Z, Lado-Abeal J, Yarbrough S. Diagnosing and managing low serum testosterone. Proc (Bayl Univ Med Cent). 2014 Oct;27(4):321-4. doi: 10.1080/08998280.2014.11929145. PMID: 25484498; PMCID: PMC4255853.
Q.
Does Low Testosterone Cause Erectile Dysfunction (ED)?
A.
Low testosterone can be one reason for erectile dysfunction, especially in men with very low levels, but ED is usually caused by a mix of factors.
References:
Rizk PJ, Kohn TP, Pastuszak AW, Khera M. Testosterone therapy improves erectile function and libido in hypogonadal men. Curr Opin Urol. 2017 Nov;27(6):511-515. doi: 10.1097/MOU.0000000000000442. PMID: 28816715; PMCID: PMC5649360.
Onyeji IC, Clavijo RI. Testosterone replacement therapy and erectile dysfunction. Int J Impot Res. 2022 Nov;34(7):698-703. doi: 10.1038/s41443-021-00512-w. Epub 2022 Jan 8. PMID: 34997198.
Wang Y, Jiang R. Androgens and erectile dysfunction: from androgen deficiency to treatment. Sex Med Rev. 2024 Jun 26;12(3):458-468. doi: 10.1093/sxmrev/qeae030. PMID: 38719619.
Q.
Can You Tell Low Testosterone by Looking at Their Face?
A.
You can't tell for sure if someone has low testosterone just by looking at their face, even though certain facial features might hint at changes.
References:
Nukana RP, Rusyati LMM, Praharsini GAA, Winaya KK, Suryawati N, Karna NLPRV. Association of testosterone level with melasma in men: a case-control study in Indonesia. Pan Afr Med J. 2022 Dec 16;43:194. doi: 10.11604/pamj.2022.43.194.37435. PMID: 36942149; PMCID: PMC10024555.
Bhasin S, Brito JP, Cunningham GR, Hayes FJ, Hodis HN, Matsumoto AM, Snyder PJ, Swerdloff RS, Wu FC, Yialamas MA. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018 May 1;103(5):1715-1744. doi: 10.1210/jc.2018-00229. PMID: 29562364.
Q.
Can Low Testosterone Cause High Blood Pressure?
A.
Low testosterone might be linked to changes in blood pressure, but it is not clear if it directly causes high blood pressure.
References:
Li N, Ma R, Wang S, Zhao Y, Wang P, Yang Z, Jin L, Zhang P, Ding H, Bai F, Yu J. The potential role of testosterone in hypertension and target organ damage in hypertensive postmenopausal women. Clin Interv Aging. 2019 Apr 29;14:743-752. doi: 10.2147/CIA.S195498. PMID: 31118595; PMCID: PMC6501555.
https://doi.org/10.1161/JAHA.120.019559
https://doi.org/10.1161/JAHA.120.019559
Hackett G, Mann A, Haider A, Haider KS, Desnerck P, König CS, Strange RC, Ramachandran S. Testosterone Replacement Therapy: Effects on Blood Pressure in Hypogonadal Men. World J Mens Health. 2024 Oct;42(4):749-761. doi: 10.5534/wjmh.230239. Epub 2024 Feb 14. PMID: 38449452; PMCID: PMC11439806.
Q.
Does Low Testosterone Cause Hair Loss?
A.
Low testosterone is not usually the main cause of hair loss in men, but in some cases of hormonal imbalance—especially in women—adjusting testosterone levels might improve hair growth.
References:
Glaser RL, Dimitrakakis C, Messenger AG. Improvement in scalp hair growth in androgen-deficient women treated with testosterone: a questionnaire study. Br J Dermatol. 2012 Feb;166(2):274-8. doi: 10.1111/j.1365-2133.2011.10655.x. Epub 2012 Jan 9. PMID: 21967243; PMCID: PMC3380548.
Kische H, Arnold A, Gross S, Wallaschofski H, Völzke H, Nauck M, Haring R. Sex Hormones and Hair Loss in Men From the General Population of Northeastern Germany. JAMA Dermatol. 2017 Sep 1;153(9):935-937. doi: 10.1001/jamadermatol.2017.0297. PMID: 28403384; PMCID: PMC5817427.
Asfour L, Cranwell W, Sinclair R. Male Androgenetic Alopecia. [Updated 2023 Jan 25]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet].
Q.
Can Low Testosterone Cause Depression ?
A.
Low testosterone has been linked to depression, as research shows that men with low levels may experience a lower mood and symptoms of depression, though depression can also be influenced by many other factors.
References:
Zitzmann M. Testosterone, mood, behaviour and quality of life. Andrology. 2020 Nov;8(6):1598-1605. doi: 10.1111/andr.12867. Epub 2020 Jul 30. PMID: 32657051.
Hauger RL, Saelzler UG, Pagadala MS, Panizzon MS. The role of testosterone, the androgen receptor, and hypothalamic-pituitary-gonadal axis in depression in ageing Men. Rev Endocr Metab Disord. 2022 Dec;23(6):1259-1273. doi: 10.1007/s11154-022-09767-0. Epub 2022 Nov 22. PMID: 36418656; PMCID: PMC9789012.
Q.
Is Low Testosterone Genetic?
A.
Yes, genetics can play a role in low testosterone. Some men inherit genes or genetic conditions, like Klinefelter syndrome, that make them more likely to have low testosterone levels.
References:
Fantus RJ, Na R, Wei J, Shi Z, Resurreccion WK, Halpern JA, Franco O, Hayward SW, Isaacs WB, Zheng SL, Xu J, Helfand BT. Genetic Susceptibility for Low Testosterone in Men and Its Implications in Biology and Screening: Data from the UK Biobank. Eur Urol Open Sci. 2021 May 25;29:36-46. doi: 10.1016/j.euros.2021.04.010. PMID: 34337532; PMCID: PMC8317803.
Millar AC, Faghfoury H, Bieniek JM. Genetics of hypogonadotropic hypogonadism. Transl Androl Urol. 2021 Mar;10(3):1401-1409. doi: 10.21037/tau.2020.03.33. PMID: 33850776; PMCID: PMC8039576.
Los E, Leslie SW, Ford GA. Klinefelter Syndrome. [Updated 2023 Nov 12]. In: StatPearls [Internet]
Q.
Does Low Testosterone Make You Tired?
A.
Yes, low testosterone can make you feel very tired because this hormone helps keep your body energized.
References:
Mani SB, Clavijo RI. Medical Treatment of Hypogonadism in Men. Urol Clin North Am. 2022 May;49(2):197-207. doi: 10.1016/j.ucl.2021.12.008. PMID: 35428426.
de Almeida Ferreira M, Mendonça JA. Long-term testosterone replacement therapy reduces fatigue in men with hypogonadism. Drugs Context. 2022 Feb 2;11:2021-8-12. doi: 10.7573/dic.2021-8-12. PMID: 35211178; PMCID: PMC8823386.
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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