Causes of Low Testosterone

Low testosterone popularly referred to as low T for short, affects 4 to 5 million men in the US. Testosterone is an important hormone in the human body, however, it begins to decrease each year from age 30. This can be substantial in some men. In recent years, older men with low T have increasingly sought after testosterone replacement therapy (TRT).

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Symptoms like low libido, poor muscle mass and low energy is addressed with TRT. Apart from older men, low T can equally affect young men, even babies and children too.

Symptoms of Low Testosterone

Low levels of testosterone that are uncharacteristic of normal aging are as a result of other primary or secondary causes of hypogonadism. In men, hypogonadism occurs when the testicles is unable to produce enough testosterone. Hypogonadism can begin during fetal development, during puberty, or during adulthood.

Fetal development

If hypogonadism begins during fetal development, it may cause impaired growth of external sex organs. Depending on when hypogonadism begins and the level of testosterone present during fetal development, a male child can develop:

  • underdeveloped male genitals
  • female genitals
  • ambiguous genitals, neither clearly male or female


If hypogonadism occurs during puberty, normal growth can be affected. Symptoms may include:

  • enlarged breasts
  • muscle development
  • deepening of the voice
  • lack of body hair
  • underdeveloped genitals
  • overly long limbs


Later in life, insufficient testosterone can lead to other problems such as:

Fatigue and mental fogginess are some commonly reported mental and emotional symptoms in men with low T.

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Causes of low testosterone

The two basic types of hypogonadism are primary and secondary hypogonadism.

Primary hypogonadism

Underactive testes cause primary hypogonadism because they don’t produce sufficient levels of testosterone for optimum growth and health. This underactivity can be caused by a hereditary trait. It can also be gotten by accident or illness.

Inherited conditions include:

  • Undescended testicles: When the testicles fail to descend from the abdomen before birth
  • Klinefelter’s syndrome: A condition in which a man is born with three sex chromosomes: X, X, and Y.
  • Hemochromatosis: Excessive iron in the blood causes testicular failure or pituitary damage

Types of testicle damage that can lead to primary hypogonadism include:

  • Physical injury to the testicles: Injury must occur to both testicles to affect testosterone levels.
  • Mumps orchitis: A mumps infection can injure testicles.
  • Cancer treatment: Cancer treatment like chemotherapy or radiation can cause damage to the testicles.

Secondary hypogonadism

Secondary hypogonadism is caused by damage to the pituitary gland or hypothalamus. These parts of the brain control hormone production by the testes.

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Inherited or disease conditions in this category include:

  • Pituitary disorders:This is caused by drugs, kidney failure, or small tumors.
  • Kallmann syndrome: This is a condition connected to abnormal hypothalamus function.
  • Inflammatory diseases: Such as tuberculosis, sarcoidosis, and histiocytosis, which can impact the pituitary gland and the hypothalamus.
  • HIV/AIDS: This can affect the pituitary gland, hypothalamus, and testes

Acquired circumstances that can lead to secondary hypogonadism include:

  • Normal aging: Aging affects production and response to hormones.
  • Obesity: High body fat can affect hormone production and response.
  • Medications: Opioid pain meds and steroids can affect function of the pituitary gland and hypothalamus.
  • Concurrent illness: Severe emotional stress or physical stress from an illness or surgery can cause the reproductive system to temporarily shut down.

You may be affected by primary, secondary, or a mixed hypogonadism. Mixed hypogonadism is more common with increased age. People undergoing glucocorticoid therapy can develop the condition. It also can affect people with sickle-cell disease, thalassemia, or alcoholism.

Lifestyle changes you can make

If you’re experiencing symptoms of low T, lifestyle changes may help to reduce some of your symptoms. You can increase your activity levels and maintain a healthy diet so to reduce body fat. It can also be helpful to avoid glucocorticoid medications such as prednisone as well as opioid pain drugs.

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Testosterone replacement

If lifestyle changes is ineffective, you may need to start testosterone replacement therapy (TRT) for treatment of low T. TRT can be very essential for helping teenage males with hypogonadism experience regular masculine development. Adequate testosterone levels help maintain health and well-being in adult males.

Side effects of TRT includes:

  • enlarged prostate
  • acne
  • sleep apnea
  • low sperm count
  • testicle shrinkage
  • breast enlargement
  • increased red blood cell count

A proper TRT treatment plan should avoid many of these side effects. Discuss with your doctor to assess your options.



Disclaimer: The content provided on is purely informative and educational in nature and should not be interpreted as medical advice. Please use the content only in consultation with an appropriate certified medical doctor or healthcare professional.

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