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Low Testosterone: Symptoms, Diagnosis and Treatment

Signs of low testosterone in men, how it is properly diagnosed, and what treatment involves.

By Editorial Team · Updated · 1 min read

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Photo: Łukasz Popardowski · CC0

This article is awaiting review by a qualified medical professional.

Quick answer

Low testosterone can cause reduced sex drive, fatigue, erectile dysfunction and loss of muscle. It is diagnosed with symptoms plus low total testosterone on at least two morning blood tests. Treatment depends on the cause and may include lifestyle changes or testosterone therapy under medical supervision.

Testosterone is the main male sex hormone. It supports sex drive, muscle, bone, red blood cell production and mood. Levels fall slightly with age, but a true deficiency (male hypogonadism) is a medical condition.

Possible symptoms

  • Reduced sex drive
  • Erectile dysfunction, especially fewer morning erections
  • Low energy and fatigue
  • Reduced muscle mass and strength
  • Increased body fat
  • Low mood or difficulty concentrating
  • Reduced body hair
  • Low bone density
  • Infertility

These symptoms are not specific to low testosterone. Poor sleep, depression, obesity, diabetes, thyroid disease and some medicines can cause the same problems.

How it is diagnosed

Diagnosis needs both symptoms and consistently low blood levels. Guidelines recommend:

  1. Measuring total testosterone with a morning fasting blood test, on at least two separate days
  2. Further tests to find the cause, such as LH and FSH hormones
  3. Checking for other conditions that may explain the symptoms

A single low result is not enough, because levels vary through the day and with illness.

Treatment

Treatment depends on the cause. Lifestyle steps such as losing excess weight, exercising, sleeping well and treating other conditions can raise testosterone naturally.

Testosterone replacement therapy (gels, injections or patches) may be offered when deficiency is confirmed. It can have risks, including raised red blood cell count, effects on fertility and possible effects on the prostate, so it needs medical supervision and regular monitoring. It is not usually recommended for men who want to father children.

When to see a doctor

See a doctor if you have persistent symptoms. Avoid buying testosterone or "booster" supplements online without medical advice, as they can be unsafe and can harm fertility.

Frequently asked questions

What is a normal testosterone level?

Reference ranges vary by laboratory. Guidelines generally treat a total testosterone below roughly 264 to 300 ng/dL (about 9 to 10 nmol/L) as low, but diagnosis also needs symptoms and repeat testing.

Can low testosterone be raised naturally?

Losing excess weight, exercising, sleeping well and treating other conditions can help raise levels in some men.

Does testosterone therapy affect fertility?

Yes. It can reduce sperm production, so it is not usually recommended for men who want to father children.

Sources

  1. Testosterone therapy in men with hypogonadism: Endocrine Society guideline (Bhasin et al., 2018)

This article is for educational purposes only and does not replace advice from a doctor or other qualified health professional. See our medical disclaimer.