TRT

What is low testosterone?

Low testosterone (also called “low T” or “hypogonadism”) is, quite simply, when your body doesn’t make enough of a key hormone called testosterone.

For men, “low” usually means blood levels under 8nmol/L (nanomoles per litre) and levels between 8 and 12 nmol/L are considered borderline.

Testosterone has several important functions in a man’s body, like:

• Building up muscle and bones
• Regulating sex drive (libido)
• Supporting fertility
• Maintaining energy levels and mood
• Contributing to facial and body hair growth, and a deeper voice during puberty

Who gets low testosterone?

Anyone can have low testosterone. But some groups are more susceptible than others.

About 1 in 4 men have low T. But because testosterone levels drop by 100 ng/dL every decade, low T becomes even more common with age. Around 4 in 10 men over 45 and half of men in their 80s have low levels.^[1]

Is it safe to use low testosterone treatment?

Generally, yes, it’s safe to use low testosterone treatment. But, like any other medication, it doesn’t come without some possible side effects.

Because treatment usually consists of gels that are applied on shoulders and upper arms, the most common side effects show up on your skin. These could be things like redness, dryness, itchiness, or a prickling or burning feeling. Some people also get a rash.

A quick word of caution. Testosterone gel can accidentally transfer to others. In children, this can cause early puberty and genital changes, while in women, it may lead to increased facial hair, a deeper voice, or changes to their periods.^[2]

To prevent this, you should always:

• wash your hands after each application,
• cover the area where you’ve applied the gel once it’s dry (for example, with clothes),
• and wash the skin before close contact with anyone else.

What causes low testosterone?

There are many possible reasons why your body might produce less testosterone than normal. Some include:^[1]

• Natural ageing (testosterone decreases by about 1% every year after age 30);
• Problems with your testicles, like injury or disease;
• Issues with glands that control hormone levels, like the pituitary gland or hypothalamus (which regulate how much testosterone your body makes);
• Certain medications, like steroids, opioids, or chemotherapy;
• Chronic conditions, like obesity, diabetes, sleep apnoea, and HIV infections;
• Stress, which can also be the result of things like surgery or trauma;
• High blood pressure.^[2]

Some studies also suggest that low vitamin D levels could be linked to lower testosterone. But the results aren’t clear yet, and more research is needed.^[3]

What are the symptoms of low testosterone?

In men, low testosterone can show up in several ways. You might notice:

• a lower sex drive;
• feeling constantly tired, even after a good night’s sleep;
• trouble getting or keeping an erection;
• mood changes like irritability or just feeling down;
• difficulty focusing or remembering things;
• decreased muscle mass; and:
• increased body fat—especially around your belly.

Over time, some men may also see thinning hair on their face or body and more fragile bones (which may put them at higher risk of fractures).

But it doesn’t mean you’ll get all of these symptoms. The type of severity can vary widely from person to person.

Can low testosterone lead to other problems?

Yes, low testosterone has been linked to other issues. But it’s worth noting that these problems can be caused by multiple factors, low T being just one of them. So, having low testosterone doesn’t automatically mean you’ll experience any of these:

• Erectile dysfunction: Low T can make it harder to get or maintain an erection.^[4]
• Anxiety and depression: Research shows that treating low T can help reduce depressive symptoms in men, especially with higher doses.^[5]
• Infertility: Low T in men may affect sperm quality and lower the chances of a successful pregnancy.^[6]