What to Do If Your Testosterone Levels Are Below Normal?

What should I do if my testosterone levels are below the standard?

Hello Dr.
Du: Due to prolonged excessive sexual activity (about 7 years, 1-2 times daily, and recently needing to engage at least once at night to sleep well), I have recently noticed a decrease in erection hardness and that my semen has a transparent color, but I didn't pay much attention to it.
On October 28, I engaged in sexual activity twice during the day and, before bed, decided to use my hand (usually I use a blanket without my hand).
However, I found that there was no response, which made me realize this might be a symptom of erectile dysfunction.
For the next 2-3 nights, I had trouble sleeping and did not experience morning erections.
When I tried to stimulate myself manually, there was still no response.
I quickly went to the hospital for an examination (on November 1 at 10 AM).
The doctor performed a physical examination and confirmed that the size of my penis and testicles were normal.
Then, I had blood tests scheduled for November 12 to review the results.

From November 2 to 4, I experienced morning erections.
On November 5, I traveled abroad and had an early flight at 3 AM, so I didn't get much sleep.
From November 6 to 10, I had morning erections again, and on November 11 and 12, I also experienced morning erections.
When I returned to the hospital for the results, my testosterone level was 2.86 ng/ml (normal range: 3.00 - 9.23), which is below the standard.
The doctor advised me to get adequate sleep (7 hours), exercise more, and drink more water (150 cc per hour).
He did not prescribe any medication and said to return if I had further issues.

On the night of November 12, I tried to test if I could masturbate normally, but it still didn't work.
On November 13, I had no morning erection.
Could you please advise me on what I should do next? Are there any specific things I should pay attention to regarding diet or exercise? Should I continue to monitor my testosterone levels? I apologize for asking so many questions...
Thank you for your help.

Zhen, 30~39 year old female. Ask Date: 2018/11/14

Dr. Du Mingyi reply Urology

It is not recommended to start hormone replacement therapy at the age of 33, especially if you have not had children yet, as it may increase the risk of infertility.
It is advisable to focus on lifestyle adjustments, such as ensuring adequate sleep of at least 7 hours, increasing physical activity, staying hydrated, and reducing the frequency of sexual activity.
Among these, engaging in regular exercise, particularly strength training exercises like squats that target the thigh muscles, can be beneficial.

Reply Date: 2018/11/14

More Info

When testosterone levels are below normal, it can lead to various symptoms, including reduced libido, erectile dysfunction, fatigue, and mood changes. In your case, the testosterone level of 2.86 ng/ml is indeed below the normal range for adult males, which is typically between 3.00 and 9.23 ng/ml. Given your symptoms of erectile dysfunction and changes in sexual function, it is understandable that you are concerned.

First and foremost, it is essential to follow your doctor's advice regarding lifestyle changes. Here are some strategies that may help improve your testosterone levels and overall sexual health:
1. Sleep: Aim for 7-9 hours of quality sleep each night. Sleep is crucial for hormone production, including testosterone. Poor sleep patterns can significantly affect your testosterone levels and overall health.

2. Exercise: Regular physical activity, especially strength training and high-intensity interval training (HIIT), can boost testosterone levels. Aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity each week, along with muscle-strengthening exercises on two or more days a week.

3. Nutrition: A balanced diet rich in whole foods can support hormone health. Focus on:
- Healthy fats: Include sources like avocados, nuts, olive oil, and fatty fish, which can help maintain hormone levels.

- Protein: Ensure adequate protein intake to support muscle mass and hormone production.

- Zinc and Vitamin D: These nutrients are vital for testosterone production. Foods rich in zinc include meat, shellfish, legumes, and seeds. For Vitamin D, consider fatty fish, fortified foods, and safe sun exposure.

4. Stress Management: Chronic stress elevates cortisol levels, which can negatively impact testosterone. Engage in stress-reducing activities such as meditation, yoga, deep breathing exercises, or hobbies that you enjoy.

5. Avoid Alcohol and Drugs: Excessive alcohol consumption and recreational drug use can lower testosterone levels. Reducing or eliminating these substances can have a positive impact on your hormone levels.

6. Monitor Symptoms: Keep track of your symptoms and any changes you notice as you implement these lifestyle changes. This information can be valuable for your healthcare provider.

7. Follow-Up Testing: It is advisable to have your testosterone levels rechecked after a few months of implementing these changes. This will help determine if your levels are improving and if further intervention is necessary.

8. Consult a Specialist: If your testosterone levels remain low despite lifestyle changes, consider consulting an endocrinologist or a urologist specializing in male hormone health. They can provide further evaluation and discuss potential treatment options, such as testosterone replacement therapy (TRT), if appropriate.

In summary, while your current testosterone level is below normal, there are several lifestyle modifications you can make to potentially improve your levels and overall sexual health. It is essential to maintain open communication with your healthcare provider and follow their recommendations closely. If symptoms persist or worsen, further evaluation and treatment may be necessary. Remember, addressing both physical and psychological aspects of your health is crucial for overall well-being.

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