Low Testosterone: Causes, Symptoms, and Solutions

Low testosterone?

Hello, doctor.
I recently participated in a health check organized by my company and had my male hormone levels tested.
The results showed that my levels were too low, with the only abnormal value highlighted in red.
The standard range is 3.5 to 10, and my result was 3.14.
I looked up the average levels for normal males, which are about 7 at age 20, declining by 1-2% each year, reaching around 6 by ages 40-49, and about 5 by age 65.
Does this mean my levels are even lower than my father's? Am I experiencing early menopause? What are the implications of this? The report mentioned the risk of osteoporosis (but my bone density T-score is 2.2, which seems fine), and I do feel more fatigued (though my GOT is 21 and GPT is 25, both normal), have a decreased libido (which has always been low; while my classmates enjoyed watching adult films, I never had much interest; I haven't had sexual relations with my girlfriend for the past six months, but we don't sleep together every day, usually just 2-3 times a month), and sometimes experience erectile dysfunction (I occasionally don’t wake up with an erection, but I definitely did when I was younger; my girlfriend thinks I only engage with her when I do have an erection in the morning, as I usually fall asleep immediately at night).
I have some central obesity (a bit; my visceral fat is consistently around 7-8, but my body fat is 18.6%, BMI is 23.7, and waist circumference is 78 cm, which is fairly normal except for a bit of belly fat that I can't seem to lose).
I cycle once a week, covering about 50-100 km each time (taking 2-4 hours).
Could this have an impact? I’ve heard that prolonged cycling in high temperatures can negatively affect the testes.
Is this the reason for my low male hormone levels?
Additionally, I would like to know the causes of low male hormone levels.
Is this something innate or could it be caused by short-term factors? (I have been under significant work stress recently, and about three months ago, I experienced anxiety and insomnia due to my landlord wanting to reclaim the property, which I had never experienced before.) I do feel different from typical males; I don’t have an Adam's apple, my hair is not dense, it is finer and softer, I have facial hair but it is sparse and grows slowly, I don’t have much body odor, I have a sexual life but prefer masturbation, I don’t enjoy video games, I like cleanliness (enjoy doing housework), I am detail-oriented, and I prefer using women's body wash (attracted by the scent, I dislike the smell of men's products).
Are these traits related to my low male hormone levels? (Friends say I seem very "gay," but I know I’m not.)
Additionally, here are some health check data for your reference: TSH 0.38, HB 14.1, CRE 1.16, UA 4.8, TG 51, CHO 169, HDL 52, LDL 107, GLU 75.
My girlfriend and I are planning to have a child in the next couple of years; will this have any impact? What can be done to improve this? (If it’s innate, then there’s no need for improvement, haha.) I’ve shared a lot of information, and I hope it helps you in your assessment.
Thank you for your guidance! By the way, I just feel a bit odd (not quite like other guys, which is why I wanted to check this, and the result was indeed too low, haha, I’m at a loss for words).

mooncat, 30~39 year old female. Ask Date: 2016/03/12

Dr. Fu Shizhang reply Urology

It is advisable to check other related hormone levels, as the secretion of male hormones is primarily regulated by the stimulation of the hypothalamus, which prompts the anterior pituitary gland to secrete FSH and LH.
It is quite possible that issues with one of these hormones could lead to low levels of male hormones.

Reply Date: 2016/03/12

More Info

Low testosterone, or hypogonadism, can significantly impact various aspects of a man's health and well-being. Understanding its causes, symptoms, and potential solutions is crucial for anyone experiencing low testosterone levels, such as in your case.

Causes of Low Testosterone
1. Age: Testosterone levels naturally decline with age, typically starting around the age of 30. By the time men reach their 40s and beyond, they may experience a decrease of about 1-2% per year. However, your levels being low at a younger age could indicate other underlying issues.

2. Medical Conditions: Conditions such as obesity, diabetes, metabolic syndrome, and certain hormonal disorders can lead to lower testosterone levels. Your mention of central obesity and body fat percentage may suggest a link, as excess body fat can convert testosterone into estrogen, further lowering testosterone levels.

3. Stress and Mental Health: Chronic stress can lead to hormonal imbalances, including low testosterone. The anxiety and insomnia you experienced due to housing issues could have contributed to your current situation.

4. Lifestyle Factors: Regular cycling, especially for extended periods, can indeed affect testosterone levels due to heat exposure and pressure on the testicles. Additionally, factors like diet, sleep quality, and exercise frequency play significant roles in hormone production.

5. Genetic Factors: Some men may have a genetic predisposition to lower testosterone levels, which can manifest in physical traits such as less body hair or a softer voice.

Symptoms of Low Testosterone
The symptoms you described align with common signs of low testosterone, including:
- Fatigue: Feeling unusually tired despite adequate sleep can be a symptom.

- Reduced Libido: A decrease in sexual desire is often reported.

- Erectile Dysfunction: Occasional difficulties with morning erections or during sexual activity can indicate hormonal issues.

- Mood Changes: Feelings of anxiety, depression, or irritability can also be linked to low testosterone.

- Physical Changes: Central obesity and changes in body composition, such as increased fat and decreased muscle mass, are common.

Potential Solutions
1. Lifestyle Modifications:
- Exercise: Incorporate strength training and high-intensity interval training (HIIT) into your routine. These types of exercises can help boost testosterone levels.

- Diet: Focus on a balanced diet rich in healthy fats (like omega-3 fatty acids), lean proteins, and whole grains. Avoid excessive sugar and processed foods.

- Sleep: Prioritize good sleep hygiene. Aim for 7-9 hours of quality sleep per night, as poor sleep can significantly affect hormone levels.

2. Medical Evaluation:
- Hormone Replacement Therapy (HRT): If your testosterone levels are confirmed to be low and symptomatic, your doctor may discuss the possibility of testosterone replacement therapy. This can be administered via injections, patches, or gels.

- Address Underlying Conditions: If conditions like obesity or diabetes are present, managing these can help improve testosterone levels.

3. Stress Management: Techniques such as mindfulness, meditation, or therapy can help manage stress and improve overall mental health, potentially leading to better hormonal balance.

4. Regular Monitoring: Keep track of your testosterone levels and symptoms with your healthcare provider. Regular check-ups can help assess the effectiveness of any interventions.

Conclusion
Your concerns about low testosterone are valid, and it’s essential to address them holistically. While some aspects may be genetic or inherent, many lifestyle factors can be modified to improve your situation. It’s advisable to consult with a healthcare professional who specializes in hormonal health to explore your options and develop a tailored plan that suits your needs. Remember, you are not alone in this, and many men face similar challenges. Taking proactive steps can lead to significant improvements in your quality of life and overall health.

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