In short
- Testosterone falls gently with age, but a true deficiency is not the rule.
- It mainly shows as low desire, erection problems and fatigue.
- Diagnosis relies on symptoms and two morning blood tests.
- Treatment is decided case by case and needs regular follow-up.
In this article
Signs of a deficiency
These signs should raise the possibility:
- Lower sex drive and fewer morning erections
- Erection problems
- Fatigue, low energy, low mood
- Loss of muscle, fat gain around the waist
How is it confirmed?
Testosterone is measured with a morning blood test, when levels are highest, preferably fasting. A low result must be confirmed by a second test. The andrologist also checks other hormones to find the cause.
Causes
A low level can come from:
- Excess weight, diabetes, metabolic syndrome
- Lack of sleep, stress, certain medicines
- A disease of the testicles or the pituitary gland
- Age, gradually
Treatment
Correcting the cause (weight loss, sleep, diabetes control) often brings levels back up. When a deficiency is confirmed and troublesome, testosterone treatment as a gel or injection may be offered, with regular blood and prostate monitoring.
It is not suitable for a man who wants to have a child, as it reduces sperm production.
Frequently asked questions
Does testosterone build muscle?
In a man with a genuine deficiency, treatment can improve muscle mass and energy. In a man with normal levels, it is not indicated and carries risks.
Is treatment for life?
Not necessarily: if the cause is corrected, levels can return to normal. Follow-up allows the treatment to be adjusted.
Learn more
- CareLow testosteroneTiredness, low libido, erection problems: low testosterone may be the cause.
- CareErectile dysfunctionErectile dysfunction is the ongoing inability to get or keep an erection firm enough for satisfying sex.
- CareMale fertilityWhen pregnancy takes a while, a male factor is involved in a large share of cases.
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Article published by Dr Ayhan Bakar, urologist in Brussels (INAMI 17718534450).
Reference: European Association of Urology (EAU) guidelines.