Apart from increasing age, the causes of low testosterone include inherited genetic conditions, damage to the testes (whether from infections or trauma) and tumours affecting the brain. Dr Jonathan Chong of DTAP Clinic tells us about the symptoms, potential complications and treatment available.
Low testosterone can reduce energy levels and lean muscle mass.
As testosterone concentration decreases, men may report symptoms including issues related to sexual dysfunction like erectile dysfunction or reduced libido, reduced energy levels with increased fatigue, depressed mood or irritability, decreased lean muscle mass and decreased body hair. In severe cases, they may experience hot flashes as well as the enlargement of breast tissue.
There is a potential association with metabolic disease.
Low testosterone level can adversely affect fertility and lead to a subnormal sperm count. In fact, the diagnosis is sometimes made after a patient is found to have a reduced sperm count on a seminal analysis. Other potential complications include reduced bone density (i.e. osteoporosis) and a reduced red blood cell count (i.e. anaemia). There is also a potential association with metabolic disease (e.g. obesity and diabetes) although this link is still somewhat controversial.
Pre-existing medical conditions may increase risk.
These conditions include diabetes, kidney disease, HIV infection and lung disease. The prolonged use of some painkillers or steroids can also heighten risk.
A diagnosis can be made through a blood test.
The blood test is typically performed in the morning and there may be recommendations on other blood tests to be performed together. These tests may be helpful in identifying potential underlying causes as well as determining the suitability of treatment.
Treatment usually entails testosterone replacement therapy.
This involves the administration of testosterone in the form of an injection, a gel or an oral capsule to restore the testosterone level to normal physiological concentration. Treatment is usually long-term, and if successful, patients may experience an improvement in erectile function, libido, mood-related symptoms, red blood cell counts, bone density and lean body mass.
