Written by: Centre for Men's Health
Low testosterone, low T, male menopause, andropause, late onset hypogonadism and testosterone deficiency syndrome are just some of the names given to the condition that can wreck many men’s health and love lives. There are a range of low testosterone symptoms and signs, some of them serious. So what is low testosterone, what causes it and could you be suffering from it too?
What is testosterone?
First of all, let’s start with the basics: what is testosterone? In short, it is the hormone – the body’s chemical messenger – responsible for normal sexual development and function in men, the most important of a group of hormones called androgens. However, its role in men’s bodies is wider ranging than that. The level and effectiveness of testosterone can have an impact on many aspects of men’s health, from their ability to get erections and enjoy sex to the strength of their bones and the functioning of the brain.
What is low testosterone?
A man suffers from low testosterone levels when the hormone is either not present in the blood in sufficient quantities or not enough is available for use by the body’s tissues.
Out of the total testosterone circulating in the blood, 40-50% is weakly bound to a type of protein called albumin and 50-60% is tightly bound to Sex Hormone Binding Globulin (SHBG), a protein produced by the liver. This means only 1-3% is left circulating as free testosterone. This is just one of many factors that can affect how active testosterone actually is in a man’s body,
What causes low testosterone?
As the Centre for Men’s Health’s founder, the late Professor Malcolm Carruthers, explained in his book Testosterone Resistance, low testosterone levels and activity can be caused in many different ways. Infections like mumps, stress, heavy drinking, obesity, trauma to the testes and certain prescription drugs can all have a negative impact.
How is testosterone deficiency diagnosed?
All this means that your total testosterone level on its own, while important to test and monitor before and during any treatment, can’t tell you whether you are suffering from low testosterone or not. In order to reach a diagnosis of low testosterone or testosterone deficiency syndrome you will need a full blood test covering a wide spectrum of measures to reach a complete understanding of your hormonal health. Your doctor should also take a complete medical history and undertake a physical examination, in addition to a detailed discussion of your symptoms. This is to exclude the possibility that your symptoms might be related to other health problems.
16 Signs of low testosterone
Low testosterone can show itself in a number of different ways. Low Testosterone symptoms include:
Physical low testosterone symptoms
- Decline in feeling of general wellbeing and health;
- Physical exhaustion and lack of vitality;
- Joint pain and muscular ache, including general back ache or lower back pain;
- Excessive sweating/night sweats and hot flushes;
- Decrease in the number of morning erections;
- Decrease in the ability to perform sexually/frequency of sex;
- Decrease in beard growth;
- Decrease in muscular strength;
Emotional/mental low testosterone symptoms
- Feeling burnt out and having reached rock bottom/that you have passed your peak;
- Depressive mood or mood swings and lack of drive;
- Decrease in libido/sexual desire
- Anxiety/Nervousness;
- Irritability/anger;
- Increased need for sleep/often feeling tired;
- Sleep problems including difficulty in falling asleep, difficulty in sleeping through, waking up early.
- Brain fog or confusion;
Of these, fatigue, depression, irritability, reduced sex drive and erection problems are the most common. However, not everybody with the condition will have all of these symptoms and the severity of each will vary from person to person. It is also important to note that some of these, for instance fatigue, depression or anxiety may be non-specific to low T and maybe due to lifestyle factors. So it’s important that any diagnosis should be backed up by a comprehensive blood test, such as the one provided by the Centre for Men’s Health, that will also take into account other potential causes of these symptoms.
What are the wider health effects of low T/testosterone deficiency?
Research has shown that low or ineffective testosterone levels are also implicated in many of the severe, long term illnesses which become common in men with ageing. Metabolic syndrome and diabetes, Alzheimer’s disease, coronary heart disease and angina, and erectile dysfunction are illnesses where it has been shown testosterone deficiency can both be both part of the cause and be responsible for making the health consequences more severe.
The effects of low testosterone in men can be devastating for their quality of life. If you think you might be suffering, and want to know how to check for low T, try taking the free low T symptoms questionnaire. This has been validated by international researchers and will allow you to assess the level of your low testosterone symptoms.
What treatments are available for low testosterone?
The good news is that low testosterone in men can be successfully treated with testosterone replacement therapy (TRT), involving supplementing or stimulating the testosterone that a man’s body is already producing. There are a range of treatments to correct your low T levels that can be tailored to your needs and lifestyle, ranging from gels to testosterone injections. You can find out more about your low T therapy and treatment options here.
Conclusion
If you find you are suffering from a number of these low testosterone symptoms at the same time, it is important to have your testosterone levels checked (both total and free testosterone) to understand the underlying cause and to see whether you could benefit from testosterone replacement therapy.
Last updated: 23 April 2025
References:
https://www.nhs.uk/conditions/male-menopause