Signs of Low Testosterone in Men, and When to Get Tested

The common signs of low testosterone in men are a lower sex drive, erection problems, low energy, poor concentration, trouble sleeping and loss of muscle bulk and strength. Because other conditions cause the same symptoms, they can't confirm it on their own. Diagnosis needs symptoms plus low results on fasting morning blood tests taken on two separate days.

What are the most common signs of low testosterone?

Reduced sexual desire and erectile dysfunction are among the most common, along with low energy, poor concentration, sleep problems and reduced muscle bulk and strength. More specific signs, such as losing body hair or having very small testes, are less common.

The Endocrine Society's guideline on testosterone therapy in men separates these into more specific and less specific signs. MedlinePlus also lists breast enlargement and muscle loss in men with hypogonadism, the medical term for when the body doesn't make enough sex hormone. One sign on its own means little. A pattern that has built up over months is worth a conversation.

Why can't symptoms alone tell you it's low testosterone?

Tiredness, low mood, poor sleep and a fading sex drive have many possible causes, including thyroid problems, depression, sleep disorders, medications and stress. Only blood tests, read alongside your symptoms, show whether testosterone is part of the picture.

That's why guessing, or buying supplements that promise to 'boost T', can send you in the wrong direction. If fatigue and weight gain are your main complaints, it's also worth reading about the thyroid and weight gain, since an underactive thyroid can look similar.

Sleep is a good example. Loud snoring, waking up unrefreshed and heavy daytime sleepiness can point to sleep apnea, and untreated severe sleep apnea is one of the conditions in which the Endocrine Society advises against starting testosterone. Mention symptoms like these at your visit, even if they seem unrelated, so your provider can look at the whole picture.

How is low testosterone diagnosed?

Low testosterone is diagnosed with a fasting morning blood test for total testosterone, confirmed by a second fasting morning test on another day. The diagnosis is made only when symptoms fit and the results are consistently low.

Both steps come from the Endocrine Society guideline, which recommends against diagnosing low testosterone from a single result. When total testosterone sits near the lower limit of normal, or you have a condition that changes the protein testosterone travels on in the blood, a free testosterone level may be added. Your provider may also check other hormones, such as LH and FSH, which MedlinePlus lists among the tests used to find the cause. The American Urological Association guideline likewise centers care on accurate testosterone testing together with symptoms and signs.

What causes low testosterone?

Low testosterone comes either from the testes not making enough (primary hypogonadism) or from the brain's signal to make it being too weak (secondary hypogonadism). Causes range from injury, infection and genetic conditions to pituitary problems and certain medications.

MedlinePlus lists causes including autoimmune and genetic disorders, liver or kidney disease, radiation, surgery, trauma, pituitary problems, rapid weight loss and some medicines. Testosterone also decreases gradually with age. The Endocrine Society notes that some causes can be reversible, such as obesity and medicines like opioids and glucocorticoids (steroids). Finding the cause matters, because it can change the plan.

When should you get your testosterone checked?

Get checked if you have several of the symptoms above, especially a lower sex drive or erection problems, or if you have a condition linked to low testosterone. Routine testing of every man without symptoms isn't recommended.

The Endocrine Society recommends against screening all men, and suggests testing when symptoms point to low testosterone or when certain conditions are present, such as long-term opioid or steroid use, a pituitary problem, infertility, or a fracture from a minor fall. Don't stop any medication before testing; tell your provider what you take instead.

Is low testosterone always treated with testosterone?

No. Treatment depends on the cause, your symptoms and your plans. Testosterone therapy is considered after you and your provider discuss its possible benefits, its risks and the monitoring it requires.

Guidelines advise against starting testosterone in men who are planning to father a child soon, and in men with certain conditions, such as prostate or breast cancer. If a reversible cause is found, addressing it may be the first step. Read what to expect at a TRT clinic for how the evaluation and monitoring work.

How does testosterone testing work at Padgett in Tampa?

At Padgett Medical Center, hormone care is lab-guided and medically supervised, and lab testing comes first. Your plan, and its cost, depend on your labs, which your provider reviews with you before anything is decided.

Visits are with Morgan Colee, PA, in person at our clinic at 6904 W. Linebaugh Ave, Tampa, FL 33625, or by telehealth anywhere in Florida. For telehealth, you need to be in Florida at the time of the visit and show a valid Florida driver's license or ID on camera. No diagnosis or prescription is promised in advance. Learn about testosterone therapy (TRT), or book your visit to start with labs.

This article is educational and is not medical advice. Talk with a licensed provider about your own health, medications and treatment options.