Low Testosterone in Men

Jul 18, 2014 0 Comments in Low T (Low Testosterone) by
Low Testosterone in Men

Low Testosterone in Men

Moderate to severe alterations in the normal serum concentration of testosterone can present as:

  • Emotional issues (such as mood and behavior).
  • Physical issues (changes in the appearance of genitals and other distinct male features).
  • Changes in the sex drive or sexual issues.

Testosterone’s Role in Physical & Sexual Development of Young Males

Testosterone is secreted by testes – also known as male gonads and serves as a regulatory hormone that is responsible for producing characteristic changes in the body of males at the time of puberty (Puberty Wiki Page). The activity of testosterone persists throughout the life; however, the effects are more noticeable in young males.

Role of testosterone in the development of male sexual characteristics are discussed as:

Testosterone in the Fetal Development

The secretion is initiated in the maternal womb where it mainly promotes the differentiation and formation of male external genitalia. Testicular descent is also initiated under the influence of this vital hormone. In case of moderate testosterone deficiency (due to genetic aberration or maternal use of drugs/ hormones), fetal sexual differentiation is usually compromised.

Low secretion levels at the time of fetal development may present as:

  • Ambiguous (or ill-differentiated external genitalia).
  • Female genitalia (in case of complete absence of testosterone).
  • Underdeveloped external genitalia (also known as hypogonadism).

Low Secretion Levels in Men Photo

Low Secretion Levels in Men

At Puberty:

At the time of puberty, testosterone leads to the enlargement of testes and male external genitalia (penis). It also promotes the growth of pubic and facial hair (secondary male sexual characteristics). Any disease or damage to testicles that may affect the secretion of testosterone may lead to a wide variety of issues; such as:

  • Inadequate gain of muscle mass at puberty.
  • Impaired growth of the penis and testicles.
  • Growth spurt that is only evident in the area of arms and legs as compared to trunk.
  • Inability to develop deepening of voice.
  • Poor development of body hair.
  • Abnormal development of breast tissue (gynecomastia).

Role of Testosterone in Adult Males

Throughout the life of an adult male, normal testosterone secretion is needed for optimal production of sperm cells, normal fertility and maintenance of libido. Testosterone is also responsible for stronger and denser bones as compared to females in addition to bulky muscles and strong built. The serum levels of testosterone are carefully monitored by the human body with the help of higher brain centers and other regulatory hormones such as the pituitary gland, hypothalamus and others.

What You Should Know About Testosterone Metabolism

Several factors can compromise normal metabolism of testosterone.

  • For example, about 40% of the serum testosterone is tightly bound to protein (referred to as sex hormone binding globulin) and thus is unavailable for immediate action.
  • Almost 58% of testosterone is bound to albumin (and so is unavailable).
  • Only 2% testosterone is free, available and reflects the functional testosterone concentration in the serum (for practical reasons). Many medical conditions can affect the available concentration of testosterone and therefore it is highly suggested to perform appropriate medical evaluation before choosing a viable therapeutic option.

Throughout the day the testosterone levels in the body fluctuates significantly (peaking in morning hours and low during most of the day).

Those at Risk of Developing Low Testosterone Levels

As discussed previously, certain inherited or acquired factors can increase the risk of abnormal metabolism or secretion of testosterone in males. Most notable risk factors that are usually implicated in low testosterone levels are:

  • Previous chemotherapy or radiation therapy.
  • Mumps infection affecting your testicles.
  • Kallmann syndrome.
  • Undescended testicles during infancy.
  • Hemochromatosis (inherited disorder of iron metabolism).
  • Injury to testicles.
  • Testicular or pituitary tumors.
  • Klinefelter syndrome (inherited genetic disorder of chromosomal aberration).
  • Untreated sleep apnea.
  • Chronic untreated illness or chronic emotional stress.

Managing Low Testosterone Levels

The hormone replacement therapy is available in the form of:

  • Gel and patches.
  • Injections.
  • Implantable pellets.

Gel therapy is the most frequently used variety of HRT as 70% of all the patients reportedly rely on gel formulations as a source of testosterone. According to rough estimates 17% individuals use testosterone injections and 10% use testosterone patches to manage andropause. About 13% individuals use other testosterone formulations like testosterone pellets or oral testosterone.
Lifetime risk of developing hypogonadism is 20-40% (2) above the age of 65 years. However, most cases in young males are secondary and responds very well to lifestyle and diet modification along with management of primary causes. Speak to your healthcare provider if you were exposed to certain risk factors that may have compromised your testosterone levels.


Cotter, A. G., & Powderly, W. G. (2011). Endocrine complications of human immunodeficiency virus infection: hypogonadism, bone disease and tenofovir-related toxicity. Best Practice & Research Clinical Endocrinology & Metabolism, 25(3), 501-515.
Dandona, P., & Rosenberg, M. T. (2010). A practical guide to male hypogonadism in the primary care setting. International journal of clinical practice, 64(6), 682-696.


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