Male menopause; Andropause; Testosterone deficiency; Low-T; Androgen deficiency of the aging male; Late-onset hypogonadism
Testosterone is a hormone made by the testicles. It is important for a man's sex drive and physical appearance.
Certain health conditions, medicines, or injury can lead to low testosterone (low-T). Testosterone levels also naturally drop with age. Low testosterone can affect sex drive, mood, and changes in muscle and fat.
Treatment with testosterone therapy may help reduce symptoms.
Testosterone makes a man look and feel like a man. In a man, this hormone helps:
Beginning around age 30 to 40, testosterone levels may start to slowly decrease. This occurs naturally.
Other causes of low testosterone include:
Some men with low testosterone do not have any symptoms. Others may have:
Some symptoms may be a normal part of aging. For example, it is normal to feel less interested in sex as you get older. But, it is not usually normal to have no interest in sex.
Symptoms may also be caused by other conditions, such as high blood pressure or diabetes. If any of these symptoms are bothering you, talk with your provider.
Your provider will likely have you get a blood test to check your testosterone level. You will also be checked for other causes of your symptoms. These include medicine side effects, thyroid problems, or depression.
If you have low testosterone, hormone therapy may help. The medicine used is man-made testosterone. This treatment is called testosterone replacement therapy, or TRT. TRT can be given as a pill, gel, patch, injection, or implant.
TRT may relieve or improve symptoms in some men. It may help keep bones and muscles strong. TRT seems to be more effective in young men with very low testosterone levels. TRT can also be helpful for older men.
TRT has risks. These may include:
At this time, it is unclear whether TRT increases the risk of prostate cancer or symptoms of benign prostatic hyperplasia. Cardiovascular risks are also unclear. However, based on inconclusive data, the FDA does warn of a possible increased risk of cardiovascular disease.
Talk with your provider about whether TRT is right for you. If you do not notice any change in symptoms after treatment for 3 months, it is less likely that TRT treatment will benefit you.
If you decide to start TRT, be sure to see your provider for regular checkups.
Contact your provider if:
Morgentaler A, Zitzmann M, Traish AM, et al. Fundamental concepts regarding testosterone deficiency and treatment: international expert consensus resolutions. Mayo Clin Proc. 2016;91(7):881-896. PMID: 27313122 pubmed.ncbi.nlm.nih.gov/27313122/.
Swerdloff RS, Wang C. The testis and male hypogonadism, infertility, and sexual dysfunction. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 221.
U.S. Food and Drug Administration website. FDA drug safety communication: FDA cautions about using testosterone products for low testosterone due to aging; requires labeling change to inform of possible increased risk of heart attack and stroke with use. www.fda.gov/drugs/drugsafety/ucm436259.htm. Updated February 26, 2018. Accessed May 31, 2023.BACK TO TOP
Review Date: 5/12/2023
Reviewed By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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