Low Testosterone: Hypogonadism Could Be the Cause

A lull in your sex drive may be just one of many subtle clues that could point to an abnormal decline in testosterone. A natural and gradual decline in testosterone is normal as you age. But some conditions, medications and even being overweight can trigger abnormally low levels. Though the signs and symptoms are often vague and inexact, a blood test can help tell if hypogonadism may be causing low testosterone levels.

When your body doesn't produce enough testosterone, it's called hypogonadism. Symptoms include:

• Fatigue
• Depression
• Trouble concentrating
• Hot flashes
• Weak bones

And because testosterone is responsible for male characteristics, a decrease can cause:

• Erectile dysfunction
• Less facial and body hair
• Growth of breast tissue and body fat
• Infertility
• Decreased muscle mass

What causes male hypogonadism?
Some men are born with hypogonadism, while others develop it later in life. It can be caused by a problem in the testicles. Or, it can be triggered by faulty hormone signals from the brain that don't stimulate the testicles to produce testosterone. Causes include:

• A genetic abnormality, such as Klinefelter's syndrome, in which males have an extra "X" chromosome. This can cause testicular failure and low testosterone.
• Undescended testicles.
• Problems with hypothalamus or pituitary gland function. These organs produce and control levels of testosterone. Problems may include cancer, injury, inflammation and autoimmune disease.
• Injury or infection of the testicles.
• Diabetes.
• Testicular cancer or its treatment.
• Liver or kidney damage.
• Thyroid problems.
• Iron overload (hemochromatosis).
• Obesity.
• Effects of alcoholism.
• Use of certain medications:
• Certain corticosteroids
• Antifungal medications
• Certain diuretics or anticonvulsants
• Immunosuppressants

Treatment of hypogonadism depends on the underlying cause. Sometimes testosterone replacement therapy is needed. This is available in several forms, including injections, patches or gels. There are some side effects of testosterone therapy. They include prostate enlargement, infertility and sleep problems. If you have symptoms that could be hypogonadism, ask your doctor whether you might need your testosterone level checked.

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External Sources Dartmouth-Hitchcock Medical Center. Endocrinology: male hypogonadism. Accessed December 4, 2007. Haren MT, Kim MJ, Tariq SH, Wittert GA, Morley JE. Andropause: a quality-of-life issue in older males. Medical Clinics of North America. 2006;90(5):1005-1023. Rakel RE. Ovarian and Testicular Disorders. In: Rakel Textbook of Family Medicine, 7th ed. Philadelphia, PA: Saunders/Elsevier Inc.; 2007.

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