Hypogonadism: How Low Testosterone Affects Men

Testosterone is more than just a sex hormone. We tend to associate testosterone with sexual performance or being buff. But did you know that lacking testosterone can become debilitating? This article provides an in-depth discussion on the steep price of living with testosterone deficiency. 

What is Hypogonadism? 

Hypogonadism, also called testosterone deficiency, occurs when a man’s blood testosterone falls below 300 ng/dL, which is the normal level, due to irregularities with either the testicles or the hypothalamic-pituitary axis. In males, testosterone is secreted from the testicles or testes by the Leydig cells. The Leydig cells are stimulated by the luteinising hormone produced by the pituitary gland, which is triggered by the gonadotropin-releasing hormone from the hypothalamus. 

Types of Testosterone Deficiency 

Hypogonadism has two types, which are determined by where the issue of your lack of testosterone lies: 

• Primary Hypogonadism – also called hypergonadotropic hypogonadism, this is diagnosed when your testosterone deficiency is caused by an abnormality in the testes. This can also be your diagnosis even if you reach the passing mark for a healthy testosterone range if the level of your luteinising hormone is excessive. This is because your pituitary gland is often trying to compensate for the lack of testosterone by releasing more hormones. 
• Secondary Hypogonadism – also called hypogonadotropic hypogonadism, this condition happens when your testosterone deficiency is caused by a lack of luteinising hormone or gonadotropin-releasing hormone. Remember, your endocrine system needs to signal your body to start biological processes. Your testes may be capable of producing enough testosterone, but if there’s nothing ordering them to, you’ll still be dealing with low testosterone. 

Both primary and secondary hypogonadism can be caused by genetic conditions that damage your testes, hypothalamus, or pituitary gland. It can also be due to inflammation caused by an infection, collateral damage from chemotherapy, injury, or another chronic disease. Kidney failure, liver scarring, diabetes, alcohol addiction, and obesity contribute to both secondary hypogonadism and sexual dysfunctions. 

Consequences of Having Low Testosterone 

The effects of low testosterone coincide with symptoms of other conditions like hypothyroidism and mood disorders, which is why it’s important to get tested. It becomes even more imperative if you display many of these: 

Muscular Atrophy 

Muscular atrophy is the term for when you’re losing muscle mass. Most men don’t notice that their shrinking muscles are not just because of their lack of exercise, but that it’s mainly caused by low testosterone secretion. Testosterone deficiency can also lead to fatigue and loss of motivation, so one can become more sedentary. Note that testosterone is responsible for muscular and skeletal growth. 

Testicular Atrophy 

Your muscles aren’t the only thing that can be reduced by a lack of testosterone. Your testicles themselves can also shrink. Testicular atrophy and testosterone deficiency have a bidirectional relationship, which means they affect each other. Hypogonadism can be triggered by testicular atrophy caused by a sexually transmitted disease like HIV/AIDS. 

Erectile Dysfunction 

Testosterone triggers the penile tissues to release nitric oxide. Nitric oxide is necessary for your penile vessels to relax and dilate so that blood can enter for an erection. If your blood vessels remain constricted, you inevitably experience a weakened erection. Studies show a strong link between low testosterone and erectile dysfunction. 

Low Libido 

Another sexual problem you might encounter due to low testosterone is a lack of sexual desire. Sex drive is often spearheaded by increased circulating testosterone. Some attribute morning wood to your testosterone being at its peak in the morning. Of course, the fatigue and mood swings that result from testosterone deficiency also make it harder to be in the mood for sex. 

Infertility 

Testosterone is crucial for sperm production. Not having enough testosterone often leads to oligospermia (low sperm count) or azoospermia (zero sperm count). Additionally, the pituitary gland releases follicle-stimulating hormone, alongside luteinising hormone, to signal sperm production. Oligospermia can make it difficult for couples to conceive because there aren’t enough sperm cells to try and penetrate an egg cell. 

Hair Loss 

Balding or a receding hairline aside, do you notice that you simply don’t have much hair in the armpit and pubic area? That’s a big sign of low testosterone. Note that testosterone is responsible for the development of male characteristics, which is why men tend to have a beard or hairy limbs. Males also lose testosterone as they age, which is why balding is common among older men. 

Gynecomastia 

If you barely have any testosterone, chances are your oestrogen levels are high. Luteinising hormone, which triggers the release of testosterone, balances oestrogen levels in men. Just as testosterone affects the size of your penis, oestrogen affects the size of your breasts. If you have too much oestrogen, your breasts may become enlarged. 

Anaemia 

A lesser-known function of testosterone is its role in red blood cell production. Not only does testosterone help stimulate the production of your erythrocytes, another term for red blood cells, but it also keeps your iron levels sufficient and contributes to the survival of your red blood cells. Research shows a correlation between anaemia and testosterone deficiency. 

Fatigue 

Anaemia aside, a lack of testosterone can result in exhaustion, which may also be why men with testosterone deficiency often have trouble concentrating. Testosterone is necessary for male metabolism and strength. If there’s less testosterone, your body may become more inefficient with its processes, causing greater energy consumption and a resulting feeling of tiredness. 

Depression 

Some studies show a relationship between testosterone and depression through serotonin. Serotonin is a neurotransmitter that’s more commonly known as the happy hormone. Lacking serotonin is linked to depression, which is why selective serotonin reuptake inhibitors (SSRIs) are one of the treatment options for depression. Serotonin is also necessary for ejaculatory control. This may be why some men with hypogonadism also experience premature ejaculation. 

What To Do If You Suspect You Have Hypogonadism 

If you’re experiencing most of the negative impacts of testosterone deficiency listed above, here are the steps you should take: 

• Test your testosterone levels – talk to your doctor about your symptoms. They will refer you for a total testosterone level blood test. If the test results confirm low testosterone, they will most likely refer you for testosterone replacement therapy (TRT).  
• Check for dietary deficiency – sometimes, dietary deficiencies like a lack of vitamin D and zinc can result in some of the symptoms. If you’ve tested for both testosterone deficiency and hypothyroidism yet the results show as normal, check for these. 
• Avoid stress at all costs – cortisol, the stress hormone, throttles your testosterone production. It’s also a risk factor for sexual dysfunctions and chronic diseases. Try to use stress management activities like meditation, yoga, and breathing exercises. 
• Don’t compromise sleep – if you’re frequently sleep deprived, you may end up with low testosterone. This is because sleep is crucial for regulating testosterone and cortisol. Not having enough sleep can spike your cortisol levels, which will hinder testosterone release. 
• Try resistance training – resistance training has been shown to be one of the exercises that stimulate testosterone the most. Note that if your testes, hypothalamus, or pituitary gland is damaged, you may still have low testosterone, but exercise will keep you healthy. 
• Eat the right food – you should aim for a balanced diet of vegetables, fruits, meat, and seafood. Avoid products that have been heavily processed, like crisps, canned instant food, and takeaways. You may also want to incorporate more testosterone-enhancing foods into your meals while reducing sugar consumption. 
• Reduce alcohol intake – low to moderate alcohol consumption may not pose as much risk to your testosterone levels. However, long-term heavy consumption of alcohol will lower your testosterone. Alcohol may also trigger erectile dysfunction. 
• Getting into TRT – TRT is the main treatment for hypogonadism. It can come in the form of gels, patches, injectables, pellets, and pills. However, some conditions that trigger low testosterone, like obesity, may be treatable without TRT. 

Conclusion 

Not only can low testosterone wreak havoc on your intimacy, but it also takes a significant toll on your quality of life. So, if you think you may have hypogonadism, please get checked ASAP. And if you're also suffering from ED or PE, our team of experts will gladly step in to help. Book an appointment with us to begin regaining your sexual wellness!