Mayo Clinic Minute: Low Testosterone Symptoms
An Expert's Take on Low T
A men's health expert explains why low testosterone needs to be taken seriously. Learn why hormone replacement therapy isn't the only answer.
By Dennis Thompson Jr.
Medically Reviewed by Farrokh Sohrabi, MD
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Much of the current discussion regarding low testosterone in men seems to be missing the point, according to noted men's health expert Harry Fisch, MD, a clinical professor of urology and reproductive medicine at Weill Cornell Medical College and attending urologist at Cornell University Medical Center/New York Presbyterian Hospital. People caught up in the craze are focusing on testosterone levels and hormone replacement rather than getting at the root causes of low T.
"The lack of testosterone is not a disorder. It's only a disorder if it's associated with some sort of condition," said Dr. Fisch. "We're not just treating a number. We're treating a condition called hypogonadism."
Sales of prescription testosterone products have soared more than 500 percent since 1993, Fisch said, but he is concerned that many of the men who are receiving hormone replacement are only treating the symptom while ignoring the real problem.
"If you have a fever, you don't just treat the fever with aspirin. You find out why you have the fever," he said. "You could be missing a life-threatening condition if you don't investigate the underlying cause of low testosterone."
Low T Symptoms and Causes
Testosterone is one of the major male hormones, and the symptoms associated with low T may be directly linked to its impact on masculine build and male drive, Fisch said. These include:
- Loss of interest in sex
- Loss of muscle mass and muscle weakness
- Erectile dysfunction
- Weight gain, particularly around the waist
- Irritability or moodiness
- Difficulty concentrating
- Hair loss
The reasons behind a man's low T can be simple or dire, but usually go beyond the mere reduction in testosterone levels that come with aging. "At no age is it supposed to be below normal," Fisch said. "Yes, it decreases, but at every age, there is still a normal range it should fall within."
Some of the factors that can cause low T include:
Lack of sleep."Lack of sleep is a major cause of low testosterone, and it's one of the most overlooked," Fisch said. "Testosterone is created while you sleep. I had one patient come in who runs a Greek restaurant and is up early every day for fish deliveries. He said, 'Why don't you give me testosterone?' I said, 'Why don't you sleep more?'"
Overweight or obesity."The bigger the belly, the lower the testosterone because testosterone is broken down in fat cells," Fisch said. "If you have a big belly, there's a bigger risk of having low testosterone. Belly fat breaks down testosterone at a higher rate than other fat in the body."
Diabetes.About 40 percent of men with diabetes also experience low T, Fisch said.
Drug use.People taking opiates can experience low T through the drug's interaction with their hormone systems, explained Fisch.
Overexertion.Moderate exercise can provide a boost to testosterone levels, but people who exercise excessively can actually experience a drop in testosterone, Fisch said.
A more serious medical issue.Low T can indicate a pituitary tumor or another potentially serious medical condition that's interfering with the function of the testicles, explained Fisch.
Just taking hormone replacement therapy wouldn't solve any of these underlying problems and could potentially mask a serious illness.
Seeking Help for Low T
Men experiencing any of the symptoms associated with low T should seek medical treatment, Fisch said. He finds it encouraging that all the recent discussion of low T appears to have eroded some of the embarrassment that men used to feel regarding the problem.
"Once people realized there was a treatment available, they started coming out of the woodwork," he said. People are more aware and knowledgeable about low T now, he added.
That said, some men still need encouragement from the partner in their lives to seek help for low T. "I have a radio show on Sirius, and a lot of time women call because the men in their lives are in denial and they don't want to face the issue," Fisch said. Fisch urges partners to go to his website, HarryFisch.com, and elsewhere to learn more about low T. Armed with that information, they can talk with their men and urge them to talk with their doctor or a urologist.
"Understand that in order to have a better sex life, to be healthier and to live better, you need to see a doctor," Fisch said. "You have to go to a doctor and get a testosterone test. It's potentially correctable.
Video: Low T - Health Risks of Testosterone Therapy - Mayo Clinic
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