What Causes Low Testosterone in Men?

What Causes Low Testosterone in Men?
Medically Reviewed
February 3, 2020

Testosterone is an essential hormone that helps men develop and maintain muscle mass, bone density, and sexual function. According to the Cleveland Clinic, low testosterone affects almost 40% of males aged 45 years or older. Low testosterone symptoms include erectile dysfunction, memory issues, and even depression.

12 Causes of Low Testosterone

While testosterone levels in males tend to increase throughout adolescence and early adulthood, most individuals’ testosterone levels naturally decrease by roughly 1% each year after 30. However, certain diseases, lifestyle choices, and environmental factors can also affect testosterone levels. By understanding what causes low testosterone in men, you may be able to fix the problem by adjusting your lifestyle, changing your medications, or beginning hormone replacement therapy.

Common causes of low testosterone include the following:

  • Obesity: One recent study found that obese men were 2.4 times more likely to have low testosterone. Fat cells can metabolize testosterone into estrogen, which decreases overall testosterone levels. Plus, high estrogen levels are a separate risk factor for low testosterone, making obesity especially unfavorable for those trying to keep their testosterone levels high. Losing weight through exercise and eating nutritious food can help reverse the damage.

  • Sleep deprivation: A 2011 study published in the Journal of the American Medical Association found that men restricted to five hours of sleep per night for eight nights experienced a 10-15% decrease in testosterone levels. Sleep apnea is a common cause of decreased testosterone levels — men with sleep apnea are roughly 50% more likely to have low testosterone. To help improve sleep, keep a consistent bedtime routine, avoid caffeine and alcohol, and avoid looking at screens before bedtime.

  • Hormonal disorders: A variety of hormonal conditions can disrupt proper testosterone production and regulation. The pituitary gland and the hypothalamus, brain regions responsible for regulating testosterone production in the testes, can often be affected by diseases including Kallmann Syndrome, Klinefelter Syndrome, and certain cancers. Some metabolic disorders can also lead to low testosterone. For example, hemochromatosis, a condition in which the body stores too much iron, can interfere with proper hormonal regulation. As many as half of hemochromatosis patients experience some form of sexual dysfunction.

  • Excessive alcohol use: Alcoholism is damaging to your entire body, including the testes. Plus, alcohol-related diseases like cirrhosis of the liver can contribute to low testosterone. Abstaining from alcohol may help improve testosterone levels. However, advanced cirrhosis is usually irreversible. As with most diseases, prevention is often your best bet.

  • Diabetes: According to WebMD, as many as half of individuals with diabetes have low testosterone. However, medical professionals aren’t yet sure whether diabetes causes low testosterone, or whether low testosterone causes diabetes. Testosterone helps regulate blood sugar levels, so low testosterone may lead to insulin resistance.

  • High estrogen levels: Both men and women naturally have testosterone and estrogen. However, excessive estrogen levels can contribute to low testosterone. Common causes of elevated estrogen levels include genetic factors, certain medications, chronic stress, obesity, and liver disease.

Less Common Causes of Low Testosterone

  • Injury to the testes: The testes, which produce testosterone in men, are relatively unprotected in comparison to other vital organs. Because testes hang from the body in the scrotum, they are at risk of being hit during sports or other strenuous activities. Testicular trauma can lead to problems producing testosterone, especially if it isn’t treated promptly after the accident.

  • Testicular infection: Low testosterone can be caused by an infection of the testes, including testicular cancer and epididymitis, which involves inflammation of the epididymis. Epididymitis is frequently treated with antibiotics and anti-inflammatory medicines. You can also use condoms to help prevent epididymitis, as the sexually transmitted disease Chlamydia is a common cause. Unfortunately, treating testicular cancer can often carry additional risks of reducing testosterone, as radiation, drugs, and surgery may further decrease testosterone levels.

  • Adverse effects of medications: Many medications, including opioids, steroids, and various cancer treatments, can lead to lower testosterone levels. Radiation therapies, including chemotherapy, can be particularly likely to decrease testosterone. In some cases, your doctor may suggest avoiding certain medications responsible for causing low testosterone.

  • Brain trauma: As many as 80% of men with traumatic brain injuries experience low testosterone following the accident, possibly due to interference with brain regions responsible for hormone regulation. Hormone replacement therapy is a standard treatment for men after brain trauma.

  • Chronic kidney failure: Men with kidney disease are more likely to have low testosterone levels. Even after a successful kidney transplant, many men still experience symptoms of low testosterone. These individuals often require hormone therapy to restore their testosterone levels to normal.

  • HIV/AIDS: AIDS can lead to lower testosterone levels, as the disease can affect the pituitary gland, hypothalamus, and testes, all of which are essential to proper hormone regulation.

How to Treat Low Testosterone

Some cases of low testosterone can be reversed by lifestyle changes, such as eating more high-testosterone foods, exercising more, or getting more sleep. However, in many cases, doctors may recommend other low testosterone treatment options such as low testosterone supplements. Medical professionals often advocate for hormone replacement treatment, which can include injections, pills, or topical remedies like patches or oils. Testosterone therapy treatments typically take one to two months to begin working. Eventually, patients may experience improved mood, sex drive, and energy.

As a variety of other conditions can also cause many symptoms of low testosterone, be sure to check with a medical professional and test your testosterone levels before undergoing testosterone hormone therapy. Once you begin therapy, regularly consult with your doctor to ensure the treatment is working without any serious side effects.

Looking for Help With Low Testosterone?

Approximately 6% of men suffer from low testosterone, and that number rises significantly for older men. If you’ve experienced any symptoms or have any of the risk factors mentioned above, don’t hesitate to contact Nava Health and Vitality Center for an appointment. We can discuss low testosterone treatment costs, side effects, and other considerations. We provide hormone therapy in the DC, MD, and VA area, and to the entire US through telemedicine.