What is testosterone deficiency?
Testosterone is the body’s principal male sex hormone and plays a vital role in maintaining health and wellbeing. It helps preserve muscle mass and bone strength, supports energy levels and mood, and is essential for a healthy sex drive and normal erectile function. Although testosterone levels naturally decline with age, some men develop testosterone deficiency (male hypogonadism), where the body no longer produces enough hormone to meet its needs.
Testosterone deficiency can cause a wide range of symptoms, including tiredness, reduced libido, erectile dysfunction, low mood, loss of muscle strength, increased body fat and poor concentration. Because these changes often develop gradually, they are frequently mistaken for a normal part of ageing and may go unrecognised for years. The good news is that, once diagnosed, testosterone deficiency is usually very treatable, with many men experiencing significant improvements in their symptoms, wellbeing and quality of life.
Symptoms
Common symptoms of testosterone deficiency include:
- Reduced sex drive and erection difficulties
- Tiredness and low energy
- Low mood or irritability
- Loss of muscle and strength
- Poor concentration
The above symptoms are very common in older men and do not always indicate a testosterone deficiency. Other causes comprise lifestyle and psychological factors, including poor diet, lack of exercise, high alcohol intake, smoking, stress, depression and anxiety.
How it is diagnosed
Diagnosing testosterone deficiency is based on a combination of your symptoms and blood tests confirming consistently low testosterone levels. Because testosterone levels naturally fluctuate throughout the day, blood samples are taken in the morning, when levels are at their highest, and are usually repeated on a separate day to confirm the diagnosis. Additional blood tests are also performed to measure related hormones, such as luteinising hormone (LH), follicle-stimulating hormone (FSH) and prolactin, helping to identify the underlying cause and determine the most appropriate treatment.
Treatment
Treatment begins by identifying and addressing any underlying medical conditions or lifestyle factors that may be contributing to low testosterone, such as obesity, poor sleep, excessive alcohol intake or certain medications. In some men, improving these factors can increase testosterone levels naturally and reduce symptoms without the need for hormone replacement.
When testosterone deficiency is confirmed and symptoms are significant, testosterone replacement therapy (TRT) can be highly effective. TRT is available as a daily gel or long-acting injection and can improve energy levels, mood, sex drive and erectile function, while also helping to preserve muscle mass, bone strength and overall wellbeing.
Because testosterone treatment needs to be carefully tailored to the individual, regular follow-up is essential. Blood tests are performed to ensure testosterone levels remain within the normal range and to monitor for potential side effects, including changes in red blood cell count and prostate health. With appropriate monitoring, TRT is a safe and effective treatment for appropriately selected men.