Low testosterone in men: symptoms and treatment


Testosterone has become a byword for what it is to be a man. And while that’s not necessarily accurate, it’s unquestionable that the amount of testosterone a person has will determine traits that are associated with masculinity. 

But low testosterone in men will have more of an impact than denting your ego. There are a number of mental and psychological effects which can halt you in your tracks if your testosterone levels start to dip. 

In this guide, we’re going to identify how to spot signs of lowered testosterone, assess what might be causing it, and provide actionable advice for anyone who might be experiencing a lowered level.

Signs of low testosterone in men

If you’re concerned you might be experiencing a dip in your natural levels of testosterone, there are certain signs to look for. While experiencing one of these symptoms doesn’t mean you have definitely seen a dip, a combination of a few of them might be something you want to look into. 

  • Sexual activity. If you’ve noticed your libido has significantly lowered, it could be as a result of a dip in testosterone. This is quite common with men as they age. Other symptoms related to sexual activity include the inability to achieve and maintain an erection, or a lowered volume of semen.
  • Loss of muscle mass. Testosterone is one of the key components in the production of muscle tissue. If you’ve noticed your muscles are smaller than what you’re accustomed to, or it is harder than usual to gain muscle, it might be as a result of a drop. Interestingly, some studies have found that while mass may decrease, overall strength and function remain the same. 
  • Mood swings. Much like any hormone in your body, a sudden rise or fall can trigger startling changes to your overall mood. Irritability, a general lack of focus and, in extreme cases, depression can all occur as a result of low testosterone. It’s also been theorised that other cognitive functions, like memory loss, can occur. 
  • Fatigue. If you’ve felt a sudden shift in energy levels, but have no clear reason as to why, this could also be a sign. It could even be a factor at play if you’re finding it harder to get mentally motivated to go out and exercise.

low testosterone low energy

Having one of these symptoms doesn’t mean you’ve definitely got low testosterone. But you can’t completely rule it out either without a blood test.

Potential causes of low testosterone in men

If you do find yourself in a position where you’ve experienced a dip, your first step should be to try and work out what might be causing it. In some instances these could be things you can actively change. In others, it might require you to seek medical help. Some of the most common causes of low testosterone in men include: 

  • A lack of sleep. There’s very little in life more important for our health than getting the right amount of sleep. This period of rest gives our body the chance to recharge and repair any external or internal injuries we may be suffering from. One study on the relationship between testosterone and sleep even found that restricting a man to just five hours a night saw a 10-15% dip in levels. 
  • Type 2 diabetes. A recent study found that 43% of men with type 2 diabetes experienced a notable drop in their levels of testosterone. In an interesting development, testosterone replacement therapy (TRT) was found to have a positive impact when treating prediabetes – the precursor to full blown type 2. While the relationship between the two has yet to be fully understood, it’s clear there is some kind of link. 
  • Your DNA. Our bodies are made up of a number of complex genes and strands of biological data. Fascinatingly, one study has revealed that just one gene, the sex hormone-binding globulin (SHBG) gene, could have a direct impact on a man’s ability to develop testosterone. Of 14,000 men studied, those with irregularities in their SHBG were found to be 6.5x more likely to have lower levels. 
  • Drinking too much alcohol. Just as sleep has a plethora of positive health effects, the consumption of alcohol does the opposite. For those who overindulge in alcohol, there are a number of ways the substance can reduce testosterone production: 
  • By affecting Leydig cells in the testicles, which produce testosterone 
  • By increasing the level of cortisol in your body (a stress hormone), suppressing testosterone production
  • By aiding the rapid conversion of testosterone to oestrogen by increasing aromatase levels
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ADAM Questionnaire

Low Testosterone Test

The ADAM questionnaire has been shown to have 88% sensitivity in testing for low testosterone.

Getting tested for low testosterone by a professional

The only way you’re going to know for sure if you’re experiencing a dip in your testosterone levels is to turn to a medical professional. Knowing you’re being tested by someone with an extensive background in TRT could really help with peace of mind. 

Optimale has a long history of providing both testing and TRT for anyone who’s concerned. The testing process itself is carried out as followed:  

  • Step 1 – Collect your sample. This can be done either in the comfort of your own home, or by visiting a nurse or clinic local to you. You can also pay for a nurse to visit you at home. The finger-prick blood sample will be collected with the help of a specialised kit, which also contains instructions for those opting to do it themselves. 
  • Step 2 – Send off your sample. Once you have your sample, you can send it back to us. Our specialists will be able to assess whether you do in fact have low levels, and provide information on what your next steps should be. 
  • Step 3 – A second test. In order for TRT to be provided, you need to have had a more comprehensive blood test. This can be completed by a specialist at one of our clinics. This is a necessity for anyone looking to be accepted for treatment. 
  • Step 4 – A consultation. If the second test also shows that you have lowered levels, you will be asked to undergo a consultation with a UK GMC registered doctor. This must be face-to-face if you’re aged over 45 and haven’t had a recent, clear prostate exam. 

Blood Test

Testosterone test kits

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Treatment and fixes for low testosterone

Fortunately, even if you are found to have less testosterone in your system than you should, there are a series of treatments which can help to supplement and replace the hormone. 

  • Injections. While they might feel a little extreme, testosterone injections are one of the most effective ways to ensure you’re receiving a comprehensive level of TRT. With the hormone injected directly into your body, there’s more consistency as to how it will be released and there aren’t absorption issues. 

The regularity of the injections will vary depending on what kind of treatment you need. They can be administered weekly, monthly or as infrequently as quarterly, in accordance with your testosterone levels.


  • Gels/creams. For those less comfortable with needles, you can also rub gel onto your skin. In some instances this method can suffer from absorption issues, so be sure to consult with your doctor first. 
  • Pellets. These will be inserted into your body every six months. They’ll slowly break down over that time and give you a healthy and constant supply of the hormone. These are most commonly inserted underneath the skin, near to your hip. 
  • Patches. In much the same way that someone weaning themselves off of smoking will use nicotine patches, so too can someone looking to boost the amount of testosterone in their system. These can be worn on the arm, and will vary in frequency depending on your needs. 


If low testosterone is something that you think might be an issue for you, then the next step is to get a blood test. Whilst having the symptoms above is usually a good sign that low testosterone is the cause of your symptoms, they can also indicate other issues that may also need investigating,

Getting a blood test will provide clear evidence of low testosterone or rule out this as a cause. It will also help one of our doctors to provide a diagnosis which can lead to treatment through testosterone replacement therapy.

If you aren’t sure of which test is best for you then please contact us on the link below for further expert advice!

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