Can Young Men Get Low Testosterone?
Can Young Men Get Low Testosterone?
Low testosterone (male hypogonadism) is a condition where your body doesn’t produce enough testosterone. As the primary male sex hormone, testosterone deficiency impacts many aspects of male physiology. It affects your sex drive, muscle mass, energy levels, and mood.
Testosterone levels naturally decline with age, so male hypogonadism is typically associated with middle-aged or older men. But can young men get low testosterone? Although less common, the answer is yes—younger males and adolescents can have declining testosterone levels.
Here we look at the link between testosterone and age, the causes of reduced testosterone levels in younger males, and the treatment options available.
What is the Link Between Testosterone and Age?
Many studies have established a clear link between testosterone levels and age. When we are born, our blood testosterone levels are low. They initially start increasing in puberty and peak toward the end of our teenage years—around 18 or 19—where they stay relatively stable until the age of 30.
After this, total testosterone levels start declining at a rate of 1.6% per year. This drop is nothing to be concerned about; it’s a natural part of healthy ageing. However, this age-related decline does explain why low testosterone is more common in older males. The older you get, the more your testosterone levels drop and the more likely you will suffer testosterone deficiency.
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Can a Young Man Have Low Testosterone?
Although generally related to ageing, testosterone deficiency can occur in younger males. Some younger men have low testosterone as their hormone levels drop prematurely, usually due to lifestyle choices or comorbidities. Other males are born with medical conditions that prevent them from ever producing the correct levels of testosterone.
It is important to note that low testosterone is rare in young men, affecting less than 1% of males in their 20s. In contrast, around 40% of males over 45 have low testosterone, and the incidence rate increases to 50% in men over 80. It’s clear that age has a significant impact on the risk of developing the condition—but it isn’t the only factor involved.
What Causes Low Testosterone in Young Males?
The causes of low testosterone in younger men can typically be divided into two groups: (1) underlying medical conditions and (2) health or lifestyle factors.
Medical Conditions Causing Low T
Underlying medical conditions are a common cause of hypogonadism in younger males. Some men are born with low testosterone due to rare congenital disorders like Noonan syndrome and Klinefelter syndrome. These genetic conditions stop typical development and result in abnormal testosterone production throughout life.
In other cases, men develop low testosterone from acquired conditions that affect the testicles (the primary site of testosterone production) or the hypothalamic-pituitary axis (responsible for regulating testosterone production). Examples include:
- Injury to one or both testicles by accident
- Pituitary gland disease or pituitary tumours
- Cancer treatments (downregulate testosterone production)
- Removal of one or both testicles due to cancer
- Diabetes (16% of men with diabetes have low T)
Health & Lifestyle Factors
While underlying medical causes should always be considered, your testosterone levels may have declined prematurely due to health and lifestyle factors. Several factors aside from age can contribute to declining testosterone levels, such as those listed below:
- Obesity: If you’re overweight, you’re more likely to have low testosterone. According to one study, the chance of having testosterone deficiency is 4x higher for obese men. This study looked at men aged 45+, but it likely applies to younger males.
- High Blood Pressure: The same study found that men over 45 were 1.8x more likely to have low testosterone if they had high blood pressure. High blood pressure is linked with high cholesterol, which is also seen in men with low testosterone.
- Drugs & Alcohol: Research suggests that substance abuse can reduce testosterone production. Therefore, drinking excessive alcohol, misusing androgenic steroids, or taking recreational drugs can cause low testosterone in young men.
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What Are the Symptoms of Low Testosterone in Young Males?
The main symptoms of low testosterone are the same regardless of your age and include:
- Lack of energy and fatigue
- Reduction in sex drive
- Trouble maintaining an erection
- Loss of muscle mass
- Increase in body fat
- Reduced bone density
- Low mood and increased irritability
- Difficulty concentrating
- Reduced performance
- Loss of body and facial hair
However, the prevalence of symptoms differs among age groups. Older men with age-related hypogonadism commonly report low libido or erectile dysfunction, whereas younger men under 40 primarily suffer from low energy and non-specific symptoms like poor memory and focus.
Diagnosing low testosterone in young men is more challenging, as many of the non-specific symptoms commonly experienced by younger males can be caused by other conditions or lifestyle factors. This commonly leads to misdiagnosis with conditions like depression and anxiety.
What Is the Treatment for Low Testosterone in Young Males?
Testosterone replacement therapy (TRT) is the primary treatment option for men with low testosterone, irrespective of age. This therapy involves administering exogenous testosterone to increase levels in the blood. It can be delivered through injections, patches, pellets, tablets, or gels.
However, whether TRT is an appropriate therapy depends on the cause of the condition and the fertility goals of the man. While correcting the symptoms of male hypogonadism, TRT decreases sperm production and fertility. This may be less relevant for older men that already have families, but it is a crucial consideration for younger men that want children.
Therefore, lifestyle changes are usually recommended for younger males before they begin TRT. Below are some lifestyle changes your doctor might ask you to make:
- Going on a formal weight loss programme to reach a healthy weight
- Avoiding excessive alcohol consumption and the use of recreational drugs
- Avoiding certain medications, such as opioids and xenobiotics
- Exercising regularly to maintain a healthy weight and promote overall good health
- Priotising sleep, aiming to get at least seven hours per night
If these lifestyle changes don’t raise your testosterone levels to the healthy range, TRT can be used as an alternative. Fortunately, fertility can also be maintained through therapy with HCG. This drug stimulates sperm production and testicular growth and can be taken alongside TRT to treat low testosterone in younger men wanting children.
TRT is the only treatment for young men with conditions such as Klinefelter syndrome, testicular cancer, or pituitary disease. These causes of hypogonadism cannot be reversed by lifestyle changes and need tailored treatment with exogenous testosterone.
Should Young Men Get Their Testosterone Levels Checked?
You should consider getting your testosterone levels checked if you notice any unusual symptoms, regardless of your age. Never assume you’re “too young” to have a testosterone deficiency. Low testosterone can affect men of all ages, including adolescents and young adults.
Getting a testosterone test is the only way to be officially diagnosed and begin treatment. And even if you don’t qualify for TRT, a blood test can help reveal whether any underlying conditions or lifestyle choices are affecting your hormonal balance. Your test result also acts as a benchmark for your blood testosterone, so if you exhibit symptoms in the future, it’s easy to compare hormone levels.
At Optimale, we offer a range of testosterone blood tests that can be completed in the comfort of your home. Click here to order your test online and start learning about your testosterone levels today—it’s never too early to gain knowledge about your health and hormones.
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Published: November 10th, 2023
Last updated: November 10th, 2023