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Testosterone is the male hormone that everyone has heard of; it is often used as a byword for virile masculinity. This image is reflected in popular culture, where films featuring muscular and highly competitive action men are often described as ‘testosterone-fuelled.’ But how do you tell if your levels of this important hormone are within normal range?

What is the function of testosterone?

Testosterone plays a key role in the male body, regulating fertility and sex drive, muscle mass, fat distribution, and red blood cell production. When the level of the hormone drops in the body, it can lead to a lower sex drive and erectile dysfunction (ED), reduced muscle mass and bone density, hair loss, and infertility.

What are the causes of low testosterone?

The primary cause of low testosterone is thought to be age, as levels tend to drop naturally after the age of 30, at a rate of 1% per year. Injury, infection, or blocked blood supply to the testes can also be a factor. Lifestyle factors such as misuse of alcohol and steroids, and obesity or extreme dieting can affect testosterone production.

Certain medications, chemotherapy for cancer, and various chronic health conditions will also cause levels to drop off. Some men have lower levels due to a genetic condition that is present at birth, and this is known as hypogonadism. The condition may also be triggered in later life by disease or lifestyle. In summary, there are many potential factors and causes.

What are the signs of low testosterone?

A common symptom is a low sex drive, and difficulty achieving and maintaining an erection. Sperm count and fertility levels will be low, and the testicles may appear small. Lean muscle mass will be reduced, and loss of bone density may occur. Levels of body fat rise, and gynecomastia, or ‘man-boobs’ may develop.

The individual may also notice a worse sense of wellbeing, and feel depressed, moody, and irritable. They will become tired easily and may experience problems with concentration and memory. Night sweats and hot flushes may also be a problem, and there may be a decreasing need to shave, and a poorer performance in sport and exercise.

How is low testosterone diagnosed?

Diagnosis involves measuring the levels of testosterone present in the body, by carrying out a blood test. Several tests may be needed as levels can fluctuate, and tend to peak in the morning. Depending on symptoms, other checks may be needed to determine if further health conditions are present.

How is low testosterone treated?

The condition can be treated with testosterone replacement therapy, which takes various forms. The hormone can be injected directly into a muscle at intervals of three months; testosterone patches can be applied to various parts of the body daily; or a gel can be applied to the upper back and arms.

What are the risks of testosterone replacement therapy?

Known side effects of treatment include acne, painful erections, thickening of the blood, and increased aggression.

Many potential causes of low testosterone are due to genetics and ageing, and cannot be avoided. However, following a balanced diet and exercise routine, and avoiding substance abuse, can help to maintain healthy levels of testosterone.

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