Low Testosterone Level – Testosterone Deficiency

Low Testosterone Level – Causes and Symptoms of Testosterone Deficiency

Perhaps the word “hormone deficiency” has been associated with women.  But more and more men lack testosterone, the masculine hormone par excellence.  The causes and symptoms of a low testosterone level are manifold.  Numerous factors can be the trigger for testosterone deficiency.

Testosterone is the most important hormone in the male body.  This is particularly evident when it is lacking: if the testicles produce too little testosterone, symptoms occur which significantly impair the quality of life.

Symptoms of Low Testosterone Level / Testosterone Deficiency



  • General loss of vitality, inexplicable fatigue and / or fatigue
  • Less or no desire for sex
  • Declining strength, performance weakness
  • Decrease of muscle mass, increase of adipose tissue
  • Concentration and memory disorders
  • Moody mood, depressed thoughts
  • Sleep disorders
  • Heat sweating, increased sweating
  • Potency problems (erectile dysfunction)
  • Dry skin, reduced body hair

Low Testosterone Level : Testosterone Deficiency

Many men do not take the first signs seriously.  If the body is lacking testosterone (the term “hypogonadism”), the affected individuals do not usually feel clearly sick.   The symptoms are diffuse and are often dismissed as harmless.

  • Constantly tired? This is certainly due to the weather.
  • No more sex? Oh, the stress in the job sometimes hits the libido.
  • Sleep disorders? Well, we have almost every now and then!

In addition, the symptoms of a low level of testosterone or testosterone deficiency rarely occur all at the same time.  The disease often begins creeping and develops over a long period of time.  Life stages, habits and diseases all favor a low testosterone level.

In certain cases, however, it is particularly important to think of a testosterone deficiency as early as the first of the above symptoms.  In certain phases of life, with an unhealthy lifestyle and / or existing diseases, the danger is particularly great to develop a deficiency in the masculinity hormone.

Andropause is the term of life of a man, in which his hormonal balance changes noticeably and the testosterone drops sharply.

Causes of Low Testosterone Level / Testosterone Deficiency

Testosterone and Age

“Andropause” is sometimes referred to as the life stage of a man in whom his hormonal balance changes noticeably and the testosterone drops sharply.  Today, it is known that only part of the older men are affected.

Between the ages of 35 and 40, each man’s testosterone level drops by one to two percent per year. This is a very natural process. The hormone drop is so slight that a healthy man should not notice it.

In some men, however, over the years – from the age of 50 to 55 years – the symptoms are so low that they develop symptoms of deficiency such as hot flashes, diminished libido or impotence.

Whether the hormone deficiency is so great that it needs to be treated, or the symptoms are normal companionship of the aging process or a stressful life, only a doctor can decide.

Unhealthy Lifestyle, Overweight

Testosterone deficiency also occurs more and more frequently at a young age.  In many patients, this is the case along with overweight and / or unhealthy habits.  Excessive consumption of alcohol, smoking, one-sided diet and also drug abuse can hinder testosterone production.

Especially abdominal overweight (“metabolic syndrome”) can quickly lead to a testosterone deficiency due to certain hormonal processes in the body.

Too little exercise and / or mental activity can push the testosterone level.


Certain diseases such as diabetes mellitus, hypertension, increased blood fat (“cholesterol”) and metabolic syndrome often occur together with testosterone deficiency.

Stress / mental problems

Permanent stress in the workplace, family problems or mental illness (such as depression, burnout syndrome) can have a negative effect on testosterone production.

Basic Diseases / Family Pre-stress / Medication

In a number of men, a testosterone deficiency can result from underlying other diseases.  This is also a medical examination.  Testosterone deficiency can also have genetic causes. Klinefelter syndrome is due to a mis-distribution of the genetic material, the chromosomes, and is associated with a testosterone deficiency.   In addition, drugs that interfere with the hormone balance or even certain antidepressants can lower testosterone levels.

Is every man affected?

The values ​​should remain within the normal range even in old age.  After the age of 35 (in some cases slightly earlier, some later), a slow drop in the testosterone level occurs in all men.  This is completely normal.  In healthy men, however, the masculinity hormone is only one to two percent per year, so the values ​​often remain within the normal range even in old age.

Testosterone deficiency occurs in older age.  More and more men are suffering from testosterone deficiency in America.  At least one in five men have a too low level of testosterone.  For all older men, the testosterone level drops over the years.

Common concomitant diseases of testosterone deficiency are:

  • high blood pressure
  • overweight
  • diabetes
  • increased blood fats (“cholesterol”)

Testosterone deficiency in combination with unhealthy lifestyle

A low testosterone level can also occur in young men.  In addition to specific diseases such as a Klinefelter’s disease, an unhealthy lifestyle and its physical consequences can cause a testosterone deficiency in young men. More and more younger patients suffer from typical civilization diseases such as hypertension, metabolic syndrome or type II diabetes.

Habits and civilization disorders that lower testosterone levels:

  • overweight / obesity (especially the “Metabolic Syndrome“, with increased fat formation in the abdomen)
  • lack of exercise
  • unhealthy / irregular die
  • smoking
  • alcohol consumption
  • consumption of drugs such as marijuana, cocaine etc
  • stress

Most patients suffer from concomitant illnesses – or live unhealthy

Only to a minor extent is a malfunction of the testicular cause of a testosterone deficiency.  Most patients who have a testosterone deficiency suffer from concomitant illnesses or maintain an unhealthy lifestyle, which affects the regulation of the testosterone level.

Forms of Testosterone Deficiency

The hormone testosterone is produced in the Leydig cells of the testicle.  Testosterone production is controlled by the pituitary gland and other centers. If there is a defect, three types are distinguished.  It is important to know where and why problems arise with the testosterone production.

Key factors responsible for low testosterone levels: cigarettes & alcohol

An unhealthy lifestyle often leads to deficiency symptoms.  The testosterone level is lowered by an unfavorable metabolism, stress, chronic diseases or operations into the deficiency range.  The most common is the deficiency of overweight men, with age-related testosterone decline.

Age-related testosterone deficiency

In all men the testosterone production decreases with increasing age.  The process starts at about the age of 35.  As the age grows, the testosterone level drops below the normal values, with an increasing percentage of men.

However, an increasing number of men develop a hormone deficiency over the years that can be associated with unpleasant symptoms such as drowsiness, muscle weakness, libidomaniacs or erectile dysfunction. Very often, not only is age but also an unhealthy lifestyle with overweight, one-sided diet, cigarettes or too much alcohol responsible for a low testosterone level.  Also mental or physical stress can lead to a noticeable low testosterone level.

Primary testosterone deficiency / hypogonadism

Sometimes a disorder of hormone formation in the testis is the cause of the low testosterone level.  Doctors then speak of “primary testosterone deficiency” (also: primary hypogonadimus).  This disorder may be congenital, such as in Klinefelter syndrome, where a gene defect leads to a deficiency of the androgen.

A primary testosterone deficiency can also be caused by the following disorders: diseases of the testes, for example inflammations, infections or testicular cancer, injuries, for example a twisting of the testes (hodentorsion), developing disorders, e.g. testicular height (inguinal hocks), missing testes (congenital or by surgery, eg after cancer)

Secondary testosterone deficiency / hypogonadism

To stimulate testosterone production in the testes, the control centers in the brain (pituitary / hypothalamus) have to emit messenger substances (e.g. LH, GnRH).  If this process is disturbed, physicians speak of “secondary testosterone deficiency” (also: secondary hypogonadimus).  An underlying disease can be, for example, the condition after surgery of a hypophysis dorsal or a thyroid dysfunction. Drugs, circulatory disorders, disease or drug use may also lead to a secondary testosterone deficiency.

Testosterone Gel or Injection: What is the right therapy for me?

The doctor has diagnosed you with a testosterone deficiency.  Now they will decide together which therapy is best for you.  Testosterone injections or testosterone gels are often prescribed.

However, you should be involved in deciding on the type of testosterone therapy.  As a rule, you can rely on the advice of your doctor: Testosterone therapy is something quite common to most andrologists and urologists, most of whom can rely on numerous experience values.

Gels and injections are the most effective remedies for testosterone deficiency.  Often, gels or injections are prescribed.  Both embodiments have various advantages.  Testosterone gel is applied once daily to the skin.  Testosterone injections are administered at intervals at the doctor’s office.

Testosterone Gel

Many men prefer the use of a testosterone gel because they themselves control their therapy. The testosterone-containing gel is applied once daily, usually in the morning, to upper arms, shoulders or stomach. The masculinity hormone is then evenly distributed into the blood over the skin for 24 hours.


  • Very uncomplicated application – fast action: The gel dries without residue. The effect is very fast as the testosterone level is normalized on the first day. From the second day, a constant value has been reached, which remains stable in the long term if used regularly.
  • Discrete treatment: After the gel has dried on the skin, the testosterone treatment remains completely invisible to others. However, avoid the direct skin contact of the application sites with other persons.
  • Individually dosed: When you are treated with testosterone gel, keep full control. Any overdose or underdosing can be compensated by an adjustment of the applied gel quantity – after consultation with the doctor. By more gel, testosterone levels and testosterone effects can be flexibly increased, reduced by less gel. Also, the treatment can be interrupted at any time, if necessary.
  • Even testosterone levels: The hormone levels remain even over a longer period of use, there are no unwanted testosterone highlights or “absacker”
  • Flexibility: The therapy can be carried out both at home and on the road.


  • Large application area
  • Occasionally skin irritations are possible
  • Children and pregnant women must not come into contact with the testosterone gel.

After each treatment, thorough, very thorough hand washing is required.  Thanks to the testosterone gel, the hormone is released into the blood through the skin in 24 hours.

Testosterone Injections

Testosterone injections are generally administered in the doctor’s office.  The hormone is injected into the buttock muscle. The testosterone injections have a depot effect.  That is, the hormone is stored in the body and acts there over a longer period of time.  There are two types of testosterone injections. In the “3-month syringe”, the patient visits the doctor’s office every 10 to 14 weeks to get the masculine hormone injected.


  • Very comfortable because the patient does not have to think about the treatment over a longer period of time.
  • For each treatment, a personal consultation with the doctor is possible (for questions, etc.).


  • The treatment is dependent on the doctor’s visit, i.e. the patient can not become active himself.
  • In case of possible side effects the effect can not be interrupted immediately for a longer period of time.
  • An oily solution is injected into the muscle.  Therefore, it can be a bit painful. In rare cases, the oil may spread in the blood vessel system causing serious discomfort that may need medical attention.
  • Often the effect increases shortly after the injection, in order to fall then noticeably in the days / weeks before the next injection.  This so-called “testosterone hole” at the end of the injection interval may be associated with mood swings and heat buildup.

At the beginning of the treatment, the individual interval up to the next syringe can not yet be specified precisely (because there are no empirical values ​​yet).

In addition to the “3-month-injection”, there is the classic testosterone injection.  It has a shorter duration: the patient gets an injection in the doctor’s office every two to three weeks. Pros and cons are by and large the same as in the 3-month-injection.  Due to the shorter duration of the action, however, the doctor can react more quickly in case of undesirable side effects and change the dosage.

Check-Ups Are Important

During the testosterone treatment, control visits are very important to the treating physician.  In the first year of treatment, the doctor will measure the testosterone level, determine a blood count (blood collection), prostate and general physical condition every three to six months. If the treatment has been successful and has been running for at least one year, only annual checks are carried out.

Diagnosis of Testosterone Deficiency

Many men avoid doctor’s visits for as long as possible.  Perhaps you are no exception?  The diagnosis of a testosterone deficiency is really not a big deal.

“I’m constantly tired and can not pull myself to anything … Probably too much stress!” 

Too much stress?  The symptoms that a low testosterone level can cause are creepy and are often diffuse.  Many men do not even think they can be sick.  However, especially from the age of 35, it is important to have the testosterone level checked even at the first symptoms (e.g. unexplained fatigue, performance drop, muscle loss, weight gain, no desire for sex, erectile dysfunction).

Early detection is important

Studies have shown that men with low testosterone levels are more likely to have a heart attack or stroke than men with testosterone levels.  It is therefore important to identify and compensate for a deficiency at an early stage.

In addition, the earlier a hormone deficiency is discovered, the easier it can be corrected. Sometimes a change in the way of life is enough. Treatment with testosterone, e.g .in the form of a testosterone gel , will often be necessary.

The diagnosis is uncomplicated

The physician (e.g. a urologist, the family doctor or an andrologist) can determine relatively easily a low testosterone level.  In the consultation hours, you can first describe your complaints. Afterwards, your physician may perform a physical examination that provides information on the general constitution (physique, skin, muscle strength).

The diagnosis Testosterone deficiency is ensured by a blood test.  Only a blood test brings certainty

If your doctor suspects you are suffering from testosterone deficiency, the diagnosis is confirmed by a blood test.

Important: The diagnosis testosterone deficiency / low testosterone level can only be ensured if typical symptoms occur and the testosterone values ​​determined by the laboratory are below the normal range.  Doctor’s visit and blood tests are mandatory for diagnosis.

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Last update was on: June 24, 2022 12:16 pm

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