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Testosterone Deficiency : Causes, Symptoms, Treatment, Side Effects of Testosterone Replacement Therapy

Loss of libido in males may indicate testosterone deficiency. Owing to its important function, testosterone is one of the necessary hormones in men. Hence, it is essential to know about the symptoms of testosterone deficiency & its treatment.

The male testicles produce a hormone called testosterone. This hormone is essential for the development of male sexual characteristics. Testosterone is responsible for building bone and muscle mass, optimal sperm production, proper sexual function and libido, and a sense of well-being. It affects male pattern fat distribution, red blood cell production and bone density. The normal lower limit of testosterone level in men is nearly 300 ng/dl while the upper normal limit is approximately 1000-1200 ng/dl. In a normally developing male, testosterone peaks during early adulthood. But the level of this hormone gradually starts declining by around 1% a year after a man reaches the age of 30 years. This is considered to be a normal part of aging.

Low testosterone or testosterone deficiency is defined as underproduction or lack of production of testosterone in men. It is important to investigate a low testosterone level to differentiate it from normal aging. Read on to know all about testosterone deficiency, its causes, symptoms of testosterone deficiency & its treatment.

What Causes Testosterone Deficiency?

There are certain conditions which can lead to low testosterone levels. Some of the common causes of testosterone deficiency include diabetes type 2, obesity, infections, hormonal disorders, Klinefelter syndrome, hemochromatosis, kidney failure, liver cirrhosis, sarcoidosis and stress. Even corticosteroid drugs, chemotherapy, radiation, narcotics, injury, loss of testicles, and alcoholism can cause testosterone deficiency.

What are the Symptoms of Testosterone Deficiency?

Signs and symptoms of testosterone deficiency include weight gain, decreased muscle mass, insomnia, sleep disturbance, worsening of sleep apnea, decreased libido, infertility, sexual dysfunction, anemia, changes in cholesterol and lipid levels, fragile bones, lesser body hair, depression, mood swings, decreased motivation, lack of concentration and worsening of congestive heart failure.

Symptoms of testosterone deficiency may not be easily noted, as similar problems can be seen in other conditions. This makes it necessary to be vigilant about the possible symptoms and seek timely medical advice for relevant investigations and appropriate treatment.

How is Testosterone Deficiency Diagnosed?

Testosterone deficiency can be diagnosed by correlating low testosterone level in blood, i.e.300 ng/dl or less, with symptoms. While most of the symptoms are very obvious, some symptoms like low bone density need to be investigated further. A testosterone measurement test also needs to be conducted to detect a testosterone deficiency.

What is the Treatment for Testosterone Deficiency?

Testosterone replacement therapy is a fully accepted treatment for testosterone deficiency. In this therapy, testosterone can be administered trans-dermally through a skin patch, as mucoadhesive material applied above the teeth, or as gel applied directed on the skin or inside the nose. Testosterone can also be delivered in the body through intramuscular injections or long-acting subcutaneous pellets. All these options are very effective in providing optimal levels of hormone replacement in the body.

Treatment for testosterone deficiency is also available as a pill but some experts believe that long term oral delivery of testosterone can harm liver. Older men are advised to clearly discuss these hormone replacement method and their side effects with the doctor before starting with this therapy. Some natural remedies are also effective as a treatment for testosterone deficiency. These include getting adequate sleep, exercising regularly, staying active, maintaining a healthy weight and practicing stress management techniques.

What are the Side Effects of Testosterone Replacement Therapy?

Some possible side effects of testosterone replacement therapy for normal aging males include skin reactions, shrinkage of testicles, decreased sperm production, increased aggression, over production of red blood cells, increased risk of cardiovascular problems and prostate cancer.

Who Should Not Take Testosterone Replacement Therapy?

Testosterone replacement therapy is an accepted treatment for testosterone deficiency. But the effectiveness of testosterone therapy in reversing any aspects of natural aging in males is still not clearly proven. Older adults with considerably decreased testosterone levels without significant symptoms, or modestly decreased levels with significant symptoms, should undergo testosterone therapy only after consulting a doctor. Prostate cancer patients and men with severe urinary tract infections, sleep apnea and heart problems should not take testosterone replacement therapy. All men should undergo a rectal exam, prostate specific antigen (PSA) test and complete prostate cancer screening before starting with testosterone replacement therapy.

Also Read:


  1. Mayo Clinic – Testosterone therapy: https://www.mayoclinic.org/tests-procedures/testosterone-therapy/about/pac-20385089
  2. Cleveland Clinic – Testosterone Deficiency: https://my.clevelandclinic.org/health/diseases/15687-testosterone-deficiency-male-hypogonadism
  3. Healthline – Symptoms of Low Testosterone in Men: https://www.healthline.com/health/symptoms-of-low-testosterone-in-men
  4. Harvard Health Publishing – Testosterone deficiency: A guide for men: https://www.health.harvard.edu/mens-health/testosterone-deficiency-a-guide-for-men

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 1, 2023

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