Androgen deficiency in men (2023)

Reproductive system - male

Summary

Read the full fact sheet
  • Androgens (including testosterone) are the hormones that give men their 'male' characteristics.
  • Androgen deficiency means the body has lower levels of male sex hormones, particularly testosterone, than is needed for good health.
  • Causes of androgen deficiency include problems of the testes, pituitary gland and hypothalamus.
  • Androgen deficiency is treated with testosterone replacement therapy.
(Video) Androgen Deficiency

On this page

  • Androgens are sex hormones
  • Symptoms of androgen deficiency
  • Androgen deficiency in older men
  • Androgen deficiency in boys
  • Causes of androgen deficiency
  • Diagnosis of androgen deficiency
  • Treatment of androgen deficiency
  • Side effects of treatment of androgen deficiency
  • Self-prescription may not be safe
  • Where to get help

Androgen deficiency is when the body has lower levels of male sex hormones, particularly testosterone, than is needed for good health. This deficiency may be caused by problems in the areas of the brain that control the function of the testes (the pituitary gland and the hypothalamus), or by problems in the testes themselves. Treatment involves testosterone replacement therapy.

The term 'male menopause' is meaningless as it doesn't exist: there is no sudden, severe or inevitable drop in sex hormone production in men as experienced by women.

A modest and gradual drop in sex hormone levels is seen across male populations from the age of about 30 but this fall is not seen in all men. In most cases the drop in testosterone appears to be caused by them developing other illnesses along the way.

Androgens are sex hormones

Hormones can be thought of as chemical messengers. They communicate with tissues in the body to bring about many different changes. Hormones are needed for different processes like growth, reproduction and well-being.

Androgens are the group of sex hormones that give men their 'male' characteristics (collectively called virilisation). The major sex hormone in men is testosterone, which is produced mainly in the testes. The testes are controlled by a small gland in the brain called the pituitary gland, which in turn is controlled by an area of the brain called the hypothalamus.

Androgens are crucial for male sexual and reproductive function. They are also responsible for the development of secondary sexual characteristics in men, including facial and body hair growth and voice change. Androgens also affect bone and muscle development and metabolism.

The term androgen deficiency means your body is not making enough androgens, particularly testosterone, for full health. The effects of this depend on how severe the deficiency is, its cause and the age at which the deficiency begins.

Testosterone

The major sex hormone in men is testosterone. Some of the functions of testosterone in the male body include:

  • starting and completing the process of puberty
  • bone and muscle development
  • growth of body hair, including facial hair
  • change of vocal cords to produce the adult male voice
  • sex drive (libido) and sexual function
  • prostate gland growth and function
  • sperm production.

Symptoms of androgen deficiency

When there is not enough testosterone circulating in the body, it can cause a wide range of symptoms. However, a number of these symptoms may be non-specific and can mimic the symptoms of other diseases and conditions.

(Video) What is testosterone (androgen) deficiency? - A/Prof Carolyn Allan

Some of the symptoms of androgen deficiency include:

  • reduced sexual desire
  • hot flushes and sweating
  • breast development (gynaecomastia)
  • lethargy and fatigue
  • depression
  • reduced muscle mass and strength
  • increased body fat, particularly around the abdomen
  • weaker erections and orgasms
  • reduced amount of ejaculate
  • loss of body hair
  • reduced bone mass, therefore increased risk of osteoporosis.

Androgen deficiency in older men

If testosterone levels decline with age, a number of factors may be causing it. In particular, any cause of poor general health, including obesity, will lower testosterone. Recent research shows that testosterone levels do not drop significantly in healthy older men.

The impact of the fall in testosterone levels in older men is still not completely understood. There has been much media coverage of 'andropause' or 'male menopause', suggesting that many older men would benefit from testosterone treatment (testosterone replacement therapy). However, there is limited evidence to suggest benefit, and the risks are not clear.

A recent study on the effects of testosterone treatment in older men showed a small increase in sexual function with testosterone treatment (in some cases for less than 12 months), but no significant improvement in mood, vitality or physical function.

Do not start any testosterone treatment without careful diagnosis of androgen deficiency. Make sure you have a full health assessment, and that your testosterone levels have clearly been shown to be consistently low. Often, there are other health problems at play (such as obesity and diabetes) that should be treated first, which may make testosterone replacement therapy unnecessary.

The effect of lower testosterone levels with increasing age and the effects of testosterone replacement therapy in men are currently being studied. Of concern are some studies suggesting a rise in cardiovascular disease after starting testosterone therapy in older men, but this remains controversial.

Androgen deficiency in boys

Boys who have not completed puberty should only be treated by paediatric hormone specialists (paediatric endocrinologists).

Causes of androgen deficiency

Some of the causes of androgen deficiency include conditions affecting the:

  • testes – medical problems that affect the testes can stop them from making enough testosterone. Some of these conditions are present from birth (for example, Klinefelter's syndrome – a genetic disorder where there is an extra sex chromosome in the body's cells). Other conditions may occur at various stages of a boy's or a man's life, such as:
    • undescended testes
    • loss of testes due to trauma or 'twisting off' of the blood supply (torsion)
    • complications following mumps
    • side effects of chemotherapy or radiotherapy
  • pituitary gland – the most common condition that affects the pituitary gland and leads to low testosterone levels is the presence of a benign tumour (adenoma). The tumour may interfere with the function of the pituitary gland, or it may produce the hormone prolactin, which stops the production of the gonadotrophins, which are the hormones needed to signal the testes to produce testosterone
  • hypothalamus – particular conditions, such as tumours or a genetic disorder (Kallmann’s syndrome), can prevent the hypothalamus from prompting the pituitary gland to release hormones. This will inhibit testosterone production by the testes. This is a rare cause of androgen deficiency.

Diagnosis of androgen deficiency

Androgen deficiency is diagnosed using a number of assessments, including:

  • medical history – a full history is taken, including details about fertility, sexual function, symptoms of androgen deficiency, other medical problems, occupation, medication and drug use (prescribed and non-prescribed)
  • physical examination – a thorough general examination is performed, including measuring the size of the testicles and checking for breast development
  • blood tests – are taken to determine the level of testosterone in the blood. Ideally, a fasting blood test should be taken in the morning to detect the body's peak release of testosterone. Testosterone levels should be measured on two separate mornings. The pituitary hormone levels should also be measured
  • other tests – may be required to determine if testosterone deficiency is due to another underlying medical condition. These may include blood tests to check for iron levels, genetic tests (to diagnose an underlying genetic condition, such as Klinefelter’s syndrome), or MRI scans of the brain (to examine the pituitary gland). Semen analysis will help to determine the potential fertility of men with androgen deficiency.

Treatment of androgen deficiency

Treatment for proven androgen deficiency is based on testosterone replacement therapy. Testosterone is best administered by skin gels creams, or by injection (short- or long-acting).

If your testosterone deficiency is caused by your pituitary gland and you are also wishing to father a child, your doctor will probably recommend gonadotrophin injections, several times a week for many months, to stimulate both testosterone and sperm production.

Testosterone treatment is not recommended for men trying to have a child as it acts as a powerful contraceptive by suppressing the pituitary hormones that drive sperm production. If you are androgen deficient and you and your partner are trying to have a baby, see a fertility specialist.

If you are having testosterone replacement therapy you will have regular reviews with your doctor. How often you have these will depend on your age and other risk factors for prostate cancer.

Older men need to be checked for prostate cancer before testosterone replacement therapy can be started, because increased levels of testosterone could make unrecognised prostate cancer grow. However, testosterone replacement therapy is not thought to increase the risk of a new prostate cancer above that of the general population.

Side effects of treatment of androgen deficiency

Once testosterone levels are restored to the normal range, side effects of testosterone replacement therapy are not common. Some of the possible side effects include:

  • weight gain
  • mild acne
  • mood changes and increased aggression
  • male pattern baldness
  • breast development
  • problems with urine flow (older men).

Self-prescription may not be safe

There is a large commercial market for testosterone products or herbal products to increase testosterone production. Do not start taking medications based on symptoms of low testosterone without consulting your doctor, who will assess your overall health and check for any serious conditions.

Using products that you buy online may:

  • not help your symptoms
  • mask other health disorders
  • have unknown side-effects.

Where to get help

(Video) LOW TESTOSTERONE (Low-T), Causes, Signs and Symptoms, Diagnosis and Treatment.

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Androgen deficiency in men (2)

This page has been produced in consultation with and approved by:

Androgen deficiency in men (4)

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(Video) Low Testosterone almost killed me

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FAQs

What happens if androgen levels are low in males? ›

Low androgen or low testosterone (male hypogonadism) can cause fatigue, anxiety and depression, difficulty concentrating, poor exercise tolerance, low sex drive and erectile dysfunction. It can also lead to breast development (gynecomastia).

What happens if you don't have enough androgens? ›

Male hypogonadism, also called testosterone deficiency syndrome (TDS), results when the testes do not produce enough androgen. Low testosterone symptoms in men can vary. Decreased libido is one of the most common symptoms, though males may also experience fatigue, erectile dysfunction, and body composition changes.

What causes androgen deficiency in males? ›

Causes of androgen deficiency include problems of the testes, pituitary gland and hypothalamus. Androgen deficiency is treated with testosterone replacement therapy.

How is androgen deficiency diagnosed? ›

A diagnosis of possible androgen deficiency is confirmed by measuring the amount of testosterone in the blood. Hormones made by the pituitary gland in the brain that act on the testes to make testosterone – luteinising hormone (LH) and follicle stimulating hormone (FSH) – are also measured.

How can men increase androgen levels? ›

Starke offers the following tips:
  1. Improve your diet. Adopting and maintaining a healthy diet benefits your testosterone levels in two primary ways: ...
  2. Mix cardio with strength training, and vice versa. ...
  3. Get plenty of sleep. ...
  4. Take steps to reduce stress. ...
  5. Address any underlying medical conditions.
9 Apr 2021

What is the most important male androgen? ›

Testosterone is the most important androgen (male sex hormone). You need it to have normal reproductive and sexual function.

Does lack of androgen cause hair loss? ›

However, androgen deficiency may also lead to thinning hair due to loss of a more general testosterone-dependent anabolic effect on hair growth.

What happens if you don't get enough hormones? ›

Low estrogen can affect your body in various ways, depending on where you are in terms of your sexual development. Low estrogen: May delay puberty, slow or prevent sexual development. Occurs in perimenopause and menopause, often leading to painful sex, lower sexual desire and hot flashes.

How do you fix androgen imbalance? ›

Androgen disorders cannot be cured but they can be treated, usually with medication. If you are overweight, losing as little as 5 to 10 percent in body weight can restore fertility and decrease hirsutism in some women with androgen excess. Treatment may also include oral contraceptives.

What foods increase androgens in males? ›

  • Fatty fish. Fatty fish like salmon and sardines are rich in nutrients that are important for hormonal health, such as vitamin D, zinc, and omega-3 fatty acids. ...
  • Dark, leafy greens. ...
  • Cocoa products. ...
  • Avocados. ...
  • Eggs. ...
  • Berries, cherries, and pomegranates. ...
  • Shellfish.

How do you balance androgen levels in males? ›

Eating enough protein can help you maintain healthy testosterone levels and can aid in fat loss, which may be beneficial too (19). Consuming plenty of healthy fats may also help support testosterone levels and hormone balance. Some research shows that a low fat diet could actually decrease testosterone levels (20).

Can you test androgen levels at home? ›

At-home testosterone tests allow you to collect your own sample and ship it back to a lab for evaluation. These test kits require you to collect either saliva or blood, and they come with everything you need to return your sample safely and securely.

What causes androgen imbalance? ›

Causes. In healthy women, the ovaries and adrenal glands produce about 40% to 50% of the body's testosterone. Tumors of the ovaries and polycystic ovary syndrome (PCOS) can both cause too much androgen production. Cushing disease is a problem with the pituitary gland that leads to excess amounts of corticosteroids.

What are normal androgen levels? ›

Male: 300 to 1,000 nanograms per deciliter (ng/dL) or 10 to 35 nanomoles per liter (nmol/L) Female: 15 to 70 ng/dL or 0.5 to 2.4 nmol/L.

What supplements increase androgen levels? ›

6 supplements that may increase testosterone
  • Vitamin D. Vitamin D is the only vitamin that the body can technically synthesize on its own when the skin is exposed to the ultraviolet rays of the sun. ...
  • Ashwagandha. ...
  • Fenugreek. ...
  • Zinc. ...
  • Magnesium. ...
  • Ginger. ...
  • Related content.
17 Feb 2022

How do you build androgens? ›

Quick exercises that take a lot of exertion stimulate a release of testosterone, along with an increase in androgen receptor synthesis and function. Endurance activities run the risk of boosting cortisol – a stress hormone that blocks the activity of androgens.

What is the most powerful androgen? ›

Testosterone and dihydrotestosterone (17-beta-hydroxy-5-alpha-androstan-3-one) are the most potent androgens in humans and four-legged vertebrates. The weaker androgens androstenedione and dehydroepiandrosterone (DHEA) occur in small amounts in all vertebrates.

Which cells produce androgen in males? ›

Leydig cells of the testis and theca cells of the ovary are critical cell types in the gonadal interstitium that carry out steroidogenesis and provide key androgens for reproductive organ function.

What is the main purpose for androgens? ›

Androgen effects

The androgens function as paracrine hormones required by the Sertoli cells to support sperm production.

Does hair grow back after low testosterone? ›

The Main Causes of Hair Loss in Men

Raising your testosterone levels won't magically stop balding or cause your hair to grow back. However, hormones can have an impact on your hair loss. There are three main causes of thinning hair or balding in men: This is perhaps the most common reason for baldness and hair loss.

What hormone increases hairloss? ›

In both sexes, the specific hormone responsible for hair loss is the same: dihydrotestosterone (known as “DHT”), a hormone that your body produces as a byproduct of testosterone. Both men and women need testosterone.

Which hormone is responsible for hair loss in male? ›

Dihydrotestosterone (DHT) can play a significant role in hair loss in both men and women. Learn more about what DHT is and how it contributes to baldness as you begin your treatment program.

How can men treat hormonal imbalance? ›

How can I prevent a hormonal imbalance?
  1. Maintaining a healthy weight.
  2. Eating a balanced, healthy diet.
  3. Exercising regularly.
  4. Managing your stress.
  5. Getting enough quality sleep.
  6. Managing your chronic health conditions well (if applicable).
  7. Quitting smoking or using tobacco products, if you smoke.
4 Apr 2022

Can a man have hormonal imbalance? ›

Men experience states of hormonal imbalance during their life, including puberty and aging. Hormone imbalance might also be brought on by stress, an acute injury or illness, poor nutrition, inadequate exercise, or several other factors.

What stimulates androgen? ›

Testicular androgen secretion is controlled by luteinizing hormone (LH) and follicle stimulating hormone (FSH), which influence the Leydig cell response to the LH.

How do you check androgen levels? ›

A testosterone test is a blood test that measures total testosterone, free testosterone, and a protein called sex-hormone binding globulin (SHBG). A free androgen index measures testosterone in your blood and compares the total amount of testosterone to SHBG in your body.

Does coffee increase androgen? ›

Chronic caffeine intake increases androgenic stimuli, epithelial cell proliferation and hyperplasia in rat ventral prostate - PMC. The .

Which fruit has more testosterone? ›

Bananas. Bananas contain an enzyme called bromelain which is known to help boost testosterone levels.

Does milk increase testosterone? ›

It truly does! Milk is an outstanding source of protein, calcium, and vitamin D. It can also keep testosterone in check for men with low levels.

How can a man balance testosterone? ›

“That includes diet, exercise, drinking less booze, and not smoking. All of those things can help maintain healthy testosterone levels.” Some doctors say that getting a good night's sleep and reducing stress can also have a positive effect. If those things don't work, you might be a candidate for testosterone therapy.

How do I know if my testosterone is low? ›

What are the symptoms of low testosterone?
  1. Reduced sex drive.
  2. Erectile dysfunction.
  3. Loss of armpit and pubic hair.
  4. Shrinking testicles.
  5. Hot flashes.
  6. Low or zero sperm count (azoospermia), which causes male infertility.
2 Sept 2022

When should androgens be checked? ›

When Can Androgen Levels be Checked? Androgen levels can be checked at any time because they are stable across your menstrual cycle.

Can stress affect androgens? ›

Chronic stress elevates ACTH, which stimulates androgen secretion, for which there is no negative feedback loop. Androgen hormones are protective against the long-term effects of chronically elevated stress hormones like cortisol and adrenaline.

When do men start losing testosterone? ›

A man's ability to produce testosterone starts to decline at about 40 years of age, and levels continue to drop 1 – 3% a year thereafter. It is important to note that just because the levels are dropping after 40 doesn't necessarily mean that all men are candidates for therapy.

Does androgen increase size? ›

This study demonstrated that high prepubertal androgen levels do not alter adult penile size. Despite marked virilization and a resultant decrease in final height all patients had penile length in the normal adult range (12.7 plus/minus 2.6 versus 12.4 plus/minus 2.7 cm., respectively).

What happens when male hormones are low? ›

If a male has low testosterone, symptoms can include erectile dysfunction, and males and females may have reduced bone mass and sex drive. The hormone has many important functions, including: the development of the bones and muscles. the deepening of the voice, hair growth, and other factors related to appearance.

What does androgen do in males? ›

An androgen, or male sex hormone, is defined as a substance capable of developing and maintaining masculine characteristics in reproductive tissues (notably the genital tract, secondary sexual characteristics, and fertility) and contributing to the anabolic status of somatic tissues.

Does masturbating reduce testosterone? ›

The short answer to this question? No. Masturbation and ejaculation haven't been shown to have any long-term or negative effects on testosterone levels, also known as T levels.

How do men fix low hormone levels? ›

Alternative treatments
  1. Maintain a healthy weight. Overweight men are more likely to have low testosterone levels. ...
  2. Exercise regularly. Sedentary men tend to have reduced levels of testosterone, as the body doesn't need as much. ...
  3. Sleep 7 to 8 hours every night. Lack of sleep affects the hormones in your body.

How do men fix hormone levels? ›

How can I prevent a hormonal imbalance?
  1. Maintaining a healthy weight.
  2. Eating a balanced, healthy diet.
  3. Exercising regularly.
  4. Managing your stress.
  5. Getting enough quality sleep.
  6. Managing your chronic health conditions well (if applicable).
  7. Quitting smoking or using tobacco products, if you smoke.
4 Apr 2022

How can men improve hormonal imbalance? ›

Here's a list of 8 proven way to naturally boost testosterone levels:
  1. Get Ample Sleep. ...
  2. Eat a Healthy, Balanced Diet. ...
  3. Maintain a Healthy BMI, and Lose Weight if Necessary. ...
  4. Exercise Regularly. ...
  5. Keep Stress at Bay. ...
  6. Take Vitamins and Supplements. ...
  7. Check to See if Your Medications are Lowering Your Testosterone Levels.
16 Jun 2020

How do men balance androgens? ›

Eating enough protein can help you maintain healthy testosterone levels and can aid in fat loss, which may be beneficial too (19). Consuming plenty of healthy fats may also help support testosterone levels and hormone balance. Some research shows that a low fat diet could actually decrease testosterone levels (20).

Where is androgen produced in males? ›

Androgens are synthesized from cholesterol and are produced primarily in the gonads (testicles and ovaries) and also in the adrenal glands. The testicles produce a much higher quantity than the ovaries. Conversion of testosterone to the more potent DHT occurs in prostate gland, liver, brain and skin.

Are androgens in sperm? ›

Introduction. Androgens, which are mainly produced in testicular Leydig cells, are essential throughout male life, as they play a fundamental role in sexual differentiation, maintenance of spermatogenesis, and expression of secondary sexual characteristics (Wang et al.

Can a man live with low testosterone? ›

Some men have lived the majority of their life with low testosterone, and once they experience the benefits of hormone optimization therapy, everything changes. They feel as though they have a new lease on life, they have sky-high energy levels, and they have an overall improved sense of well-being.

Which treatment is best for low testosterone? ›

TRT: The Best Treatment For Low Testosterone

Although low testosterone levels can create a wide variety of subtle or severe symptoms, there's one widely prescribed and highly effective treatment for them all: testosterone replacement therapy (TRT).

Why do men's testosterone get low? ›

Low levels of testosterone that are atypical of normal aging are due to other primary or secondary causes of hypogonadism. Hypogonadism in males happens when the testicles don't produce enough testosterone. Hypogonadism can start during fetal development, during puberty, or during adulthood.

Does having a girlfriend increase testosterone? ›

Results showed that levels of testosterone of single men and men in new relationships did not differ, but both had significantly greater levels of testosterone than men in long-term relationships. Differences in levels of testosterone were unrelated to sociosexual orientation and extra-pair sexual interest.

What is normal testosterone by age? ›

Age-specific middle tertile levels were 409-558 ng/dL (20-24 years old), 413-575 ng/dL (25-29 years old), 359-498 ng/dL (30-34 years old), 352-478 ng/dL (35-39 years old), and 350-473 ng/dL (40-44 years old). Age-specific cutoffs for low testosterone levels were 409, 413, 359, 352, and 350 ng/dL, respectively.

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