Low testosterone: Recognising the symptoms and knowing when to seek help
Understanding low testosterone
Testosterone plays an important role in men's physical and mental health, influencing libido, energy levels, muscle mass, bone strength, mood and overall wellbeing. Low testosterone, also known as hypogonadism, occurs when the body does not produce sufficient levels of this hormone. Although testosterone naturally declines with age, persistently low levels should not simply be dismissed as an inevitable part of getting older.
Recognising the symptoms
Symptoms can develop gradually and vary between individuals. Common signs include reduced sex drive, erectile difficulties, persistent tiredness, low mood, irritability and difficulty concentrating. Some men may also notice reduced muscle mass, increased body fat, loss of body hair or decreased physical strength.
In more significant cases, low testosterone can affect fertility and bone density. However, these symptoms can have several underlying causes, so they should not automatically be attributed to testosterone deficiency.
Appropriate investigations and the role of blood testing
A proper assessment begins with a discussion of symptoms, medical history, lifestyle and any relevant medications. Blood testing is essential to help establish whether testosterone levels are genuinely low. A total testosterone blood test should ideally be taken in the morning, usually between 7am and 11am, when levels are typically highest. Importantly, a low result should be confirmed with a second morning test on a separate day.
Depending on the findings, further investigations may include sex hormone-binding globulin (SHBG), calculated free testosterone, luteinising hormone (LH), follicle-stimulating hormone (FSH) and prolactin to help identify the underlying cause.
When to seek professional support
Men experiencing persistent symptoms should consider speaking to their GP or a healthcare professional with an interest in men's health. Early assessment can help identify treatable causes and rule out other conditions, including thyroid disorders, diabetes and sleep-related problems.
Testosterone replacement therapy may be appropriate for some men, but only following a confirmed diagnosis and careful assessment of potential benefits and risks. A personalised approach is essential to achieving better long-term health and wellbeing.
