Low testosterone: a guide to the causes & symptoms

Testosterone boosts libido and energy levels, maintains muscle mass, keeps bones strong and even ensures your privates remain sensitive to touch. Levels naturally drop as we get older, but experts disagree as to whether this is a problem that needs treating.

After the age of 50 a man’s testosterone levels drop to between 20 and 50 per cent of the peak level by the time he's 80 years old. Unlike menopause in women, when hormone production stops completely, testosterone decline in men is a slower process. According to some experts, it’s a condition that needs to be taken more seriously, while other experts argue that the male menopause, or andropause as it's also termed, is just another example of how normal ageing processes are being medicalised unnecessarily.

Whatever the cause of it, however, it does seem that men do go through ‘a change’ during midlife. Given that men’s testosterone levels do decline, albeit usually gradually over time, it would make sense that they would also go through some related physical changes and therefore also psychological changes. But how much and what depends very much on the individual. Below are details of how the male body may change, hormonally, as it ages, as well as other factors that can affect a man physically and psychologically.

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When do testosterone levels start to decline?

All men’s testosterone levels decrease as they age but because the decrease is gradual, unlike for women who may experience a comparatively sudden change in hormone production, men’s physical responses aren’t so easy to study. Testosterone levels fall by about 1% per year from the age of 30, on average. That means that by the time a man reaches 70 years of age, he might have 60% or less of the testosterone he once had.

Research from the University of Manchester showed that there are some men who go through what’s termed late-onset hypogonadism. This is where men’s testosterone levels fall relatively quickly and they experience symptoms such as less frequent morning erections, reduced sex drive and erectile dysfunction. The findings revealed, however, that from a study group of around 3,500 men only around 2% went through this type of low-testosterone-related ‘menopause’. Testosterone supplementation may help reduce symptoms in these men but taking medication must be weighed up against the possible side effects, which include enlarged breasts or testicle shrinkage.

What happens when your testosterone declines?

Bearing in mind that men will experience these changes gradually, the effects may still be the same as for men who experience a sudden drop in testosterone but less noticeable as they will occur over a far longer period of time.

• Loss in muscle strength
• Weight gain
• Loss of sexual desire
• Loss of erectile function
• Fatigue
• Feeling of unhappiness, probably related to one or more of the above symptoms

Do men go through menopause?

According to the NHS it’s common for men over the age of 40 to experience one or more of the symptoms that could be classed as part of ‘male menopause’, but the term itself isn’t useful because men are no more likely to experience symptoms in mid-age than they are earlier or later, seeing as testosterone is decreasing gradually and steadily from the age of 30.

While some men do have exceptionally low testosterone levels (see above) most men who experience symptoms of ‘male menopause‘ such as tiredness, poor concentration, loss of enthusiasm, increased sweating and loss of muscle mass could be doing so as a result of lifestyle or psychological factors.

To encourage over-50s to act quickly and seek advice, Saga Health Insurance customers can call a 24/7 GP helpline for free. People can call for advice and often get a diagnosis from the comfort of their own home without having to wait for a slot with their local GP.

Testosterone and weight gain

Fat cells – particularly those around your midriff – convert testosterone into estradiol, a form of the female sex hormone oestrogen. As testosterone declines with age men see an increase in abdominal fat. This change tends to further reduce testosterone levels, so the bigger the tyre around your waist, the more you convert, leaving less of the muscle-boosting, desire-enhancing hormone testosterone in your body.

Maintaining a healthy weight as you age is therefore one of the truly positive things you can do as you get older to ensure you get the most out of your testosterone.

Are your hormones making you fat?

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Getting your testosterone levels measured

Low libido in both men and women is more often a symptom of psychological issues, but it is possible low testosterone might be the cause. Several studies have shown that injections of testosterone improve sexual desire in post-menopausal women – and a middle-aged woman’s sex drive is also determined by the level of testosterone in her body. For men, below-average  testosterone levels will dramatically reduce the ability to get and maintain an erection. If lack of sex drive is causing a rift between you and your partner it's a good idea to talk about it.

7 ways to boost libido

Physical and psychological causes

Before you rush off to book an appointment with your GP, take heed: Very few men have categorically abnormal – low testosterone levels, but the normal range for adult men is huge and it’s likely, but hotly debated, that there is a larger number of older men in whom testosterone levels may be suboptimal, affecting their wellbeing. There are many potential physical and psychological causes of ‘disorders’ that might also stem from having low testosterone – and not all men with these symptoms will benefit from testosterone injections or patches – the issues are just as hotly debated when it comes to women and low testosterone. For these reasons, there’s an understandable reluctance to offer this type of treatment to patients.

There is no way in which people can decide if they have a low testosterone level, except by getting a blood test. It's rare for GPs to be asked for such a test, and many GPs might well be unwilling to order it on the NHS. An alternative would be to get it done privately.

If a blood test does reveal that your testosterone levels are too low, you could be prescribed a gel, which is applied to the skin; a patch, which you can wear on your outer thigh, for example; or an injection.

Natural ways to boost your testosterone

Eat protein

Protein will boost levels of dopamine and noradrenaline – chemicals that heighten sexual sensitivity – and the zinc in a beef steak will also help. The mineral helps boost your libido by upping levels of testosterone, as well as reducing the production of prolactin, the hormone which can interfere with arousal.

Eat nuts

A couple of handfuls of almonds, peanuts or walnuts each day could help keep your testosterone levels high. Studies have shown that men who have diets high in mono-unsaturated fat, exactly the kind found in nuts, have higher testosterone levels than those who don’t.

Build muscle

A study undertaken at Weill Medical College at Cornell University revealed that the more weight men gain, the lower their testosterone levels fall. Building more muscle is a great way to reduce body fat because it burns calories even when you’re not at the gym.

Eat cruciferous vegetables

Broccoli, cabbage and Brussels sprouts are rich in indole-3-carbinol – a mouthful of a chemical that turns ‘bad’ hormones, which shut down testosterone production, into good ones restoring natural order.

Ditch the booze

Alcohol suppresses the production of testosterone – stick to 14 units or less.

Read more about measuring your alcohol intake

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