Hormones are crucial in allowing the human body to function as it should. To fully appreciate why that is the case, it helps to know more about them and their role in the body. Essentially, hormones are chemical messengers secreted by the many glands that make up the endocrine system. Once secreted, hormones enter the bloodstream and eventually travel to target organs and tissues throughout the body to help regulate numerous physiological processes that support and sustain life. One of those hormones is testosterone, a sex hormone secreted by the testes in men and the ovaries in women.
Testosterone supports and regulates sexual development, muscle and bone growth, red blood cell production, mood, and energy levels. It does the same for libido and cognitive function. All of these functions, however, can be disrupted if testosterone levels in the male or female body dip too low. According to a study from the Boston University School of Medicine, low testosterone, also known as hypogonadism, affects an estimated 4 to 5 million men in the U.S. While there is no exact number available, most endocrinologists agree that most women struggle with low testosterone once they enter menopause.
What Constitutes Low Testosterone Levels?
According to data published by Mount Sinai, the largest hospital network in New York City, and backed by most endocrinologists nationwide, testosterone levels that are between 300 and 1,000 nanograms per deciliter (ng/dL) or 10 to 35 nanomoles per liter (nmol/L) are within the bounds of healthy and normal for men. A range of 15 to 70 ng/dL or 0.5 to 2.4 nmol/L is considered healthy and normal for women. The primary contributor to low testosterone in men and women is aging. Studies show that testosterone levels naturally decline in men after age 30 and between the ages of 45 and 55 in women. Other factors that can give way to low testosterone in both genders include the following:
- Alcohol abuse
- Certain genetic disorders
- Chronic Illnesses, such as liver disease, kidney disease, human immunodeficiency virus (HIV), and acquired immunodeficiency syndrome (AIDS)
- Chronic stress
- Long-term use of certain medications, such as opioids and antidepressants
- Metabolic syndrome
- Obesity
- Poor sleep quality and sleep disorders
- Testicular damage in men
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Common Symptoms of Low Testosterone
Symptoms of low testosterone can show up in many ways. According to an article published by the Cleveland Clinic, a nonprofit academic medical center based in Cleveland, Ohio, symptoms commonly associated with low testosterone include the following:
- Decreased muscle mass and strength
- Decreased stamina
- Depressed mood
- Difficulty concentrating
- Erectile dysfunction and shrinking testicles in men
- Gynecomastia in men
- Hot flashes in women
- Increased belly fat
- Infertility
- Irregular periods in women
- Loss of armpit and pubic hair
- Low libido
- Low sperm count
- Memory problems
Diagnosing Low Testosterone
Diagnosing low testosterone requires scheduling an appointment with a licensed physician. During that appointment, the physician will inquire about your medical history, medications you might be taking, and symptoms you are experiencing before performing a physical exam. From there, they will likely order blood tests to determine your free and total testosterone levels. Knowing an individual’s free and total testosterone levels enables physicians to determine whether their symptoms are related to low testosterone or something else.
The luteinizing hormone (LH), prolactin, and total testosterone blood tests are the blood tests physicians use to evaluate a patient’s overall testosterone health. The luteinizing hormone and prolactin** **blood tests help physicians determine whether or not pituitary gland issues are responsible for low testosterone levels. And the total testosterone test, taken between 8:00 am and 10:00 am, when testosterone levels should theoretically be at their highest, measures the total testosterone in the blood.
Testosterone Types
Free testosterone vs total testosterone is an important distinction when evaluating hormonal health. Total testosterone includes both free testosterone and testosterone that is bound to proteins like sex hormone-binding globulin (SHBG) and albumin. However, only free testosterone is unbound and biologically active—it can bind directly to androgen receptors and produce physiological effects such as increased muscle mass and strength.
Low testosterone is a common hormonal imbalance that can significantly impact quality of life. Fortunately, testosterone replacement therapy (TRT) using FDA-approved medications can help restore healthy testosterone levels and alleviate symptoms associated with deficiency. Additionally, adopting healthy lifestyle habits—such as eating a balanced diet, exercising regularly, staying hydrated, and getting deep, restorative sleep—can support natural testosterone production and overall well-being.
