SYMPTOMS

What are the symptoms and signs of androgen deficiency?

The signs of low testosterone (androgen deficiency) are different depending on the age at which testosterone levels fall below the normal range.  Showing these symptoms by themselves does not automatically mean that testosterone treatment should be given.

Low testosterone levels can be caused by many illnesses.  These illnesses, which are more common in older men, produce symptoms that overlap with those of androgen deficiency.  Lowered energy levels, declining sexual performance and mood problems often happen with significant heart, lung, brain (dementia) or other problems, and with depression.  Obesity is a major and increasing health problem and is strongly linked with lower testosterone levels.

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Can erectile problems be due to androgen deficiency?

Low testosterone levels can sometimes lead to problems with getting and keeping an erection, although it is not a common cause of erectile problems.  Erectile problems are more commonly due to changes to the blood or nerve supply to the penis, psychological causes including performance anxiety, stress and depression, and they may also be a sign of cardiovascular disease.  Testosterone therapy should not be considered the first treatment option for erectile problems unless androgen deficiency is present.

More information: Erectile Dysfunction

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Signs of androgen deficiency at different ages

The signs of low testosterone (androgen deficiency) in younger males are different depending on the age when the testosterone levels fall below the normal range.

In early childhood, low testosterone levels may cause the penis to remain small and the testes will not grow to the expected adult size.

In the early teenage years, low testosterone levels will prevent boys from having a full normal puberty. They will not have the expected increase in body and pubic hair, increase in their muscle mass, their voice will not deepen and they will not have a surge of growth.

After puberty, low testosterone levels produce a variety of symptoms which include mood changes (low mood, poor concentration, irritability), decreased energy, reduced muscle strength and a longer time to recover from exercise. Other symptoms may include sexual problems (low ‘appetite’ for sex, problems with getting an erection), hot flushes and breast development (‘gynaecomastia’). There is an increased risk of developing osteoporosis which is a condition causing a thinning of the bones, which leads to a greater chance of fracturing bones, especially in the hip and the spine. This condition does not usually have obvious symptoms, so a bone density test may need to be done to diagnose the problem. Any of these symptoms may be more severe if the testosterone levels fall quickly and by a large amount.

The effects of low testosterone levels in older men are widespread. Men with low testosterone complain of easy fatigue, low energy levels, low mood, irritability, poor concentration and reduced sex drive (libido).

As men age, body fat increases and muscle mass and strength decreases. A fall in testosterone levels is likely to contribute to these changes.

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Should I see a doctor?

If you are experiencing any of the symptoms described, it is important to visit your doctor. As the symptoms of androgen deficiency may also be caused by one of a number of other unrelated medical conditions, it is important to rule out androgen deficiency as being the problem.  Likewise, these symptoms may be caused by other serious medical conditions that need treatment other than testosterone therapy.

Androgen deficiency can only be confirmed when a blood tests shows that the level of testosterone is lower than normal. If androgen deficiency is the problem, it can be easily treated.

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