Many of us know that men with low testosterone are prone to low libido and struggle to maintain their muscle mass.
However, having low levels of the hormone can do much more damage than just problems in the bedroom or the gym.
Now experts are raising awareness about low testosterone, sometimes referred to as “male menopause,” and its debilitating effects on men’s health.
Testosterone is a male sex hormone that is mainly produced in the testicles. Testosterone receptors, however, are distributed throughout the body.
It helps maintain bone density, fat distribution, muscle mass, facial and body hair, sex drive and sperm production, according to the Mayo clinic.
Estimates from the University of Wisconsin show that low testosterone affects about 12 percent of men in their 50s, 19 percent in their 60s, 28 percent in their 70s, and 49 percent in their 80s
Male testosterone levels are usually highest around age 20 and decline naturally with age.
At their highest, testosterone levels should be somewhere between 300 and 1,200 ng/dL.
Once men reach their mid-thirties, testosterone drops by at least one percent per year.
However, men can become deficient at any age.
Experts have revealed to DailyMail.com the 10 crucial warning signs below:
Testosterone levels peak in young adulthood, around age 20, but decline by about 1 percent annually after age 30
Experts told DailyMail.com that symptoms of low testosterone include low sex drive, fatigue, decreased muscle mass, depression and weak bones.
Low sex drive
“Testosterone is the primary driver of a person’s libido, or sex drive,” Dr. Helen L Bernie, director of male sexual and reproductive health at Indiana University, told DailyMail.com.
This leads to men having no interest in sex or masturbation.
Low libido is one of the most common symptoms of testosterone deficiency and is one of the main concerns of Dr. Bernie’s patients.
This is due to the presence of androgen receptors, where testosterone binds, in parts of the brain that process desire. Without testosterone, there is nothing to indicate excitement.
Erectile Dysfunction
“You need testosterone for a man to have an erection,” said Dr. Bernie. “When you have very low testosterone levels, it’s very difficult to get an erection.”
While there must be increased blood flow to the penis to maintain an erection, testosterone is also necessary because there are receptors in erectile tissue, also known as the corpus cavernosum, in the penis.
“Erectile tissue in someone with low testosterone can atrophy or become less healthy,” Dr. Bobby Najari, urologist at NYU Langone, told DailyMail.com.
This leads to blood flow in the penis becoming less responsive to sexual stimulation, he said. Lack of testosterone can also make medications like Viagra less effective.
The lack of libido from low testosterone can also cause erectile dysfunction.
Depression
Low testosterone can ruin your mood, Dr. Najari said.
Similar to sex drive, androgen receptors are found in several parts of the brain, including the amygdala, which processes fear.
However, more research is needed to understand this relationship.
‘We know that there are androgen receptors located centrally in the brain,’ said Dr Najari. “But the exact mechanism of the symptoms is less well understood.”
Other factors on top of low testosterone can lead to depression, he said, such as poor sleep or thyroid dysfunction.
Dr. Helen L. Bernie, director of male sexual and reproductive health at Indiana University (left), and Dr. Bobby Najari, urologist at NYU Langone (right), pointed to several lasting health consequences of low testosterone, including memory problems, diabetes, fatigue, and depression
Memory problems
As with depression, androgen receptors can lead to poor memory. These receptors are found in the hippocampus, the part of the brain responsible for learning and memory, as well as the cerebrum, which controls thinking and reasoning.
If there isn’t enough of the hormone to bind to those receptors, it can lead to forgetfulness, Dr. Bernie said.
If there isn’t enough of the hormone to bind to those receptors, it can lead to forgetfulness.
Fatigue
“Testosterone is our main driver of motivation and energy levels,” said Dr. Bernie.
Testosterone is a diurnal hormone, meaning it is highest in the morning and gradually decreases throughout the day.
It is also a type of androgen hormone, a steroid, which means it keeps us energized.
Because it decreases, men with low levels will be more tired during the day than men with normal levels.
‘Men with chronically low testosterone have lower energy levels. They’ll be tired,” Dr. Bernie said.
Decreased muscle mass
Testosterone promotes muscle growth and has been shown to suppress fat gain. When levels are low, muscle mass begins to decline, Dr. Bernie said.
In a study from Japanmen with low levels of free testosterone — the amount of the hormone not bound to receptors — were two to three times more likely to lose muscle with age than men with normal levels.
This is because lean muscle mass is replaced by fatty adipose tissue, also known as body fat.
Strength training can help rebuild that lost muscle.
Increased belly fat
Having more fatty tissue, especially around the belly, could be a sign of low testosterone, said Dr. Najari.
This is due to that fat adipose tissue that replaces lean muscle mass.
A assessment in obese men found that low testosterone specifically increases fat deposits in the abdomen.
‘One of the most common reasons for lower testosterone as men age is simply the increase in the amount of fat tissue that breaks down testosterone,’ said Dr Najari.
Fat cells produce aromatase, an enzyme that converts testosterone into estrogen. Estrogen then causes more fat to be deposited in the abdomen, as well as the chest, hips and thighs.
Weak bones
‘In men, testosterone is converted to estrogen,’ said Dr Najari. “And we know, in both sexes, that estrogen is involved in maintaining bone health. So men with lower testosterone levels also have lower estrogen levels.’
This causes the bones to thin or break down. It can also lead to osteoporosis, a condition caused by weak or brittle bones.
At first, the condition may have no symptoms, but as it progresses it can cause back pain, a stooped posture, fractures and loss of height, according to the Mayo clinic.
diabetes
Testosterone is intertwined with insulin, the hormone made by the pancreas that helps the body store sugar for energy.
“Insulin is dependent on testosterone, so you need to have some testosterone in your body for insulin to function properly,” said Dr. Bernie.
When insulin function is disrupted, it leads to poor glucose control, leading to high blood sugar and diabetes.
A 2016 study in the journal Diabetes Care found that testosterone therapy could reduce insulin resistance in diabetic men with low testosterone.
Heart disease
Some research has suggested that low testosterone can lead to an increased risk of heart disease, cardiac arrest, and stroke.
Research published in the Journal of the American Heart Association, Circulationfound that men with low testosterone had a greater risk of dying from heart disease than men with normal levels.
This may be due to the fact that testosterone opens the blood vessels to the heart, allowing blood to flow more freely.
The link between testosterone and heart disease is controversial among experts, Dr. Bernie said.
While some studies have suggested that testosterone therapy might increase the risk of heart attack and stroke, she pointed to research published last week in the New England Journal of Medicine. This study found that testosterone therapy in men with low levels did not increase the risk of adverse cardiac events.