When Do Men Start Losing Testosterone?

د. لورنس ليفين، دكتوراه في الطب
Board Certified Urologist, expert in male sexual dysfunction د. لورنس ليفين، دكتوراه في الطب
Last updated 11/28/2023
older man lifting weights to help maintain testosterone levels

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Question

Hey Doc, I'm a guy in my late 40s, and I've been feeling a little off lately—less energetic, lower sex drive, and even a bit moody, if I'm being honest. I've heard that testosterone levels start to dip as men get older. 

So, when do men generally start losing testosterone? What can I do to get my testosterone levels back up?

These concerns are quite common and understandable. Testosterone levels do indeed start to decline as men age. It typically begins in the late 30s to early 40s. 

This decline is usually gradual, at a rate of about 1% per year after the age of 30. While it's a natural part of aging, lower testosterone levels can sometimes lead to symptoms such as reduced energy, decreased libido, and mood swings.

Your symptoms could very well be related to having low testosterone. But they could also be influenced by other factors such as 

  • Stress
  • Poor sleep
  • Underlying health conditions
  • Medications such as long term steroids or opioids

Given your symptoms and age, it may be beneficial to consult with a healthcare provider for a comprehensive evaluation. This may include blood tests to check your testosterone levels as well as other potential contributing factors.

What causes low testosterone levels?

There are various health conditions that can lead to a decrease in testosterone levels in men. Some of these include:

  • Obesity: Excess fat tissue can convert testosterone to estrogen, lowering overall levels of testosterone.
  • Type 2 Diabetes: This metabolic disorder has been linked to lower testosterone levels.
  • Thyroid Disorders: Both hyperthyroidism and hypothyroidism can impact testosterone levels.
  • Liver and Kidney Disease: These conditions can alter the metabolism of hormones, including testosterone.
  • Chronic Stress: High levels of the stress hormone cortisol can inhibit testosterone production.
  • Sleep Disorders: Lack of quality sleep can significantly affect various hormones, including testosterone.
  • Medications: Certain drugs, like opioids and some hormones, can reduce testosterone levels.
  • Pituitary Disorders: The pituitary gland controls hormone production, and disorders here can affect testosterone.
  • Testicular Cancer: Malignancies or treatments (like chemotherapy) can reduce testosterone levels.

What are treatments for low testosterone?

If low testosterone is confirmed, there are various treatment options available. Here are a few that might be recommended:

  • Testosterone Replacement Therapy (TRT): This is the most direct form of treatment and comes in various forms such as gels, injections, pills, and patches.
  • Clomiphene Citrate pill and Human Chorionic Gonadotropin injection (hCG): These medications stimulate the body's own production of testosterone and are often used in younger men who wish to maintain fertility.
  • Lifestyle Changes: A balanced diet rich in healthy fats, protein, and essential nutrients along with regular exercise can help boost testosterone.
  • Weight Loss: Obesity is strongly linked to low testosterone levels, so weight loss can increase testosterone.
  • Treat Underlying Conditions: Addressing chronic conditions like diabetes and thyroid disorders can improve testosterone levels.

Your healthcare provider can help determine the most appropriate course of action for you.

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Sources:

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  • Barbonetti A, D'Andrea S, Francavilla S. Testosterone replacement therapy. Andrology. 2020 Nov;8(6):1551-1566. doi: 10.1111/andr.12774. Epub 2020 Mar 9. PMID: 32068334. Accessed on Oct, 27, 2023.
The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.