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Hypogonadism/Low T

Male hypogonadism is a condition in which the body doesn't produce enough testosterone, which is the hormone that’s key during puberty to develop adult male physical features, such as muscle strength and mass, facial and body hair, voice, and sex drive. Testosterone is also needed to produce sperm.

When men have low levels of testosterone, it’s also called having “ow T.” While testosterone levels naturally decrease with age, hypogonadism can be present at birth, or it may develop later in life, due to illness or infection.

There are two types of hypogonadism: primary and secondary. Primary originates from a problem with the testicles themselves, while secondary develops due to a problem with the hypothalamus or pituitary gland.

Symptoms Can Vary

Signs and symptoms of hypogonadism are typically present at puberty for those who were born with it. When it occurs later in life, symptoms are usually most apparent after age 40.

When present at puberty, symptoms include:

  • Decreased development of muscle mass
  • No deepening of the voice
  • Impaired growth of body hair
  • Impaired growth of the penis and testicles
  • Excessive growth of the arms and legs in relation to the rest of the body
  • Development of breast tissue

When Low T develops due to aging or illness/injury, symptoms include:

  • Lower sex drive
  • Weaker and infrequent erections
  • Increase in body fat
  • Lower energy
  • Reduced muscle mass
  • Feeling depressed
  • Anemia (low iron)
  • Loss of bone calcium

Common Causes of Low Testosterone

When present at birth, hypogonadism is most often the result of an inherited trait or congenital abnormality. Later in life, certain conditions and health problems can contribute to hypogonadism or low T, including:

  • High blood pressure
  • High cholesterol
  • Diabetes 
  • Being overweight
  • Long-term opioid use

Diagnosis and Treatment

Low testosterone is typically diagnosed with a blood test. In general, a diagnosis of low testosterone is made if your hormone level is below 300 ng/dL. A PSA (prostate-specific antigen) blood test may also be performed to check for signs of prostate cancer.

Most men with hypogonadism or low T undergo testosterone replacement therapy (TRT), which can include:

  • Skin gel – Most common; rubbed onto shoulders and upper arms
  • Injections – Typically administered in a doctor’s office
  • Long-acting pellets – Implanted under the skin to slowly release testosterone
  • Patches – Prescription transdermal patch that allows testosterone to enter the bloodstream through the skin

Side effects of all types of TRT may include:

  • Acne
  • Breast swelling or soreness
  • High red blood cell count
  • Swelling of the feet or ankles
  • Smaller testicles
  • Infertility

If you were born with hypogonadism or suspect you may have developed low testosterone, the Urology specialists and at Kelsey-Seybold Clinic in Houston can administer necessary diagnostic tests, discuss the benefits and risks of TRT, and monitor your progress throughout treatment.

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