Why Does Testosterone Decrease?

Testosterone, found in very small amounts in women, has many critical functions in the male body. It serves in many metabolic processes, from sperm production to muscle development, from body hair growth to bone density. Under normal conditions, its secretion decreases starting from the 30s.

However, in some men, testosterone begins to decline due to reasons other than advancing age, or it is not produced at an ideal rate. This week, I will convey information about the potential causes leading to low testosterone, but first I would like to touch upon the symptoms.

Every Symptom is Important

In the case of low testosterone, it is possible to encounter various symptoms such as:

• Decrease in muscle mass and bone density,

• Sexual reluctance (low libido),

• Low energy (fatigue),

• Increase in body fat ratio,

• Hair loss,

• Erectile dysfunction,

• Shrinkage in testicular size (testicular atrophy),

• Decrease in semen volume.

All these symptoms affect men's health and quality of life. Knowing the symptoms that emerge due to the decrease in testosterone and the reasons for the emergence of these symptoms allows for the planning of personalized treatment processes. By determining personalized treatment processes, it is possible to improve patients' hormone values and end the complaints they experience.

The Source of Low Hormone Levels Must Be Determined

Testosterone is produced in the testes, but production in the testes is controlled by specific parts of the brain (the hypothalamus and pituitary gland). Disruption of the signaling mechanism between them, the brain not sending signals to the testes, or disorders in testicular functions bring hypogonadism to the agenda.

Male hypogonadism is a condition where testosterone, sperm, or both are not produced sufficiently. It can be congenital (present at birth) or acquired later. Hypogonadism is classified as primary or secondary. In both types, there is a problem in the hormone and/or sperm production process; the difference between the types lies in the source of the problem.

• Primary Hypogonadism: Since sex hormones in men are produced in the testes, hereditary diseases affecting the testes disrupt the testosterone production process. The presence of a history of undescended testis (Cryptorchidism), Klinefelter syndrome, and testicular failure due to high iron levels in the blood (Hemochromatosis) are among the causes of primary hypogonadism. Physical trauma, infections that damage the testes (Orchitis), and cancer treatments undergone (chemotherapy/radiation) are also among the causes.

• Secondary Hypogonadism: While primary hypogonadism comes to the agenda as a result of problems in testicular functions, the underlying cause of low testosterone in secondary hypogonadism is different. In the presence of secondary hypogonadism, the cause of low hormone levels is problems in the pituitary gland or hypothalamus, which control the hormone production process in the testes. Kallmann syndrome, pituitary gland disorders, sexually transmitted diseases, inflammatory diseases, and medications used are among the causes of secondary hypogonadism.

The variety of causes requires that the symptoms of low testosterone be taken into account. It means that those experiencing similar symptoms should consult physicians without losing time to preserve their sexual and general health.