Recognizing low testosterone levels

Men’s testosterone levels generally fall about 1% a year after age 40. But most older men still have testosterone levels within the standard range. Only about 10% to 25% of men have levels thought to be low.

Low testosterone levels in older men often go unnoticed. A blood test can check testosterone levels. But tests aren't often done. And many men who have low testosterone levels have no symptoms. Also, the signs and symptoms related to low testosterone aren't specific to low testosterone. A person's age, medicines or other conditions also can cause symptoms. For example, having a body mass index of 30 or higher can cause symptoms like those of low testosterone.

Symptoms that suggest low testosterone include:

• Lowered sexual desire and activity.
• Erectile dysfunction or decreased erections.
• Breast tenderness or swelling.
• Infertility.
• Height loss, low-trauma broken bones, called fractures, or low bone mineral density.
• Hot flashes or sweats.

Other possible symptoms include having less energy, motivation and confidence. Some men feel depressed and have trouble focusing. It's also possible to have a rise in sleepiness and sleep disturbances. Symptoms can include mild unexplained anemia, lower muscle mass and strength, and more body fat.

Experts suggest only testing older men for low testosterone if they have symptoms. If the first test shows low testosterone, experts suggest repeating the test to confirm the results. Your healthcare professional may look for conditions that can cause low testosterone:

• Obstructive sleep apnea.
• Obesity.
• Stress from a serious illness, surgery or staying in the hospital.
• Medicines such as opioid pain relievers.

Treating these conditions can return testosterone levels to the regular range.

If you have low testosterone, you’ll likely have more testing of the pituitary gland. The pituitary gland is a kidney bean-sized gland that sits at the base of the brain. It is part of the body's endocrine system. This system includes all the glands that make and control hormones. Healthcare professionals use pituitary gland testing to help find out whether the low testosterone is due to aging. Testing also can rule out low levels of other hormones.