It’s more important than ever to address the state of male hormonal health. “Studies suggest that sperm counts have declined by more than fifty percent over the last few decades, and there is evidence that environmental, lifestyle, and social factors may be contributing to this trend,” explains Jamin Brahmbhatt, M.D., a urologist at Orlando Health.
These increases in male infertility are borderline crisis-level, so if there’s ever been a time to check in on men’s reproductive health, it’s now. And that starts with testosterone.
Let’s Talk About T
Testosterone is produced in the testicles and plays a critical role in men’s normal functioning and biological processes, including libido, sexual development and function, the production of sperm, maintaining muscle mass and more, says endocrinologist Sarah Musleh, M.D., co-founder of Anzara Health.
T levels spike during puberty and start to naturally decline after age 30, but low testosterone can occur at any age, says urologist Amy Pearlman, M.D., co-founder of Prime Institute. “Healthy testosterone levels have less to do with age and more to do with the health of the person in general,” she says.
Signs It’s Time To Test Your Testosterone Levels
Here, experts break down seven signs that you should have your testosterone levels tested, whether you’re 25 or 55.
1. You Have A Decreased Desire For Sex
Decreased sex drive is often associated with low testosterone levels since testosterone is the major male sex hormone and plays an important role in sperm production, the development of the penis and testes, and your overall libido, says Pearlman. So, if you notice you’re less aroused—or less satisfied by sex—than usual, check in with your doctor to have your T levels tested. A lack of the hormone could be messing with your mojo.
2. You Struggle To Achieve Or Maintain An Erection
Testosterone helps you achieve or maintain an erection because the hormone sends a direct signal to your brain to produce nitric oxide, which triggers the series of chemical reactions necessary for an erection to occur, per a 2019 study published in Sexual Medicine Reviews. And while other factors may contribute to erectile dysfunction, such as stress, tiredness, or drinking too much alcohol, if you continually have trouble getting hard or your erections feel flimsier than usual, low T could be the culprit, making some testing warranted.
3. You’re Losing Facial Or Body Hair
While testosterone does not directly cause hair loss, it is responsible for producing dihydrotestosterone (DHT), which is the hormone responsible for the development of male characteristics such as facial hair, pubic hair, and body hair. Imbalanced testosterone levels can cause you to produce too much DHT, which can then shrink your hair follicles and reduce the hair growth cycle, ultimately resulting in hair loss, according to the Cleveland Clinic. This typically happens on the top of your scalp and causes your hairline to recede, but you may also experience the loss of body hair, adds Musleh.
4. You Have Low Energy And Constantly Feel Fatigued
It’s normal to feel tired every once in a while, but chronic fatigue may be a sign of low T levels, says Pearlman. Because testosterone is a hormone that contributes to overall energy and feeling of vitality, men with low testosterone may feel extra tired all the time.
To improve energy levels and fatigue, it’s important to first start with lifestyle modifications such as eating well, getting adequate sleep, exercising regularly, and reducing stress levels, explains Pearlman. If fatigue continues to bring you down, schedule a visit with your doc to check in on your hormone levels. “If someone reports fatigue that impacts their ability to engage in meaningful and productive daily activities, that is reason enough to be concerned and seek healthcare advice,” Pearlman says. “In my clinical experience treating men for low testosterone, many of report improved energy and vitality.”
5. You’re Continually Sad Or Grumpy
Unusual feels may be a lesser-known symptom of skewed testosterone, but males with both high and low T levels can experience mood changes, says Pearlman. You see, research shows that cells in the brain that directly impact your limbic system—which is responsible for your behavior and emotional responses—actually have testosterone receptors. If you feel sad, depressed, or are experiencing mood swings, changes in T levels could be to blame.
6. You’ve Gained Weight Or Lost Muscle Mass
Testosterone is a must-have for building muscle and bone mass, so sudden and seemingly unexplainable decreases in muscle mass could reflect dipping T levels, according to Musleh.
Low T can also contribute to increased body fat and weight gain. In some cases, an imbalance of testosterone and estrogen in the body can cause enlarged breast tissue in men, a condition called gynecomastia, according to the Mayo Clinic. If you’re suddenly packing on the pounds—and even noticing it accumulating in your chest—it’s certainly not a bad idea to check out where your testosterone levels stand.
7. Your Memory Is Slipping
Sure, memory is known to decline with age, but experiencing memory loss or struggling to concentrate in your younger years is worth talking to your doctor about, as it could be a consequence of low T levels, according to Pearlman. Though we don’t currently have a crystal-clear understanding of exactly how testosterone influences cognition, Pearlman and Musleh have patients report that they experience less brain fog after getting their testosterone levels into a healthy place. Research backs this up, too, suggesting that hormonal testosterone supplements help improve memory in older men with low testosterone levels. (This 2019 study published in the American Journal of Geriatric Psychiatry is a good example.)
Taking Back Your T
Given research suggests that anywhere from 10 to 40 percent of men globally have testosterone deficiency, the possibility of having low T is certainly nothing to be ashamed about—or to ignore!
If you’re experiencing any of the above symptoms, visit your primary care physician, urologist, or endocrinologist for a simple blood test. If that initial test detects low testosterone levels, your doctor will typically follow it up with another test or two to confirm, says Musleh. From there, they’ll work with you to figure out the best treatment plan for your needs.
Typically, this will include lifestyle factors like physical activity, stress reduction, and getting adequate amounts of sleep. Think seven to nine hours of sleep a night, prioritizing your mental health by making time for relaxing activities, and incorporating resistance training at least three times a week, explains Pearlman. Additionally, for those who are overweight, losing a few pounds also supports healthier testosterone production, adds Musleh.
Complementing these lifestyle changes with supplements known to promote healthy testosterone levels can also help move the needle in the right direction. A few popular options: zinc, vitamin D, ashwagandha, tongkat ali, and black maca. If lifestyle changes are unsuccessful, your physician may prescribe testosterone replacement therapy.
It’s also worth noting that, while women typically take an annual opportunity to check in with a gynecologist about their reproductive and sexual health, men do not seek out the same specialty care. “A lot of men have questions and need to understand that there is a place for them in the healthcare system,” explains Pearlman. “If you’re functioning in a way that is not how you want to function, you can get help for that and it’s great to be vocal and ask questions.”
Make it a point to talk to your doctor at your annual physical about reproductive care and sexual health. If needed, they can refer you to a specialist. “The biggest thing is seeing a physician who has a real interest in male hormonal deficiencies, whether that be a primary care provider, urologist, or endocrinologist,” says Pearlman. Reproductive health is a critical component of our overall wellbeing, so don’t allow it to get overlooked.