Male hypogonadism (low testosterone), also called “Low T,” is a common problem. By age 45, almost half of men have been affected. If left untreated, low testosterone can lead to a variety of health problems and may negatively affect a man’s general well-being. The skilled physicians at Memorial Hermann provide exceptional patient care to diagnose and effectively treat Low T.

What is Testosterone?

Testosterone is a male hormone that helps maintain things like bone density, muscle mass and sex drive. It is produced mainly in the testicles. Testosterone is also present in women, but usually at a much lower level.

Testosterone plays an important role in developing and maintaining many aspects of men’s health:

  • Muscle mass
  • Fat distribution
  • Bone density
  • Facial and body hair
  • Sex drive
  • Sexual function and reproduction, including sperm production

What is Low Testosterone (“Low T”)?

Male hypogonadism (Low T) occurs when the testicles do not produce enough testosterone. Low testosterone levels indicate either a problem with the testicles or with the pituitary gland.

Primary Low Testosterone

If the low testosterone level is caused by a problem in the testicles, the condition is known as primary low testosterone. Damage to the testicles could be caused by certain illnesses or an injury.

Secondary Low Testosterone

If the low testosterone level is caused by problems in the endocrine system, the condition is known as secondary low testosterone. This occurs when the pituitary gland does not send the signal to the testicles to produce testosterone. Secondary low testosterone can also be caused by other health problems, like obesity or inflammatory conditions, certain medications, or simply because of aging.

Symptoms of Low T

The specific symptoms of Low T may be different for each man. Symptoms can vary based on age and the severity of the low-hormone level.

  • Decreased sex drive
  • Erectile dysfunction (ED)
  • Depression
  • Irritability or moodiness
  • Fatigue
  • Loss of muscular mass/increased body fat
  • Loss of bone mass
  • Hair loss
  • Anemia
  • Infertility

Causes and Risk Factors of Low T

The older a man gets, the less testosterone he produces. Levels begin to drop around age 30. All men will face an increased risk of Low T as they age.

Low testosterone levels can be caused by:

  • Aging
  • Testicle injury or infection
  • Obesity
  • Type 2 diabetes
  • High blood pressure
  • Sleep apnea
  • Pituitary gland disorders
  • Chemotherapy or radiation
  • Excessive alcohol use
  • Kidney disease or kidney failure
  • HIV or AIDS
  • Chronic use of narcotics
  • Certain medications

Diagnosis of Low T

Low T is diagnosed with a routine blood test. Your blood sample will be analyzed in a laboratory to determine how much testosterone is currently in your blood.

Testosterone levels vary at different times of the day, with the highest levels usually occurring in the morning hours. Your physician may recommend a blood test in the morning to get the most accurate test result.

Treatment for Low T

Low T can be treated with testosterone replacement therapy.  There are several options for how to receive the hormone:

Testosterone gel

Daily application, usually to the arms or back

Testosterone patch

Daily application, usually to the arms, back, abdomen or buttocks


Administered by a needle into a muscle, approximately every two weeks


Implanted underneath the skin, usually in the hip or buttocks, approximately every two months

Important note: it is strongly recommended to stay away from over the counter oral testosterone supplements and pills. Testosterone taken orally can cause liver damage and other health complications.

Receiving testosterone therapy carries risk and has side effects. Discuss the options, benefits and potential risks with your physician to make the decision about whether or not to proceed with treatment.

While undergoing treatment for Low T, you may experience the following side effects:

  • Increase in oil production in the skin
  • Acne
  • Swollen ankles
  • Enlargement of the prostate
  • Enlargement of the breasts
  • Development or worsening of sleep apnea
  • Reduction in testicle size
  • Increased prostate-specific antigen (PSA) level
  • Decreased sperm count

Because testosterone replacement therapy may enlarge the prostate, men who have had prostate cancer should not receive treatment. Regular prostate exams, including prostate-specific antigen (PSA) blood tests, are recommended while undergoing testosterone replacement therapy.

Scheduling an appointment

Memorial Hermann-affiliated urologists are committed to using a multidisciplinary approach to provide exceptional urological care. Our highly skilled practitioners utilize leading-edge treatments for a full range of men’s health concerns. Find a doctor today.