Do I Have Low Testosterone? Here Are the Symptoms to Look For

As men get older, testosterone decline is inevitable. Around the age of 30, men’s testosterone levels start to dip by about 1 percent a year.¹ If testosterone levels drop below a certain threshold, men may experience a condition known as hypogonadism, or low testosterone. 

Clinically low testosterone levels are accompanied by a range of symptoms, from low energy and erectile dysfunction to mood shifts and cognitive problems.

But some symptoms of low testosterone may be subtle, and many men don’t realize their hormones could be to blame. “A lot of guys walk into clinics running on fumes when it comes to their testosterone levels,” says urologist Joshua Calvert, M.D., a physician who works with Hone Health. 

Fortunately, once they’re diagnosed with low testosterone, the symptoms are treatable. 

Here’s a rundown of some of the biggest symptoms of low testosterone in men, so that if you’re experiencing them, you can get help.

About the Experts

Dr. Joshua Calvert, M.D., is a urologist and member of The Edge’s medical advisory board. Specific areas of interest include vasectomy and vasectomy reversal, Peyronie’s disease, testosterone management, and male infertility.

Dr. James Staheli, D.O., is the Medical Director for Broad Health and a family medicine doctor in Atlanta, Georgia who specializes in hormone treatment for men.

Symptoms of Low Testosterone in Men

The following symptoms might be red flags that your testosterone levels are low. The only way to know for sure, though, is to get a blood test to assess your hormones (including free and total testosterone levels).

1. Changes in sexual function

One of the most common and noticeable symptoms of low testosterone is a low sex drive. “Study after study indicates that decreased libido is the symptom that is most indicative of testosterone deficiency,” says Calvert. “This is also an area where most men notice an improvement when they get treated.”

Other symptoms of low testosterone can chip away at your sex drive, too, like low energy or weight gain.

Trouble achieving and keeping an erection can also be a sign of low testosterone.

“The process of getting an erection is complex both physiologically and psychologically, and many men notice decreased spontaneous erections as the first sign of low testosterone,” says Calvert.²

Researchers suspect the reason for this is that testosterone acts as a vasodilator, allowing more blood flow into the penis, says Calvert. Without enough testosterone, blood may not be able to enter the penis and allow it to get rigid enough for sex.

2. Physical changes

Some physical changes to your body happen naturally with age, but some may be directly related to low testosterone.

• Decrease in muscle: When men have low testosterone levels, they might find adding muscle mass becomes more difficult. Testosterone is an anabolic hormone that aids muscle growth.³ Muscles have androgen (testosterone) receptors. When testosterone binds to these receptors, it triggers protein synthesis (allowing muscles to build and repair) and inhibits protein breakdown, which helps muscles grow. “If you have more circulating testosterone, your muscle cells are more active and they grow,” says Calvert. 
• Putting on weight: Low testosterone can drive weight gain as a secondary result of declining muscle mass. Muscle increases metabolism, aiding calorie burn. If you’re not building muscle, you’ll burn fewer calories, which can contribute to weight gain if you’re taking in the same amount of calories. What’s more, fat cells produce an enzyme called aromatase, which converts testosterone to estrogen. An imbalance in testosterone and estrogen levels can increase body fat. It becomes a vicious cycle: Excess fat causes your testosterone levels to decline, which can lead to more weight gain. 
• Man boobs: If you do gain weight, you may find it in an unwanted area: your chest. The technical term for breast growth in men is “gynecomastia.” It can be related to an increased level of estrogen as well, says Calvert. Gynecomastia is usually not harmful, but the breast tissue can be sore. And many men find it embarrassing, especially during summer months when you’re baring your chest at the pool or backyard barbecues.
• Bodywide hair loss: Losing facial and body hair can also be a symptom of low testosterone in men. Low testosterone inhibits hair growth in androgen-dependent areas like the chest, armpits, beard, and pubic region.⁴ However, hair loss on the head is typically not a sign of low testosterone.
• Hot flashes: This isn’t just something women experience during menopause. Low levels of testosterone release cortisol, which can lead to hot flashes. “This increased cortisol tells the brain to turn its thermostat up,” says Calvert.

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3. Emotional ups and downs

If you’re feeling depressed or irritable without reason, it could be a symptom of low testosterone. One small 2016 study found that men with low testosterone between the ages of 21 to 41 were more likely to be diagnosed with depression than the control group.⁵

Testosterone crosses into the brain, where it may affect the production of brain cells, create new neural connections that skew thoughts toward the positive, and regulate feel-good neurotransmitters.⁶ Without enough circulating testosterone, you may not get those brain benefits.

Also, low testosterone can make you feel low-energy, which can indirectly affect mood. 

Emotional changes you may feel because of low testosterone include:

• You’re easily irritable.
• You’re feeling depressed.
• You’re not sleeping well. 
• You have low energy or are unmotivated.

4. Memory loss and cognitive issues

According to recent research, memory loss can be a sign of low testosterone. A 2021 study found that men with higher concentrations of testosterone scored better on measures of verbal memory and mental processing speed compared to men with lower concentrations.⁷

Researchers from this same study theorized that testosterone might influence memory and mental processing due to its effect on androgen receptors in the hippocampus, the part of the brain associated with memory and spatial information. 

Additionally, many men claim that their brain fog lifts when they start testosterone replacement therapy, says Calvert. 

Some cognitive symptoms associated with low testosterone include:

• Memory issues: You struggle to remember certain words in a conversation.
• Concentration: You feel less productive at work or with completing certain tasks.
• Brain fog: You’re experiencing mental sluggishness.

5. Changes in sleep quality

Sleep and testosterone levels are connected. Testosterone levels increase during REM sleep, and there’s some evidence that disruptions in sleep could negatively impact a man’s testosterone levels, says hormone specialist Jim Staheli, D.O.

Low testosterone might impact sleep due to its impact on cortisol. Levels of cortisol climb as testosterone goes down, and cortisol contributes to wakefulness, resulting in shallower and shorter sleep, according to research in the journal Sleep.⁸

One study found that low testosterone was associated with less healthy sleep in older men. But the association was largely explained by obesity.⁹ Men with obesity tended to have lower testosterone, and obesity is associated with poorer sleep and conditions that affect sleep like obstructive sleep apnea.

6. Fatigue

Fatigue is a common sign of low testosterone.¹⁰ You might feel like you just don’t have the energy that you’re used to. Or you might be constantly worn out.

Testosterone’s role in sleep and metabolism might be the reason why fatigue is a symptom of low testosterone. 

• Sleep: Sleep disturbances driven by low testosterone levels can impact daytime energy and cause fatigue. If you’re not getting adequate nighttime rest, your testosterone levels may not reach their daytime peak. In one very small study published in the Journal of the American Medical Association (JAMA), daytime testosterone levels decreased by 10 to 15 percent among healthy young men who restricted sleep to five hours per night for one week.¹¹ 
• Metabolism: Testosterone impacts metabolic health, which is how efficiently the body processes energy.¹² As muscle mass declines, so does metabolism since muscle is essential to energy production. So some fatigue driven by low testosterone may stem from having less muscle, leading to less energy.

7. Anemia symptoms

Another way low testosterone can make you feel run-down is by causing anemia, a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your organs and tissues.

According to research in JAMA, there may be a link between testosterone deficiency and mild anemia in older men.¹³

“Testosterone stimulates the production of a hormone called erythropoietin (EPO), which in turn stimulates the production of red blood cells and decreases the production of a hormone called hepcidin,” Staheli says. “Less hepcidin allows for the absorption of dietary iron needed for red blood cell maturation.”

Some other symptoms of anemia include:¹⁴

• Chest pain
• Dizziness
• An abnormally rapid heart rate
• Shortness of breath
• Pale skin
• Sore or smooth tongue
• Brittle nails
• Hair loss

How Common is Low Testosterone?

One study found that 39 percent of men 45 and older have low testosterone, also known as testosterone deficiency (TD) or male hypogonadism. Low testosterone is defined by total testosterone levels less than 300 ng/dl.¹⁵ Testosterone naturally declines with age, and most men typically won’t notice symptoms of low testosterone until it drops below this level. 

Around 66 percent of men diagnosed with low testosterone have experienced one or more symptoms.¹⁶

Testosterone is the primary male sex hormone, but also plays a role in how you store and burn fat, your red blood cell production, and your mood. Normally, your hypothalamus releases gonadotropin-releasing hormone (GnRH), which triggers your pituitary gland to release luteinizing hormone (LH). LH causes Leydig cells in your testicles to produce testosterone. From there, testosterone enters your bloodstream and delivers messages throughout your body.¹⁷

Causes of Low Testosterone

Age is typically the reason men have low testosterone. For every 10-year increase in age, a man’s risk of hypogonadism increases by 17 percent.¹⁸ 

However, low testosterone can have medical causes as well. Getting treated for any underlying conditions may also help testosterone levels. Some causes include:¹⁹

• Kallmann syndrome (delayed puberty)
• Cancer treatments like chemotherapy and radiation 
• Obesity
• HIV/AIDS
• Pituitary gland disorders
• Hemochromatosis (overabsorption of iron)

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Treatment Options for Low Testosterone

You can take some steps on your own to boost testosterone naturally, including eating certain foods. But you may need medical treatment to bring your levels up to a normal range.

Taking testosterone replacement therapy

The most commonly prescribed fix for low testosterone is testosterone replacement therapy (TRT). 

“Millions of American men are using prescription testosterone to reverse their fatigue, low drive, mental fog, muscle atrophy, depression, anxiety, insomnia, low libido, and erectile dysfunction,” Staheli says.

TRT comes in a range of forms, including: 

• Injection
• Pills and tablets
• Topical gel and creams
• Patches
• Troches 

If maintaining fertility is a concern, you won’t be given TRT as it can lower sperm count.²⁰ Medications that contain clomiphene citrate, such as Clomid, can be used to treat some low testosterone symptoms while protecting against infertility.

If you’re considering TRT, it’s important to work with a healthcare provider. They can monitor your levels and discuss possible side effects.

Making lifestyle changes

Though testosterone levels naturally decrease with age, certain lifestyle habits can speed up that process. Here’s how to avoid symptoms of low testosterone or improve your levels.²¹

• Watch what you eat. Limit sugar, caffeine, red meat, dairy products, and processed foods. Add more multicolored fruits and vegetables, nuts, flax seed, and fiber. 
• Maintain a healthy weight. Research suggests that for every one-point drop in your body mass index (BMI), your testosterone level will increase by approximately one point.
• Get a good night’s sleep. Your body makes much of its testosterone during deep sleep.²²
• Quit smoking or using other tobacco products. Smoking has been found to negatively affect the endocrine system (including the pituitary and thyroid glands), which could affect testosterone production. Some research shows that smoking lowers testosterone, but the research is mixed.²³
• Drink alcohol in moderation. Regular drinking may cause more testosterone to be converted to estrogen, damage Leydig cells (which could decrease testosterone production), and decrease the production of luteinizing hormone in the pituitary gland.²⁴
• Try to reduce your stress. Stress releases cortisol, which can increase fat stores. This can cause more testosterone to be converted to estrogen.

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Considering natural remedies and supplements

Some men explore supplements to help with symptoms of low testosterone or maintain healthy levels of the hormone. Some supplements claim to boost testosterone, while others claim to help build muscle or improve energy or libido.²⁵ The research on taking these supplements for low testosterone is limited, and some have conflicting results. So it’s important to talk to your healthcare provider before starting any of them. 

Some of the more commonly used testosterone boosters that have some research to support them include:²⁶

• Fenugreek seed extract²⁷ 
• Ashwagandha root²⁸ 
• Zinc (if levels are low)²⁹
• Quercetin³⁰
• Dehydroepiandrosterone (DHEA), a precursor to testosterone³¹

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About the author

Emily Shiffer is a freelance writer specializing in health, nutrition, weight loss, and fitness. Her work has been published in Women’s Health, Runner’s World, SELF, Health, and more.

About the reviewer

Dr. Robert Howe, M.D., is an obstetrician and gynecologist and a Reproductive Endocrinology and Infertility Specialist with experience treating osteoporosis, menopause, hypothyroidism, hormonal deficiencies in men and women, and other endocrine problems.