Most people associate low testosterone with aging and the symptoms that come with it, but that’s not the whole story. Fatigue, low motivation, low muscle mass, changes in mood, changes in sex drive and changes in sexual function, among other issues, may make some men think about the role testosterone may be playing.

The symptoms explained above are not necessarily caused by low testosterone. These symptoms can be caused by stress, lack of sleep, obesity, certain health conditions, several health issues and others.

The current Endocrine Society guidelines state that low testosterone may not be diagnosed exclusively based on symptoms. Rather, symptoms, paired with a few blood tests that show low levels of testosterone, must be used to diagnose low testosterone.

What is Testosterone?

Testosterone is the main sex hormone in men and is responsible for sexual desire and reproductive health, but its effects extend beyond the reproductive system.

Testosterone impacts a variety of attributes and processes, including:

Muscle mass and strength
Bone health
Sexual desire
Sperm production
Energy and well-being
Red blood cell production
Body composition

Testosterone levels fluctuate naturally throughout life, and are generally highest in early adulthood. Testosterone levels fluctuate naturally throughout the day and are lowest at night.

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Is Low Testosterone Common in Men Under 40?

Low testosterone is commonly associated with aging men, but younger men can experience hypogonadism, a condition in which the body is unable to produce testosterone.

There is no such thing as a textbook case of low testosterone for men, as in some cases a man’s testosterone levels can be considered low, but in the context of other health, lifestyle, and environmental factors, they may not actually be low.

Per recommendation by the Endocrine Society, no diagnosis of hypogonadism should be made until a man is exhibiting symptoms of low testosterone and testosterone levels are confirmed to be low.

Common Symptoms of Low Testosterone in Men

Symptoms can differ in each individual, though in some men, symptoms can appear more profound in one area, whereas, in others, symptoms can appear in different areas.

Some common symptoms may include the following:

Diminished sex drive
Erectile dysfunction
Less spontaneous erections
Tiredness
Decreased lean muscle mass, increased fat mass
Low energy
Diminished motivation
Decreased concentration
Irritability, depression
Poor exercise performance
Diminished fertility

Just having one or two symptoms can’t be attributed to low testosterone. Tiredness can be attributed to poor sleep, low motivation, and poor concentration.

Why Might Testosterone Be Lower in Men Under 40?

In men under 40 years old, there are multiple causes that can disturb the production of testosterone or manifest themselves similarly to the symptoms of testosterone deficiency.

Chronic Stress

Due to long-term stress, sleep, diet, exercise, and overall health can be inhibited. These may ultimately impact hormone regulation.

Hormone regulation may be optimized by stress-reducing activities combined with regular physical activity, relaxation techniques, adequate sleep, healthy diet and routine.

Poor Sleep

Sleep is vital for men concerned about low testosterone and especially younger men.

In JAMA, a study of 10 healthy young men found that restricting sleep to 5 hours per night for a week resulted in a 10% to 15% decline in daytime testosterone levels as compared to a week of adequate sleep.

Due to the nature of the study, it cannot confirm cause-effect relationships. It is important to note that the study illustrated the connection between sleep and testosterone.

Obesity

Excess weight can also lead to poor metabolic health, which can affect hormone function. There is a positive relationship between obesity and hypogonadism, and weight-related low testosterone may resolve after correcting the metabolic issue.

Therefore, a healthy diet and active lifestyle can help improve hormonal health for men.

Lack of Physical Activity

Your metabolic health and cardiovascular health are compromised by leading a sedentary lifestyle. A sedentary lifestyle definitely contributes to health issues that affect your hormonal health. Strength training and aerobic exercise can improve your health and wellness routine.

Poor Diet

Malnutrition does not serve your body well. Testosterone levels may be negatively impacted. A healthy diet is your best option, and it’s advisable to avoid “testosterone boosting” products.

Some Medical Issues

Low testosterone may result from an existing medical problem.

Some of these medical issues may include:

Testicular injuries
Testicular problems and disorders
Pituitary problems
Type 2 diabetes
Obesity
Chronic medical conditions
Kidney and Liver issues
Sleep problems
Genetic issues and disorders
Some chronic illnesses

Some medications may affect your testosterone levels, including corticosteroids and opiates.

How Is Low Testosterone Diagnosed?

Understanding testosterone levels is more complicated than checking a single number.

Testosterone levels fluctuate during the day, with most labs conducting the tests in the morning. The Endocrine Society supports the appropriate diagnosis by repeating the morning fasting testosterone test if there is a suspicion of low testosterone levels.

Low testosterone levels are investigated further by a physician if additional blood tests do not show any abnormalities. The physician also reviews the medical history, the symptoms the patient is presenting with, and any other health concerns.

This is necessary to help avoid unnecessarily starting testosterone therapy.

Can Lifestyle Changes Support Testosterone Health?

Healthy habits can support hormone and overall health, although they may not correct testosterone deficiency caused by an underlying medical condition.

Sleep well: Aim for consistent, quality sleep each night.
Exercise regularly: Combine strength training with aerobic activity.
Maintain a healthy weight: Healthy weight management may support hormone balance.
Eat a balanced diet: Include protein, healthy fats, whole grains, fruits, and vegetables.
Manage stress: Regular exercise, relaxation, and mindfulness can help reduce chronic stress.

When Should You Talk to a Doctor?

Talk to a healthcare professional if there is no improvement in your symptoms or if the symptoms get worse. Symptoms can contribute to concerns in your sexual health, energy levels, mood, and fertility as well as your ability to perform your daily activities.

It also warrants your attention if you have unexplained fatigue, loss of muscle mass, reduced libido, or erectile problems.

Do not base your decision to have testosterone treatment on symptoms or online tests. Men who have testosterone therapy are men who have been diagnosed with hypogonadism.

This therapy can even result in male infertility. The Endocrine Society recommends that men who have testosterone therapy should not be men who are planning for fertility in the near future.

Common Myths About Low Testosterone

Myth 1: Every Tired Man Has Low Testosterone

This is not always the case. There are many possible reasons for fatigue: poor sleep, too much stress, not eating right, depression, certain medications.

Myth 2: Low Testosterone Only Affects Old Men

Younger men can have hypogonadism, too. This is especially true for older men.

Myth 3: High Testosterone is Always Better

Having testosterone outside of a normal range can have negative side effects.

Myth 4: Symptoms Can Confirm Low Testosterone

Symptoms of low testosterone can be present, but low testosterone can only be confirmed by medical professionals.

Final Thoughts

Men under the age of 40 can experience low testosterone, but that doesn’t mean that it is the reason you have fatigue and low motivation or depressed mood and low desire for sex.

Poor sleep, excess weight, stress, medications and some conditions can contribute to low testosterone levels. If symptoms don’t improve, it’s best to speak to a healthcare professional and get tested for the actual levels of testosterone rather than attempting to self-diagnose.

For men of any age, addressing the root cause typically makes more of an impact than considering how the testosterone number impacts them.

When it comes to younger men, the number on the testosterone tests can be less important as treating the underlying causes can lead to an increase in testosterone levels.