It is well know that testosterone levels decline as men age. However, we can’t always blame testosterone deficiency on aging. I often see men in my practice under the age of 40 with testosterone deficiency and on occasion, men in their 20’s present with low testosterone. Whatever the age, it is important to consider possible causes of testosterone deficiency, because it may be stemming from another health issue. The cause may not always be determined, but if found, treatment can help improve testosterone levels and overall health. Sometimes the cause is found but cannot be reversed. However, any information about the cause of testosterone deficiency is valuable when constructing a treatment plan or initiating testosterone replacement therapy.
Listed below are reversible, possible causes of testosterone deficiency. These may contribute some influence or be the sole reason for low testosterone levels.
Physical and Emotional Stress
Stress comes in many forms and can interfere with testosterone production. Stress is often thought of in terms of being overwhelmed, such as being overworked or dealing with difficult family issues. However, stress to the body may also come from things like illness, trauma, poor diet, or excessive exercise. For example, one study found an increased prevalence of testosterone deficiency in marathon runners.
We live in a very toxic world and toxins can interfere with health in many ways. Specifically, there are several thousand chemicals in our environment that have estrogen-like activity and can directly suppress testosterone levels.
Testosterone is converted to estrogen in fat cells. With more fat, one is more likely to lose testosterone as it is converted to estrogen. To make matters worse, the increase in estrogen suppresses further testosterone production, to further lower testosterone levels.
This common condition interrupts healthy sleep and is associated with low testosterone and a host of other health problems. Poor sleep habits in general can also suppress testosterone production.
There are more and more drugs being introduced to the marketplace and studies are showing that some of them can lower testosterone levels. Common medications such as opioid pain relievers, antidepressants, statins, and antifungal medication are a few that have shown to affect testosterone production.
Pituitary Gland Tumors
The pituitary gland is located in the brain and regulates many hormone functions. When pituitary function is altered, such as by a pituitary tumor, hormone regulation becomes disrupted and testosterone production can decline. Although this is not a common cause of low testosterone, it is a consideration when other symptoms suggest a pituitary problem.
Treating these problems may help improve testosterone levels. Even if these issues are not related to low testosterone, they can cause symptoms that mimic testosterone deficiency, such as fatigue, low libido, or decreased sense of well-being. Addressing these issues may improve testosterone levels and most likely, will improve one’s overall health.
Listed below are irreversible, possible causes of testosterone deficiency. Although these conditions cannot be treated, it can be beneficial for a patient, from an emotional perspective, to have some idea why his testosterone levels have declined.
Sometimes our genes program us to have low testosterone levels.
As mentioned, low testosterone is often attributed to aging. Although this article is dedicated to other causes of testosterone deficiency, aging remains the most common cause of declining testosterone levels.
Vasectomy or Treatment for Prostate Cancer
From a physiological standpoint, vasectomy procedures and some of the less invasive treatment approaches for prostate cancer should not disrupt testosterone production. However, I often see men in my practice who developed low testosterone soon after a vasectomy or prostate cancer treatment.
Previous Head Trauma
History of severe traumatic brain injury or repetitive head trauma can result in low testosterone.
History testicular trauma
Most of the testosterone produced in males is done so through the testicles. A traumatic injury directly to the testicles can permanently damage them and impair testosterone production.
History of mumps
The mumps is a childhood illness caused by a virus that infects the parotid and salivary glands in the cheeks and around the jaw. Sometimes the mumps can be complicated by orchitis, which is an inflammatory condition of the testicles. This can leave the testicles damaged and unable to produce adequate levels of testosterone.
Previous History of Undescended testicle
As we develop as an embryo to a fetus, testicles form inside our abdomen. As development progresses, they descend into the scrotum and by birth, should reside there as external organs. However, sometimes the testicles do not descend into the scrotum and remain as intra-abdominal structures. They may descend later after birth, but sometimes surgery or hormone intervention is required to bring the testicles to the proper position. If this condition is not corrected early enough, it can lead to testicular dysfunction, which in turn can cause low testosterone production. Incidentally, men with a history of undescended testicles also are at higher risk for testicular cancer and fertility issues.
Whatever the cause of testosterone deficiency, improving testosterone levels can help alleviate symptoms of testosterone deficiency and improve one’s health and quality of life.
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