What are the symptoms of low testosterone (hypogonadism)?

Signs & symptoms

Symptoms and signs of testosterone deficiency (hypogonadism) occur as a result of low testosterone levels.1-6 Due to the multiple effects of testosterone, the health consequences of hypogonadism are wide-ranging with signs and symptoms affecting sexual, physical, metabolic and psychological functions.

Figure: Common symptoms and signs of hypogonadism (low testosterone) in men.1,3-6

Sexual


  • Decreased sexual desire and activity
  • Decreased frequency of sexual thoughts
  • Erectile dysfunction
  • Delayed ejaculation
  • Decreased volume of ejaculate
  • Decreased frequency or absent morning or night-time erections
  • Small testes
  • Infertility

Physical


  • Decreased muscle mass and strength
  • Reduced physical performance
  • Hot flushes or sweats
  • Sleep disturbances
  • Fatigue
  • Reduced bone mineral density, osteoporosis, low trauma fractures
  • Decreased body hair
  • Gynecomastia (female breasts)
Signs and symptoms of low testosterone

Metabolic


  • Obesity (BMI 30 or higher)
  • Abdominal (belly) obesity (waist circumference 102 cm or higher)
  • Metabolic syndrome
  • Insulin resistance, prediabetes or type 2 diabetes

Psychological


  • Depressed mood
  • Loss of energy
  • Reduced motivation
  • Poor concentration
  • Decreased well-being and/or poor self-rated health
  • Irritability
  • Sadness
  • Impaired memory
  • Decreased cognitive function (including impaired concentration, verbal memory, and spatial performance)

Check your symptoms

See if you should have your testosterone level checked

Check your symptoms

References

  • Dean JD, McMahon CG, Guay AT, et al. The International Society for Sexual Medicine's Process of Care for the Assessment and Management of Testosterone Deficiency in Adult Men. The journal of sexual medicine. 2015;12(8):1660-1686. Return to content
  • Morgentaler A, Zitzmann M, Traish AM, et al. Fundamental Concepts Regarding Testosterone Deficiency and Treatment: International Expert Consensus Resolutions. Mayo Clin Proc. 2016;91(7):881-896. Return to content
  • Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and Management of Testosterone Deficiency: AUA Guideline. J Urol. 2018;200(2):423-432. Return to content
  • Hackett G, Kirby M, Edwards D, et al. British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice. The journal of sexual medicine. 2017;14(12):1504-1523. Return to content
  • Dohle GR, Arver S, Bettocchi C, Jones TH, Kliesch S. 2018 EAU Guidelines on Male Hypogonadism. Available at http://uroweb.org/wp-content/uploads/18-Male- Hypogonadism_2017_web.pdf. European Association of Urology. Return to content
  • Morales A, Bebb RA, Manjoo P, et al. Diagnosis and management of testosterone deficiency syndrome in men: clinical practice guideline. Appendix available at: http://www.cmaj.ca/content/suppl/2015/10/26/cmaj.150033.DC1/15-0033-1-at.pdf (accessed Sept 17, 2019). CMAJ. 2015;187(18):1369-1377. Return to content