What could be the cause for a sudden drop in testosterone levels, accompanied by lower sex drive and fatigue?

Doctor's Answers 2

Low testosterone levels can be associated with lower sex drive and fatigue. This is known as testosterone deficiency (TD), loosely termed andropause.

Unlike women who have a sudden drop in estrogens when they reach menopause, this is not the case in men. Men with TD have a gradual drop in the peak levels of testosterone. This peak usually occurs in the morning around 7 to 11 am. As a men ages, those who develop TD have a lower peak level of testosterone and in some men no peak at all. This results in the symptoms mentioned above.

If there is a sudden drop in testosterone levels, the urologist would assess if it is due to a central cause i.e. whether it is due to medical conditions affecting the pituitary gland. Other causes include medications and conditions affecting the health of the testis e.g. testicular tumour or severe infections of the testis (orchitis).

Many men with low testosterone do end up seeing many specialists from different fields as the manifestations of androgen deficiency can be seen in many areas of the body. They commonly manifest the following symptoms or conditions:

  • low energy level
  • fatigue and mental fogginess
  • irritability
  • anxiety
  • decreased muscle mass
  • infertility
  • problems with erection
  • low libido and sexual interest
  • hair loss
  • loss of bone mass
  • breast swelling (gynecomastia)

If there is a sudden drop in testosterone levels, the causes would include the following:

  • physical injury to the testicles.
  • mumps infection affecting the testicles.
  • cancer treatments – chemotherapy and radiation can affect the testicles.
  • pituitary disorders caused by medications, kidney failure or tumours.
  • obesity – as high body fat can affect the production of male hormones.
  • medications like opioid pain medicines and steroids - they can affect the function of pituitary gland and hypothalamus.

At the clinic, it is sometimes challenging to tell if the patient has low testosterone or is suffering from depression. People who have depression but have normal hormone levels generally do not experience breast swelling and decreased muscle mass and strength that are associated with low testosterone. A blood test may help. For many patients, both depression and low testosterone level need to be monitored and treated.

Male hypogonadism usually is treated with testosterone replacement to return testosterone levels to normal. Testosterone can help counter the signs and symptoms of male hypogonadism, such as decreased sexual desire, decreased energy, decreased facial and body hair, and loss of muscle mass and bone density.

However, for older men who have low testosterone and signs and symptoms of hypogonadism due to ageing, the benefits of testosterone replacement are less clear.

Similar Questions

How does going on a plant-based diet affect fatigue levels?

Fatigue can be described as having difficulty in initiating or maintaining activity. It is also associated with difficulty in concentration, memory and emotional stability. It is a common problem which negatively impacts work, performance, family and even social relationships. There are many causes for fatigue including underlying chronic medical conditions such as thyroid disease, psychological conditions as well as nutritional deficiencies.

Photo of Dr Dheeraj  Khiatani

Answered By

Dr Dheeraj Khiatani

General Practitioner

TCM

How will acupuncture help with stroke symptoms?

From a biomedical perspective, a stroke occurs when blood supply to the brain is interrupted, causing brain cells to lose their function thus leading to the signs and symptoms commonly observed. There are two main types of stroke: Ischaemic stroke occurs due to blockage of blood vessel, limiting blood flow to the brain. It is the most common, accounting for 74% of stroke in Singapore. Haemorrhagic stroke occurs due to rupture of blood vessel, causing bleeding into the brain. This makes up 24% of stroke in Singapore.

Photo of Human

Answered By

Human

Ask any health question for free

I’m not so sure about a procedure...

Ask Icon Ask a Question

Join Human

Sign up now for a free Human account to get answers from specialists in Singapore.

Sign Up

Get The Pill

Be healthier with our Bite-sized health news straight in your inbox