Low Testosterone Symptoms in Men and Women

In men, testosterone is made in the testicles and is an important part of a male's sexual function and development. It's what helps the development of features like facial and body hair, muscle strength, and a deeper voice among men. Testosterone also supports sperm production.

Also called male hypogonadism or low T, low testosterone is estimated to affect almost 40% of men aged 45 and older.

Low testosterone symptoms are a bit different in men compared to women, and they may include:

• Decreased libido
• Erectile dysfunction
• Hair loss throughout the body
• Less beard growth
• Loss of lean muscle mass
• Chronic fatigue
• Weight gain leading to obesity
• Depression

Some men may also experience additional low testosterone level symptoms, such as:

• Lower energy levels, endurance, and physical strength
• Poor memory and focus
• Difficulty with finding the right words to say

Reasons for low testosterone in men

As men age, the amount of total testosterone produced in the body gradually declines. If levels fall too low, symptoms may occur.

There are several other possible reasons for testosterone deficiency. These include injury that interferes with the blood supply going to the testes; dysfunction or tumors of the pituitary gland; medications; and chemotherapy for cancer. Things like kidney failure, obesity or extreme weight loss, and obstructive sleep apnea can also lead to low testosterone.

Women can also experience an imbalance in testosterone hormone levels, although low testosterone is sometimes seen as a male issue. Low testosterone symptoms in women can vary and can range from low sex drive to loss of strength.

Here are some low testosterone symptoms to be aware of in women:

• Thinning hair
• Dry skin
• Decreased libido
• Loss of muscle mass
• Increase in body fat, contributing to overall weight gain
• Mood changes (such as increased levels of anxiety)
• Sexual dysfunction
• Decrease in bone mass
• Overall loss of strength

Reasons for low testosterone in women

If you're experiencing low testosterone symptoms, there are several possible causes for your imbalance, including:

• Long-term use of birth control (like oral pills and contraceptive patches)
• Ovarian failure, which is where your ovaries stop functioning properly, can also lead to low testosterone levels
• Certain medications, as well as glandular tumors, can contribute to low testosterone symptoms

If you experience low testosterone symptoms, your healthcare provider may order blood tests to measure your total testosterone level, luteinizing hormone (LH), blood prolactin level, and blood hemoglobin (HgB). Because testosterone levels can fluctuate throughout the day, providers may order multiple tests before making a diagnosis.

It's worth noting that having low testosterone levels alone doesn't automatically mean you need treatment. If you have low levels but few or no symptoms—particularly fatigue and sexual dysfunction, which are the most common—your provider may take a watchful approach first, or address an underlying cause like weight gain or a medication before turning to testosterone therapy.

Who should not use testosterone therapy

Testosterone therapy is not appropriate for everyone. The Endocrine Society advises against testosterone supplementation for people who: [9]

• Have prostate or breast cancer
• Have an elevated prostate-specific antigen (PSA) level
• Have severe, untreated obstructive sleep apnea
• Have experienced a heart attack or stroke within the last 6 months
• Have a tendency to form blood clots (thrombophilia)
• Are planning to father children in the near term, as testosterone therapy can reduce sperm production

Always discuss your full health history with your provider before starting any hormone therapy.

Types of testosterone therapy

If testosterone therapy (TT) is the right option for you, there are several delivery methods your provider may consider:

• Transdermal patch. A patch applied once daily—typically in the evening—that releases testosterone gradually through the skin.
• Topical gel. Applied daily to the upper arms, shoulders, or thighs. It's important to wash your hands after applying and cover treated areas to avoid accidentally transferring testosterone to a partner or child.
• Oral/buccal tablet. Capsules that are swallowed, or tablets that adhere to the gum or inner cheek twice daily for absorption into the bloodstream.
• Intranasal gel. Applied inside the nose, typically three times per day. A less common option that avoids skin-transfer concerns.
• Injections. Administered every one to two weeks. Levels can spike shortly after injection and gradually decline before the next dose, which some people notice as fluctuations in mood or energy.
• Pellets. Small pellets implanted under the skin—usually near the hips or buttocks—that release testosterone steadily over three to six months.

Most people begin to notice improvement in symptoms such as energy and mood within four to six weeks of starting therapy. Changes in muscle mass typically take longer—around three to six months [8].

Low testosterone symptoms can significantly impact your day-to-day life. If you’re experiencing some of the symptoms highlighted in this article, have a conversation with your healthcare provider to find out what route for low testosterone treatment they recommend for you.

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