Low testosterone, or Testosterone Deficiency (TD), is experienced by two out of 100 men, and while it becomes increasingly common with age, ageing isn’t the only reason. Its impact can be upsetting, leaving men feeling unhappy and unwell. The good news is that it’s an entirely treatable problem. The difficulty can lie in identifying it.
While most people imagine low testosterone to be purely associated with libido and sex, there are actually a whole range of other symptoms that may indicate a testosterone problem, and it’s often spouses and partners who are best placed to spot them.
SYMPTOMS
Men with low testosterone levels may feel excessive tiredness, even after sleep. A lowering of testosterone can produce a range of physical and psychological symptoms in them. Many of these can be easily mistaken for other conditions, or simply the bad temper of age. Knowing what to look out for can help you to get your partner the treatment they need. Dr David Edwards, general practitioner and specialist in men’s and women’s sexual health and contributor to TRTed, shares the key signs and symptoms to be aware of:
1 He’s tired all the time
Whether it’s nodding off on the couch every evening, spending more time at home just relaxing, not wanting to get out of bed in the morning despite a full night’s sleep, or putting off tasks or events that he would usually enjoy, he may have a testosterone imbalance.
2 He’s more irritable or depressed than usual
Testosterone affects emotions and too little can lead to depression. Suppose your partner is snappish or moody for no apparent reason. In the case that he’s not stressed or obviously ill, there are no family or other personal problems—there’s a chance that it might be low testosterone pulling his emotions all over the place.
3 He’s putting on weight
A lot of people gain weight as they age, but if your partner has developed a recent 'spare tyre' around his middle and he’s not noticeably changed his diet or exercise routine, it can be an indication that his testosterone has fallen.
4 His sex drive has dropped off or he’s having trouble maintaining an erection
This is the sign that most people know to look for when it comes to low testosterone, but it can be interpreted in other ways. If your partner isn’t initiating intimacy as often as he once was, it’s easy to imagine that he’s losing interest in you. If he’s failing to maintain an erection, he may laugh it off as too much beer. But if these things are occurring regularly and there are no other reasons—like injury, stress or illness—there could be hormonal issues at play.
5 He’s not as strong as he once was
Testosterone directly impacts the building and maintaining of muscle. When testosterone levels fall, muscle mass falls, too, typically reverting to fat. And this can impact a man’s strength, his ability to lift, carry, and even exercise.
6 He’s finding it hard to concentrate
Testosterone has also been linked to cognitive function, meaning concentration becomes harder when it falls. And this can come into play at work as well as at home. If he’s complaining about not finishing his projects on time, the boss breathing down his neck at work, or he doesn’t seem to be paying attention at home, testosterone could be playing a part.
7 He’s lost his oomph and other symptoms
Although it’s really not an appropriate term, there are a lot of reasons why low testosterone is often jokingly referred to as the 'male menopause'. In some cases, men can experience a range of similar symptoms, including night sweats, hot flushes, sensitive breasts and anaemia. Shrinking testicles can also occur. It’s worth paying attention to how the man is sleeping, feeling, and whether he has any sensitivities.
THE HEALTH EFFECTS
If a man has biochemically low levels of testosterone, he can experience a range of health issues. While some of them are minor, such as tiredness and a loss of energy, others can be more serious, such as depression, diminished bone and muscle strength, as well as low red blood cell count. In fact, research has shown that men with TD have a greater chance of dying younger than men with normal levels.
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Testosterone levels and symptoms can improve with testosterone treatment gradually over many months. Interestingly, the first symptoms to improve are often the sexual symptoms such as erections, libido and early morning erections.
Men with type 2 diabetes are more likely to suffer from TD—40 per cent of type 2 diabetics (T2D) have low or borderline testosterone. Those with T2D must ask for a testosterone blood test to be carried out in annual blood tests.
Interestingly, other research has shown that men with TD and T2D can put their diabetes into remission with testosterone treatment. They see an improvement in their diabetic, cholesterol and fat blood levels. Furthermore, their weight goes down, blood pressure reduces and abdominal circumference improves year on year.
But it’s not an overnight fix, so don’t expect miracles straightaway.
How to talk to your partner about low testosterone
Unfortunately, one of the most common symptoms of low testosterone is irritability. And the last thing you probably want to do when you already feel like you’re walking on eggshells is to broach a difficult personal conversation. But the best approach is to offer honesty and sympathy. As soon as your partner realises that there’s a problem, he can start to do something about it.
Start by making a plan.
* Do some research to make sure that low testosterone could be the potential problem, and so that you can make a convincing argument. One that is factual rather than emotional.
* Think about how you’re going to open the conversation—ideally avoiding the "we need to talk" gambit—and what you’re going to cover.
* Choose a time when he’s relaxed, not distracted, has some free time, and is most likely to engage.
* Be open, honest, and sympathetic.
* Give him a chance to speak—and listen to what he has to say. He may have other explanations for his symptoms.
* Have a suggested action plan ready, so if he agrees and wants to seek treatment, you know what to do next.
TREATMENT
“In the first instance, your GP should always be the first point of contact for anyone who thinks they may have low testosterone,” says Dr Edwards. “While online services are available, to gain a true diagnosis, men need to have a medical history, physical examination, and blood work completed. Without this, misdiagnosis and missed diagnosis is common. Once a diagnosis has been made, your GP will be able to suggest the correct treatment or refer your partner to the relevant specialist.”
With the right treatment, men can recover health and their sense of vitality. It’s only when low testosterone is left untreated that wider problems develop.