Androgen Deficiency In Men
Informed by recognized medical guidance
Overview
Androgen deficiency is a condition where the body does not produce enough androgens — the male sex hormones, such as testosterone. This can happen for many reasons, and it can lead to a range of physical, mental, and sexual symptoms.
Key facts
- Androgen deficiency is also known as male hypogonadism or low testosterone.
- It can affect men of any age, but it becomes more common as men get older.
- Symptoms may include fatigue, low sex drive, erectile problems, and mood changes.
- A simple blood test can measure your hormone levels.
- Treatment is available and can help improve quality of life.
Androgen deficiency is not rare. It is estimated to affect around 1 in 200 men under the age of 60, and the number rises with age. However, many men with low testosterone do not have symptoms, and not all men with symptoms have low testosterone.
Androgen deficiency can affect men at any stage of life. It can occur because of problems with the testicles (which make testosterone) or with the brain areas that control the testicles. It is more common in older men, and also in men with certain health conditions such as diabetes, obesity, or a history of testicular injury.
Symptoms
- Sudden, severe headache or vision changes (this is rare but can be a sign of a pituitary problem)
- Chest pain or difficulty breathing (call your local emergency number)
- ⚠Sudden or severe pain in the testicles
- ⚠New or unusual skin changes in the breast area
- ⚠Unexpected weight loss
- ⚠Feeling extremely unwell or confused
Common symptoms
- Feeling tired and lacking energy
- Low sex drive (libido)
- Difficulty getting or keeping erections
- Reduced muscle mass and strength
- Increased body fat, especially around the belly
- Low mood, irritability, or depression
- Difficulty concentrating or memory problems
- Loss of body or facial hair
- Hot flushes or sweating
Symptoms in children
- Delayed puberty
- Slow growth of the penis and testicles
- Lack of deepening of the voice
- Reduced body and facial hair
- Low energy and reduced stamina
Symptoms in older adults
- Many of the same common symptoms, but they can be less obvious
- More noticeable fatigue and weakness
- Reduced interest in sex
- Falls or fractures due to weakened bones
- Mood changes and a higher chance of feeling depressed
Causes
Main causes
- Testicular failure: the testicles do not make enough testosterone
- Pituitary or hypothalamus problems: the brain parts that control hormone production do not signal the testicles properly
- Certain treatments, such as chemotherapy or radiation to the pelvic area
- Injury to the testicles
- Conditions like Klinefelter syndrome, a genetic disorder
- Long-term use of opioid pain medicines or steroid medicines
Risk factors
- Increasing age
- Obesity or metabolic syndrome
- Type 2 diabetes
- Chronic kidney disease
- HIV or other chronic illnesses
- Alcohol misuse or drug use
- Obstructive sleep apnoea
When to see a doctor
See a doctor urgently if:
- Sudden, severe testicular pain or swelling
- Sudden loss of vision or double vision
- Severe headache that comes on quickly
Book a routine appointment if:
- You have been feeling tired, sad, or lacking energy for more than a few weeks
- You notice a decrease in your sex drive or erection problems
- You have lost muscle mass or gained belly fat without changing your diet or exercise
- You are worried about low testosterone because of an illness or medication
Diagnosis
A doctor will first ask about your symptoms and medical history, and may check you for signs that can come with low testosterone. If they suspect androgen deficiency, they will usually order blood tests. You may be asked to redo the blood test early in the morning, because testosterone levels naturally change during the day and are highest in the morning.
Tests that may be done
- Total testosterone blood test
- Free or bioavailable testosterone blood test
- LH (luteinizing hormone) and FSH (follicle-stimulating hormone) blood tests
- Prolactin blood test
- Other tests to check the pituitary gland or testicles if needed
What to expect at your appointment
You will likely have a follow-up appointment to talk about your results. The doctor will explain what the numbers mean and whether more tests are needed. If you do have androgen deficiency, they will discuss treatment choices with you and help you make a plan that fits your health and lifestyle.
Treatment
The right treatment for androgen deficiency depends on the cause, your symptoms, and your overall health. If low testosterone is confirmed and is causing you problems, treatment aims to bring your hormone levels back to a more normal range. It is usually safe and effective, but it also needs regular monitoring. You and your doctor will decide together the best approach for you.
Self-care at home
- Aim for a healthy weight — losing extra fat can help raise testosterone naturally
- Get enough regular exercise, especially strength training and activities that get your heart rate up
- Address any sleep problems, such as obstructive sleep apnoea, because poor sleep can make low testosterone worse
- Limit alcohol and avoid recreational drugs, as they can lower testosterone
- Manage stress — relaxation techniques or talking to a counsellor can help
Medical treatments
Testosterone replacement therapy is the main treatment. It comes in several forms, including gels, patches, injections, and pellets. It is important to know that this treatment is only recommended for men who have a confirmed diagnosis and symptoms. Your doctor will monitor you with regular blood tests and check-ups. Other treatments may be used if the cause is in the brain or if you are trying to father a child.
When is surgery considered?
Surgery is not usually needed for androgen deficiency itself. It may be considered if a tumour in the pituitary gland or testicles is causing the condition. In that case, you would be referred to a specialist team, and surgery is just one of the possible options.
Living with this condition
Living with androgen deficiency often means managing low energy and changes in mood or sex life. It is important to give yourself time and be gentle with yourself. Once treatment starts, you may notice improvements gradually over weeks or months. Regular check-ins with your doctor can help you adjust the plan as you go.
Lifestyle tips
- Stay active — even a daily walk can improve mood and energy
- Lift weights or use resistance bands a couple of times a week to help build muscle
- Keep a regular sleep schedule and aim for 7–9 hours a night
- Cut down on ultra-processed foods and sugary drinks
- Practice mindfulness or deep breathing to help with stress
Diet and exercise
A balanced diet rich in lean protein, vegetables, whole grains, and healthy fats supports hormone health. Protein foods like chicken, fish, eggs, beans, and nuts can help maintain muscle. Regular exercise, especially strength training and aerobic activity, can boost energy, improve mood, and help with weight management.
Mental health and emotional wellbeing
Low testosterone can make you feel low, anxious, or less interested in things you used to enjoy. These feelings are not your fault, and they are a real part of the condition. It can help to talk to your partner, friends, or a mental health professional. If you are having thoughts of self-harm or feel like you cannot cope, it is very important to reach out for support right away.
Prevention
Androgen deficiency cannot always be prevented, because some causes are genetic or happen after injury or illness. However, you can reduce your risk by keeping a healthy weight, managing diabetes and other long-term conditions, avoiding excessive alcohol and opioid misuse, and talking to your doctor if you are taking medicines that could affect testosterone.
Screening programmes
There is no routine screening for androgen deficiency in healthy men. Your doctor may suggest a testosterone test if you have symptoms, or if you have a condition that makes low testosterone more likely.
Complications
If left untreated
- Weak bones (osteoporosis), which means a higher risk of fractures
- Reduced muscle mass and physical weakness
- Lower sex drive and erectile problems can affect relationships
- Increased tiredness and low mood, sometimes leading to depression
- Problems with concentration and memory
- A higher risk of cardiovascular problems in some cases
Long-term outlook
With the right diagnosis and treatment, most men notice meaningful improvements in energy, mood, sex drive, and quality of life. It may take time, and treatment may need adjusting, but there is good support available. Many men with androgen deficiency live full, active lives — treatment can make a real difference.
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
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Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: August 1, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.