The Silent Epidemic: The Underdiagnosis of Low Testosterone
Low testosterone, also known as hypogonadism, is a common yet often overlooked medical condition that affects many men as they age. Despite its prevalence and impact on physical and mental health, low testosterone is frequently underdiagnosed, leaving men with much less than their best life. Let’s explore the reasons behind this issue.
Understanding the Causes and Symptoms of Low T
Testosterone is a hormone primarily produced in the testes that plays a crucial role in male development and health. It is responsible for the development of male secondary sexual characteristics such as facial hair, muscle mass, and a deeper voice. Additionally, testosterone contributes to men’s overall well-being, mood regulation, and sexual function.
Low testosterone levels can be linked to a variety of factors, including age, obesity, diabetes, certain medications, chronic illnesses, and genetic conditions. As men age, testosterone production naturally decreases However, low testosterone can also occur in younger men due to environmental influence, lifestyle factors, or underlying health issues.
The symptoms of low testosterone can vary widely and may include:
- Decreased libido and sexual dysfunction
- Fatigue and decreased energy levels
- Muscle weakness and loss of muscle mass
- Mood swings, depression, and irritability
- Weight gain and increased body fat
- Cognitive decline and memory problems
Lack of Awareness, Social Stigma and Low T Underdiagnosis
Despite the wide range of symptoms associated with low testosterone, many men incorrectly dismiss or overlook them as a normal part of aging or attribute them to other factors such as stress or lack of sleep.
Many men (and even some healthcare providers) are unaware of the prevalence of low testosterone and its impact on health, and the symptoms of low testosterone, such as fatigue and mood changes, can overlap with other health conditions, making it challenging to identify the underlying cause.
Men are often hesitant to discuss symptoms related to sexual health or hormonal imbalances, leading to delays in diagnosis and treatment.
The True Difficulty in Reaching a Proper Diagnosis of Low T
Guidelines for diagnosing low testosterone vary, and some healthcare providers may not routinely screen for the condition in at-risk individuals.
Still, screening itself has inconsistencies. A diagnosis is commonly based on free or bioavailable testosterone and not total testosterone levels, often skewing the results. Patients’ levels are tested twice, 1 month apart, in the morning and while fasting. The final determination being the lower threshold level of young men as measured in the laboratory.
A recent survey revealed that 77% of urologists interviewed reported referring to these reference ranges for their patients.
(Read our article for more on why these ranges are problematic in Low T diagnosis.)
Eric Huygue, MD, PhD, urologic surgeon at Toulouse University Hospital in France, offered the following opinion in a recent Medscape article::
“This method has long been in use, but it has eventually become apparent that symptomatic patients with an undiagnosed deficiency could be in the reference patients’ group.”
Early detection and treatment of low testosterone are essential for improving quality of life and reducing the risk of complications. Testosterone replacement therapy can help restore hormone levels, alleviate symptoms, and improve overall well-being. Additionally, addressing low testosterone can have a positive impact on cardiovascular health, bone density, and mental health.
Do Your Symptoms Suggest Low T?
If you suspect you may have low testosterone due to symptoms associated with the condition, have an honest and frank conversation with your medical provider.
Low testosterone is a common yet underdiagnosed condition that can have a significant impact on your health and well-being. By increasing your own awareness, seeking early detection, advocating for the severity of your symptoms, and requesting the appropriate treatment, you can get the relief you need to restore your A-game.
Your symptoms don’t lie. We encourage you to take proactive steps to address your hormonal health.
