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Low T in Young Males — What’s the Underlying Cause?

Low testosterone is a condition usually experienced by middle-aged or older men. While Low T in young males isn’t unheard of, developing chronic low testosterone levels at a young age is unusual, so the root causes need to be examined.

Low T in young males, like the young man pictured here, is abnormal — but there's something you can do about it.

Low T in young males can indicate some serious concerns.

The Symptoms of Low Testosterone

Here are some of the more common symptoms of low testosterone:

  • Sexual Dysfunction
  • Low Libido
  • Weight Problems
  • Fatigue
  • Trouble Concentrating
  • Depressed Mood
  • Loss of Endurance
  • Muscle Weakness & Muscle Loss

As you can see, it would be unusual for a healthy young man to experience these kind of symptoms.

There are 3 major categories of causes for hypogonadism (the medical term for low T) in young males:

  • Lifestyle choices (including substance use or abuse)
  • Physical damage to the testicles
  • Illness

The likelihood for low testosterone increases with age. What’s important to note is that there is something more going on — there’s an irregularity causing Low T in young adults.

Low T in Young Males — Substance Use and Lifestyle Choices

This category of potential causes for low testosterone needs to be investigated and ruled out right away. Use of some medications or excessive alcohol consumption can have damaging and life-threatening consequences beyond lowering testosterone levels.

Opioid Use

Opioid medications are often utilized following serious injury or surgical procedures. Long-term use can lead to a condition called Opioid-Induced Androgen Deficiency (OPIAD), which is essentially low testosterone due to the prolonged use of opioid medications.

A study in the academic journal, Pain Physician, reached the following conclusions regarding OPIAD:

“While the literature regarding OPIAD remains limited, it is apparent that OPIAD is becoming increasingly prevalent among chronic opioid consumers but often goes unrecognized. OPIAD can have a significant negative impact on the the quality of life of opioid users, and clinicians should anticipate the potential for its occurrence whenever long-term opioid prescribing is undertaken. Once diagnosed, treatment for OPIAD may be offered utilizing a number of androgen replacement therapy options, including a variety of testosterone preparations…”

(Additional information on opioids and low testosterone can be found here.)

Excessive Alcohol Consumption

For men, it’s well documented that ethanol alcohol in large amounts:

  • Negatively impacts testicular function
  • Reduces testosterone
  • Lowers sperm count
  • Reduces fertility
  • May damage the testes themselves
  • May increase estradiol levels

Again, that’s usually only true for excessive alcohol consumption.

Alcoholic men often suffer infertility and abnormally low testosterone — a low testosterone count in younger men could signal a serious lifestyle problem with many other health consequences.

However, harmful choices aren’t the only cause of Low T in young males.

Low T in Young Males — Serious Illness and Medical Conditions

There are also some severe medical conditions that can result in low testosterone at a young age, such as the following:

  • Type II diabetes
  • Hypothalamic/Pituitary disease
  • Klinefelter syndrome
  • Kallmann syndrome
  • Down syndrome
  • Hemochromatosis
  • Sickle cell disease

These illnesses are quite serious and will require medical treatment — restoring testosterone levels will not solve these issues.

However, diagnosing low testosterone might lead to a discovery of one of these underlying illnesses.

Low T in Young Males — Testicular Trauma

Testicular trauma, which is associated with primary testicular failure, often refers to an injury to the testicles that prevents the production of enough testosterone to maintain hormonal balance.

Testicular trauma can also be the result of damage caused by trauma, tumors, inflammation, or the side-effects of cancer treatment (radiation or chemotherapy).

In simple terms, we’re referring to some type of testicular damage.

Low T in Young Males Can Indicate a Serious Problem

The point we’d like to make clear is that low testosterone is particularly abnormal in young men.

As you have read above, it’s usually caused by something much more serious — testicular trauma or damage, serious illness, or the side effects of harmful substances.

Developing the symptoms of low testosterone at 20 to 30 years old could indicate a serious problem. If you feel that you’re suffering from the above symptoms, a simple blood test may help you discover the root cause of the problem.

The relationship between alcohol and testosterone is of interest to many people who are concerned about Low T. In young males experiencing low testosterone, it’s more common than you might expect.

Read more about how beer can negatively affect testosterone levels.

Learn About the Connection



(Bill) William J. White, PA-C

(Bill) William J. White, PA-C brings over 20 years of surgical experience to our practice. He is a decorated veteran of the United States Army where he served for nearly 6 years with duty assignments, both here and abroad.   During his military career, Bill was trained as a Certified Surgical Technologist, and following an Honorable Discharge from the Army, he attended Texas Tech University.   He graduated with a Bachelor of Science in Biology and went on to attend PA School at the University of Texas Southwestern Medical Center at Dallas. He spent the first 10 years of his career in Neurosurgery.


  1. John on 08/02/2018 at 3:53 pm

    Great article.
    I’m 40yrs old and have a total T of around 295. Clomid took me upwards of 1100 TT. I assume this means I’m secondary? MRI shows no issues with pituitary. Why would my body just stop making T? I have had multiple blood tests but none of the doctors have commented or have given me a reason why my body is not producing.

    • John,

      Actually, a response to Clomid doesn’t help discern between primary and secondary hypogonadism. Testicular function or hypothalamic/pituitary function can both remain active, yet fail to respond appropriately. Furthermore, Clomid can raise your total testosterone without adequately improving your calculated free testosterone, which matters much more. The exact cause for testosterone deficiency is not identified in the vast majority of patients. Endocrine system disruptors are likely a factor in the increase in prevalence.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

  2. William FLynn on 08/07/2018 at 11:40 am

    Good Afternoon. Do you know of any treatment that can reverse “Penis venous leak”? I’m a 51 year old male, 5’8″ 175lbs, just recently retired law enforcement and have been dealing with this for a couple years. My Testosterone was low for years and a urologist refused to treat it with TRT. I have tried both Viagra and now injections with no results like the natural erections of years past. Looking for guidance.

    • William,

      Refractory ED often necessitates combination therapy (i.e. TRT with medications like Viagra). There have been no discoveries of reversal agents/procedures that I am aware of.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

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