Feeling low energy, low sex drive, or losing muscle? Those can be signs of hypogonadism — when the body doesn’t make enough sex hormones, usually testosterone in men. It’s more common than people think, and the good news: doctors can test for it and most cases have clear treatment paths.
There are two main types: primary (the testes don’t make enough hormone) and secondary (the brain — the pituitary or hypothalamus — doesn’t signal the testes properly). Causes range from genetic conditions, injuries, infections, or certain medications, to obesity, chronic illness, and aging.
Watch for these symptoms: low libido, erectile difficulties, persistent fatigue, losing muscle mass or strength, gaining body fat, mood changes or brain fog, and trouble getting or keeping a pregnancy. In teens, delayed puberty is a key red flag. If you’re noticing several of these, talk to your doctor.
Doctors won’t rely on symptoms alone. They check morning testosterone levels (when they’re highest), usually with two separate blood tests. They may also test LH, FSH, prolactin, and SHBG to see whether the issue is primary or secondary. If fertility matters to you, sperm analysis is part of the workup.
Treatment depends on goals. If you want normal testosterone levels and symptom relief, testosterone replacement therapy (TRT) is the common route. TRT comes as injections, gels, patches, or pellets. It often works well for energy, libido, and muscle, but it needs medical oversight.
Important safety points: TRT can raise hematocrit (thickening the blood), affect cholesterol, and may change PSA levels. Your doctor will check blood counts, liver and lipid panels, and prostate markers regularly. Also, if you want children, know this: standard TRT can reduce sperm production and hurt fertility.
If fertility is a priority, there are alternatives that boost your own testosterone without shutting down sperm production. Options include clomiphene citrate or hCG injections; these are prescription treatments a specialist can discuss. Lifestyle changes matter too: losing excess weight, improving sleep, cutting heavy alcohol use, and getting stronger with resistance training can raise testosterone naturally.
Thinking about buying hormones or supplements online? Only use licensed pharmacies and a valid prescription. Illegitimate sources can sell wrong doses or fake products. Ask your doctor for a prescription and verify the pharmacy’s credentials before you order.
Last bit of advice: don’t self-diagnose from symptoms alone. Start with a simple blood test in the morning and a clear conversation with your clinician about goals — symptom relief, long-term health, or fertility. From there you and your doctor can pick a safe plan that fits your life.
