Key Takeaways
- Understanding male hypogonadism low testosterone aging men treatment is important for seniors and their caregivers.
- Symptoms depend on the age when male hypogonadism develops, either before or after puberty.
- A physical exam may show:
- Male hormone supplements may treat some forms of hypogonadism.
- Many forms of male hypogonadism cannot be reversed.
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Male hypogonadism occurs when the
testicles
cannot produce or produce less sperm or male hormones, such as testosterone.
What Are the Common Causes and Risk Factors?
Understanding male hypogonadism low testosterone aging men treatment is important for seniors and their caregivers. causes of male hypogonadism include:
- Certain medicines, including glucocorticoids, ketoconazole, chemotherapy, and opioid pain medicines
-
Diseases that affect the testicle, including
hemochromatosis
,
mumps
,
orchitis
,
testicular cancer
,
testicular torsion
, and
varicocele
- Injury or trauma to the testicles
- Obesity
-
Genetic diseases, such as
Klinefelter syndrome
or
Prader-Willi syndrome
-
Other diseases, such as
cystic fibrosis
The following can increase the risk of male hypogonadism:
-
Activities that cause constant, low-level injury to the
scrotum
, such as riding a motorcycle or bicycle
-
Frequent or heavy use of
marijuana
-
Undescended testicles
at birth
What Are the Symptoms and Warning Signs?
Symptoms depend on the age when male hypogonadism develops, either before or after puberty.
Symptoms may include:
-
Enlarged breasts
(gynecomastia)
-
Infertility
- Less height increase than expected
- Loss of muscle mass
- Lack of sex drive (libido)
- Loss of armpit and pubic hair
- Slow development or lack of secondary male sex characteristics (hair growth, scrotum enlargement, penis enlargement, voice changes)
Men may also notice they do not need to shave as often.
📖 What Are Exams and Tests?
What Are Exams and Tests?
A physical exam may show:
- Genitals that do not clearly look either male or female (usually found during infancy)
- Abnormally small, firm testicles
- Tumor or an abnormal mass in the testicle or the scrotum
Other tests may show low bone mineral density and fractures. Blood tests may show a low level of
testosterone
and high levels of prolactin, follicle-stimulating hormone (
FSH
), and luteinizing hormone (
LH
). These hormone levels determine if the hypogonadism is primary or secondary (due to a pituitary gland problem).
If your concern is fertility, your health care provider may also order a
semen analysis
to examine the number of healthy sperm you are producing.
Sometimes, an ultrasound of the testes will be ordered.
Hypogonadism may be hard to diagnose in older men because testosterone level normally decreases slowly with age.
Hypogonadism also may be hard to diagnose in obese men. This is because obesity lowers a carrier molecule for testosterone called sex hormone binding globulin (SHBG). The free testosterone level in the blood is usually normal in obese men who do not have hypogonadism.
📖 How Is It Treated?
How Is It Treated?
Male hormone supplements may treat some forms of hypogonadism. This treatment is called testosterone replacement therapy (TRT). TRT can be given as a gel, patch, injection, or implant.
Avoiding the medicine or activity that is causing the problem may bring testicle function back to normal.
📖 What Is Outlook (Prognosis)?
What Is Outlook (Prognosis)?
Many forms of male hypogonadism cannot be reversed. TRT can help reverse symptoms, although it may not restore fertility.
Men who are having chemotherapy that can cause hypogonadism should discuss freezing sperm samples before starting treatment.
📖 What Are Possible Complications?
What Are Possible Complications?
Male hypogonadism that begins before puberty will stop normal body growth. It can prevent adult male characteristics (such as deep voice and beard) from developing. This can be treated with TRT.
Men who take TRT need to be carefully monitored by their provider. TRT may cause the following:
-
Enlarged prostate
, leading to difficulty urinating
-
Blood clots
- Changes in sleep and mood
- Changes in good cholesterol (HDL)
- Blood becomes too thick (polycythemia)
📖 When to Contact a Medical Professional?
When to Contact a Medical Professional?
Contact your provider if you have symptoms of hypogonadism.
Also, contact your provider if you’re on TRT and you think you’re having side effects from the treatment.
📖 How Is It Prevented?
How Is It Prevented?
Avoid higher-risk activities if possible.
Remain active and prevent weight gain as you get older.
Primary hypogonadism – male; Testicular hypofunction
-
Male reproductive anatomy
Matsumoto AM, Anawalt BD. Testicular disorders. In: Melmed S, Auchus RJ, Goldfine AB, Rosen CJ, Kopp PA, eds.
Williams Textbook of Endocrinology
. 15th ed. Philadelphia, PA: Elsevier; 2025:chap 17.
Schlegel PN. Clinical management of male infertility. In: Robertson RP, ed.
DeGroot’s Endocrinology
. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 113.
Swerdloff RS, Wang C. The testis and male hypogonadism, infertility, and sexual dysfunction. In: Goldman L, Cooney KA, eds.
Goldman-Cecil Medicine
. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 216.
US Food and Drug Administration website. FDA drug safety communication: FDA cautions about using testosterone products for low testosterone due to aging; requires labeling change to inform of possible increased risk of heart attack and stroke with use.
www.fda.gov/drugs/drug-alerts-and-statements/fda-issues-class-wide-labeling-changes-testosterone-products
. Updated February 28, 2025. Accessed April 13, 2026.
Updated by: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
-
Testicular Disorders
Frequently Asked Questions
Key Takeaways
Male hormone supplements may treat some forms of hypogonadism.
What Are the Common Causes and Risk Factors?
Certain medicines, including glucocorticoids, ketoconazole, chemotherapy, and opioid pain medicines
Diseases that affect the testicle, including
hemochromatosis
,
mumps
,
orchitis
,
testicular cancer
,
testicular torsion
, and
varicocele
Injury or trauma to the testicles
Obesity
Genetic diseases, such as
Klinefelter syndrome
or
Prader-Willi syndrome
Other diseases, such as
cystic fibrosis
The following can increase the risk of male hypogonadism:
Activities that cause constant, low-level injury to the
scrotum
, such as riding a motorcycle or bicycle
Frequent or heavy use of
marijuana
Undescended testicles
at birth
What Are the Symptoms and Warning Signs?
Enlarged breasts
(gynecomastia)
Infertility
Less height increase than expected
Loss of muscle mass
Lack of sex drive (libido)
Loss of armpit and pubic hair
Slow development or lack of secondary male sex characteristics (hair growth, scrotum enlargement, penis enlargement, voice changes)
Men may also notice they do not need to shave as often. 📖 What Are Exams and Tests?
What Are Exams and Tests?
Genitals that do not clearly look either male or female (usually found during infancy)
Abnormally small, firm testicles
Tumor or an abnormal mass in the testicle or the scrotum
Other tests may show low bone mineral density and fractures. Blood tests may show a low level of
testosterone
and high levels of prolactin, follicle-stimulating hormone (
FSH
), and luteinizing hormone (
LH
). These hormone levels determine if the hypogonadism is primary or secondary (due to a pituitary gland problem).
How Is It Treated?
About the Author: This article was researched and written by the SilverWell Hub editorial team. It was medically reviewed by Dr. Sarah Mitchell, MD, Geriatrics.
Sources: This article is adapted from MedlinePlus, a service of the National Library of Medicine.
Disclaimer: This information is for educational purposes only. See our full Medical Disclaimer.
Published: July 24, 2026 | Next review: January 2027
