Causes & Symptoms of Low Testosterone
Understanding Low Testosterone: Causes, Symptoms & Solutions
Low testosterone, also known as hypogonadism, can occur for many reasons. For some men, the issue is present from birth, while others develop it later in life due to health conditions, lifestyle factors, or the natural ageing process. Whatever the cause, testosterone deficiency can have a profound effect on energy, mood, sexual health, and overall well-being.
At Urban TRT Gibraltar, we take time during your initial consultation to explore the possible reasons behind your low testosterone. Understanding the cause helps us build a personalised treatment plan that not only restores your hormone balance but also supports your long-term health.
Whether you are in your 20s or your 60s, low testosterone can affect you. Younger men may notice signs like erectile dysfunction, fatigue, depression, or difficulty concentrating, while older men often report reduced strength, weight gain, and lower libido.
If you’ve experienced several of the symptoms outlined below, it could mean your testosterone levels are below where they should be. The only way to confirm this is with a simple blood test. At Urban TRT Gibraltar, we provide convenient and fast results.
From there, our doctors will assess your hormone profile and discuss whether testosterone replacement therapy is right for you. With the right treatment, many men find they feel like themselves again — stronger, more focused, and more energised.
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Primary Hypogonadism
Primary hypogonadism occurs when the testes are unable to produce enough testosterone, even though the body is signalling them to do so. This type of deficiency is usually linked to inherited conditions, physical injury, or direct damage to the testes.
Some inherited causes include:
- Testicles have not descended– when the testes fail to move into the scrotum before birth.
- Klinefelter’s syndrome – a genetic disorder where a man is born with an extra X chromosome (XXY).
- Excess iron in the blood – also known as Hemochromatosis, this can damage the testes and hormone-regulating glands.
Other causes may develop later in life, such as:
- Testes trauma – serious injury affecting both testicles can disrupt hormone production.
- Cancer treatments – chemotherapy or radiotherapy can affect testicular function.
- Infection from Mumps – if it occurs after puberty, mumps can damage the testes, lowering testosterone and fertility.
Men with primary hypogonadism often require TRT to restore normal hormone levels, as the testes are unable to recover full function on their own.
Secondary Hypogonadism
Secondary hypogonadism arises when the problem lies not in the testes but in the brain — specifically the hypothalamus or pituitary gland, which regulate testosterone production.
Possible causes include:
- Pituitary disorders – sometimes caused by tumours, kidney failure, or certain medications.
- Inflammatory diseases – such as sarcoidosis or tuberculosis, which can damage hormone-regulating glands.
- Kallmann syndrome – a rare genetic condition affecting the hypothalamus.
- HIV/AIDS – which can disrupt hormone production throughout the body.
Lifestyle and environmental factors also play a role, including:
- Ageing – natural hormone decline with age.
- Obesity – excess fat can interfere with hormone regulation.
- Chronic stress or illness – which can temporarily suppress testosterone.
- Medications – including long-term steroid or opioid use.
In many cases, addressing the underlying issue alongside TRT can improve both testosterone levels and overall health.
Mixed Hypogonadism
Some men experience a combination of both primary and secondary causes, known as mixed hypogonadism. This is more common in older men but can also occur in those with long-term medical conditions or who are undergoing certain treatments.
For example, mixed hypogonadism can be seen in men with:
- Chronic alcohol misuse
- Glucocorticoid therapy (medications used to suppress the immune system)
- Blood disorders such as sickle-cell disease or thalassemia
Because this type of low testosterone is multi-layered, treatment requires careful management. At Urban TRT Gibraltar, our doctors take a holistic approach to ensure your therapy addresses both the hormonal imbalance and any contributing health issues.
The Physical Symptoms of Low Testosterone
When testosterone levels drop below a healthy range, the body begins to show physical changes. Common signs include:
- Constant tiredness and reduced stamina
- Loss of muscle mass and strength
- Increased body fat, particularly around the abdomen
- Thinning or loss of body, facial, or scalp hair
- Reduced bone density, sometimes leading to osteoporosis or fractures
- Shrinking testes or reduced sperm production
These physical symptoms often build up gradually, making them easy to overlook. Many men attribute them to ageing, but in reality, they may be the result of a hormone deficiency that can be corrected.
Sexual, Emotional & Cognitive Symptoms of Low Testosterone
Low testosterone doesn’t just affect the body — it has a strong impact on sexual health and emotional well-being. Many men experience:
- Low libido and reduced sexual desire
- Erectile dysfunction, including fewer morning erections
- Infertility, due to low sperm production
- Depression and anxiety, often accompanied by irritability
- Low confidence or motivation, making it harder to feel driven at work or in personal life
- Brain fog and poor concentration, which can affect memory and focus
Together, these symptoms can take a significant toll on relationships, career performance, and quality of life. At our Gibraltar TRT clinic, our doctors and clinicians recognise the emotional as well as the physical impact of low testosterone and provide comprehensive support.
FAQs About Low Testosterone Levels
What are the main causes of low testosterone?
«Low testosterone can result from a variety of factors, including genetic conditions, testicular injury, illness, ageing, obesity, medication use, or hormonal imbalances in the brain. Our doctors at Urban TRT Gibraltar can help identify the underlying cause through thorough testing and consultation.
What is primary hypogonadism?
«Primary hypogonadism happens when the testes cannot produce enough testosterone, even though the body is signalling them to. This may be due to inherited conditions like Klinefelter’s syndrome, undescended testicles, or testicular damage from injury, infection, or cancer treatment.
What is secondary hypogonadism?
«Secondary hypogonadism occurs when the brain — specifically the hypothalamus or pituitary gland — fails to signal the testes to produce testosterone. Causes can include pituitary tumours, inflammatory diseases, chronic illness, obesity, or long-term medication use.
Can lifestyle factors cause low testosterone?
«Yes. Obesity, poor diet, chronic stress, excessive alcohol intake, smoking, steroid misuse, and lack of sleep can all contribute to reduced testosterone production. These factors often make existing hormonal decline worse.
Can young men have low testosterone too?
«While testosterone naturally declines with age, younger men can experience low levels due to genetic conditions, testicular injury, or lifestyle-related factors. Symptoms such as fatigue, erectile dysfunction, low libido, and mood changes should not be ignored, regardless of age.
Will I always have low testosterone levels?
«Some causes, such as stress, obesity, or certain medications, may lead to temporary testosterone suppression that can improve with lifestyle changes or medical adjustments. Other causes, such as genetic conditions or testicular damage, often require long-term treatment like TRT.
Can illnesses or medical treatments affect testosterone levels?
«Yes. Chronic illnesses such as diabetes, kidney disease, or thyroid disorders can impact testosterone production. Cancer treatments like chemotherapy and radiotherapy, as well as infections such as mumps, can also cause lasting testicular damage.
How can Urban TRT Gibraltar help me?
«At Urban TRT Gibraltar, we start with a detailed assessment of your hormone levels using blood testing. Our doctors then explore potential causes of your low testosterone and create a treatment plan tailored to your needs. Whether your deficiency stems from genetics, lifestyle, or ageing, we provide safe, effective testosterone replacement therapy and ongoing support to help you regain energy, vitality, and confidence.