Low Testosterone refers to low levels of the testosterone hormone in the bloodstream. This condition is diagnosed after methodical testing wherein blood and saliva samples are sought from the patient. However, before initiating a treatment, the cause of low testosterone should be established. A cause of low testosterone is further categorized as either a primary or secondary cause.
The primary causes refer to symptoms origination due to problems in the organs primarily responsible for synthesizing testosterone. These conditions are often referred to as hypogonadism, i.e. a state of lowered or impaired testosterone production in the gonads. Among males, this refers to a medical problem in the testicles while in females it refers to impaired testosterone synthesis in the ovaries.
Low Testosterone Causes—Primary Hypogonadism is caused due to:
• Undescended Testicles—this condition is established during fetal development when the testes don’t descend into the scrotal sac, leading to severe lack of testosterone.
• Cancer Treatment—chemotherapy or radiation therapy is known to have many side-effects and this includes harm to the interstitial cells present in the testes that are chiefly responsible for producing testosterone. Ovulation in women can be permanently harmed by radiation therapy.
• Aging—testosterone levels go through a natural process of depletion as the person ages. This is applicable to both men and women.
• Typical Ovarian Conditions—in some women, the surgical removal of ovaries is required to arrest a spreading infection. Some women have a condition called PCOS or Polycystic Ovarian Syndrome or Stein-Leventhal syndrome. This condition is most common in women of childbearing age. This is essentially a state of severe hormonal abnormality that often leads to infertility by causing hormonal imbalance. During PCOS, testosterone levels tend to rise and fall without any specific pattern.
Low Testosterone Causes—Secondary Hypogonadism
If the low testosterone is due to inactivity of other organs involved in testosterone synthesis, the symptoms are referred to as Secondary Hypogonadism. Secondary (or Tertiary) hypogonadism is established when testosterone production in other testosterone-producing areas like the hypothalamus—pituitary pathway or adrenal gland is affected. Pituitary-related hypogonadism is referred to as tertiary hypogonadism though it is often clubbed with secondary causes.
Causes for Secondary Hypogonadism:
• Trauma to the pituitary gland due to tumor or radiation therapy sought for treating tumors.
• Hypothalamus malformations that can be induced by rare conditions like Kallman’s Syndrome.
• Impaired blood flow to the adrenal or pituitary gland due to blood loss induced by an accident.
• Inflammation due to diseases like tuberculosis that are known to impair activity of the pituitary. Similarly, HIV and AIDS can cause inflammation of hypothalamus or pituitary.
• Obesity is known to promote the conversion of free testosterone into female hormones like estrogen.
• Congenital adrenal hyperplasia or adrenal gland atrophy present at the time of birth can impair the testosterone-producing capability of adrenal glands.
• Alcoholism and prostate cancer can induce phases of reduced testosterone production, i.e. as a result of severe illnesses that weaken the entire metabolic activities of an individual.
• Use of addictive substances like barbiturates or anticonvulsant drugs is known to have a detrimental effect on the synthesis of testosterone.