Testosterone Deficiency: How to Know and What to Do

Although often associated with older men, testosterone deficiency is a condition that can also affect women. While aging does play a role in testosterone decline, a deficiency in the level of this hormone can occur at any age. 

What is testosterone deficiency?

The testosterone deficiency definition is as follows: having low levels of testosterone (also referred to as Low T, hypogonadism, andropause). 

Testosterone is a hormone vital to men and women. However, as the primary male sex hormone, men do have significantly higher levels of testosterone than women. That does not make it any less of a necessary hormone for females. Because of the considerably lower levels, testosterone deficiency effects in women are more sensitive to even slight changes. That is why menopause brings on such rapid symptoms, whereas, in andropause, the effects occur slowly, over many years. 

Testosterone levels peak during puberty in males and then begin to decline before age thirty at a rate of about 1 to 2 percent each year after that. For women, hormone levels fluctuate considerably each month during the menstrual cycle. Then, with menopausal onset, the decline occurs rapidly.

Because testosterone is a precursor hormone to estrogen through its conversion by the enzyme aromatase into estradiol, maintaining a healthy supply is crucial for the body’s bones, muscles, sexual functions, heart, circulation, and brain functions. 

*Testosterone deficiency is a condition that can affect men and women at any age, although it occurs most often in middle age and older individuals.

Causes of Testosterone Deficiency in Men and Women

It is not always easy to pinpoint a specific reason for a testosterone deficiency diagnosis. For many people, it is a natural aspect of aging. While testosterone levels do decline with age, most men and women will find that their bodies adjust. However, that is not always the case, especially when underlying factors or a rapid decline (such as surgical menopause, injuries, or tumors) speed the process. 

The following testosterone deficiency causes in men contribute to low testosterone symptoms:

- Testicular tumor or injury

- Tumor of the hypothalamus or pituitary gland

- Treatment for a tumor or cancer

- Klinefelter syndrome

- Certain types of autoimmune disease

- Mumps orchitis

- Excess iron in the blood (hemochromatosis)

- Kallmann’s syndrome


- Opioids and certain medications

- Inflammatory diseases such as tuberculosis, sarcoidosis, and histiocytosis 

- Obesity 

The most common testosterone deficiency female causes are:

- Oophorectomy (surgical removal of the ovaries)

- Oral estrogen use

- Early menopause

- Adrenal insufficiency (the adrenal glands also produce some testosterone)

- Tumor in the ovaries, hypothalamus, or pituitary gland (and treatment of such)

Testosterone Deficiency Symptoms in Men and Women 

The signs of a testosterone deficiency are very similar in men and women. The most common differences are those that are gender-specific. For example, testosterone deficiency in women can lead to vaginal dryness, whereas men will often experience erectile dysfunction or the loss of their morning erections. Both genders typically report low sex drive, sexual dissatisfaction, and reduced sexual thoughts, fantasies, and orgasm intensity. 

While testosterone deficiency in men and women can lead to infertility in child-bearing years, Low T treatment only helps females improve fertility rates. For men, exogenous testosterone does not enter the testes, so it can further lower sperm count. That is why discussing this topic with a hormone specialist is crucial before beginning treatment if conception is a goal. Other medications, such as clomid or HCG, can help increase testosterone production. 

The most common testosterone deficiency symptoms in men and women include:

- Lack of sleep

- Reduced energy and endurance

- Weight gain (especially abdominal)

- Muscle and bone loss

- Joint pains and stiffness

- Depression

- Mood swings

- Increased stress and anxiety

- Thinning or loss of hair

- Reduced results from exercise

- Slow exercise recovery

- Lack of focus

- Impaired cognitive functions and memory

- Trouble making decisions

- Decreased drive and motivation

- Reduced productivity

- Social isolation 

- High total and LDL cholesterol and triglyceride levels

- Anemia 

- Low libido

Diagnosing Testosterone Deficiency

A testosterone deficiency diagnosis requires two primary factors: symptoms of the decline and validating blood test results. An absence of either of these factors means that a person does not have Low T. Without symptoms, a person does not need to worry or have testosterone levels checked. 

Determining if low testosterone levels are present requires measurement of free and total testosterone levels in the bloodstream. Free testosterone is the amount of the hormone that is not attached to a protein for transport through the blood and is readily available to bind with androgen receptors throughout the body. Total testosterone is all the testosterone in the body – that which is free and the testosterone bound to either sex hormone-binding globulin (SHBG) or albumin for transport.

The testosterone deficiency blood test will let the doctor know if there is a problem with testosterone production or usage in the body. 

A physical examination is also necessary to help rule out other health issues. The hormone specialist will also review the individual’s medical history to determine any underlying contributors to testosterone hormone production changes. 

Testosterone Deficiency Treatment Options

Upon diagnosing testosterone deficiency, the doctor will determine the appropriate course of treatment for each person. Treatment for a testosterone deficiency is customized based on need, level of hormonal decline, gender, body composition, symptom severity, age, and health. 

Testosterone deficiency medication comes in many forms, including patches, gels, creams, injections, pellets, and transbuccal tablets. 

Our hormone doctors have years of experience treating men and women for low testosterone levels. Through their extensive research and the results of our clients, they have determined the following testosterone deficiency best treatment options:

- Men: testosterone cypionate and testosterone enanthate injections

- Women: compounded testosterone cream

Not only are these the most effective treatment options for Low T, but they are also the most economical forms of boosting testosterone levels. 

What to Know About Getting Testosterone Deficiency Treatment

Current testosterone deficiency guidelines allow doctors to assess each person individually, often making judgment calls when testosterone blood test results are borderline. Hormone doctors utilize both symptoms and testosterone blood levels when prescribing treatment.

Testosterone deficiency treatment should always be customized to the individual’s needs for the best results. Clinics that offer one price for all type of treatment are not personalizing the hormone therapy. Dosage requirements do alter the cost of testosterone therapy.

Here at our hormone therapy clinic, each person receives a customized treatment protocol designed to supplement what their body requires. We begin with a free consultation by phone with one of our medical advisors to assess your situation and symptoms before ordering blood tests. Contact us today for your free consultation. We are here to help.