When masculine energy and drive disappear
Testosterone deficiency (medically known as hypogonadism or testosterone deficiency) is present when symptoms and insufficient testosterone production result in an actual impairment of health. The male sex hormone testosterone influences not only libido and muscle growth, but also energy, metabolism, mood, concentration, and bone density. When testosterone levels drop (due to age, stress, being overweight, sleep disorders, etc.), both body and mind suffer, often without any apparent reason.
Studies indicate that approximately 10–40% of men have a significant testosterone deficiency. Crucially, symptoms and a measurably low testosterone level, despite correct measurement (ideally at least twice in the morning), confirm the diagnosis. As a rule of thumb, values below 12.1 nmol/l suggest a condition requiring treatment.
Typical symptoms: More than just loss of libido
Early warning signs of testosterone deficiency are often subtle, but are becoming increasingly relevant:
- Significantly reduced libido , decreasing spontaneous or morning erections
- Fatigue, lack of energy, frequent midday slump, general lack of motivation
- Muscle loss, slowed training progress, increase in visceral fat
- Concentration difficulties, declining cognitive performance ("brain fog")
- Mood swings, depressive moods or irritability
- Cold sensitivity, reduced bone density
Additional changes may include reduced body hair, gynecomastia, or fertility problems .
Causes: Why does testosterone decrease?
Testosterone deficiency often develops gradually, but frequently in combination with other factors:
Primary (directly into the testicles)
- Age-related functional decline
- Previous testicular injuries, undescended testicles, varicocele, infections
- Radiotherapy/chemotherapy, genetic causes
Secondary (central hormonal axis affected)
- Pituitary or hypothalamic dysfunction
- Chronic stress or cortisol dominance
- Overtraining, severe sleep deprivation, high mental stress
- Metabolic syndrome, insulin resistance, high SHBG levels
Diagnostics: The path to clarity
Step 1 - Blood tests in the morning
Two tests on separate days between 7 and 10 a.m. are essential. Values below 12.1 nmol/l should be investigated further.
Step 2 - Consider symptoms and lab results together
Lab results alone are not conclusive without symptoms. A diagnosis is only made when both factors are consistent.
Step 3 - Additional Values
- SHBG (for determining free testosterone levels), LH/FSH, estradiol, prolactin
- Possibly thyroid values (TSH), hematocrit, PSA, lipid profile
Step 4 - Investigating the causes
Primary vs. secondary hypogonadism, possible metabolic and psychological influencing factors.
Treatment options
Once the diagnosis is confirmed, a tailored therapy is recommended depending on the cause:
Lifestyle interventions
Weight loss, sufficient sleep, stress management, regular exercise and a ketogenic or protein-rich diet can often noticeably improve testosterone levels.
Replacement therapy via the TRT check
With the premium testosterone test from Adon Health, you receive a complete hormone profile and, if needed, a medical interpretation. If a deficiency is diagnosed, medically supervised testosterone replacement therapy (TRT) can be started.
Medical therapy
- Testosterone enanthate by injection
- Testosterone gel for daily transdermal application
- Nebido or pellets for long-term storage needs
All forms should be accompanied by regular check-ups, such as laboratory tests every 3 months , PSA level, hematocrit, and evaluation of treatment success/side effects.
Long-term studies show that well-managed TRT does not increase the risk of heart attack or stroke , and may even reduce mortality in older men.
Conclusion
Testosterone deficiency is more than just a hormonal symptom; it affects energy levels, sexuality, metabolism, and quality of life. Diagnosis requires thorough blood tests and an assessment of symptoms. Anyone experiencing significant distress should have their hormone levels checked, for example, with the Premium Testosterone Test from Adon Health . If a deficiency is confirmed, well-monitored testosterone replacement therapy (TRT) can significantly improve quality of life, both physically and mentally.
With supplementary podcasts and blog posts at Adon Health, you receive background knowledge, practical guidance and medical safety, ideal for a conscious and informed path to hormonal balance.
