Testosterone deficiency

The male sex hormone testosterone is mainly produced in the testicles, but some is also produced in the adrenal glands. A complex regulatory mechanism between the hypothalamus in the diencephalon, the pituitary gland, and the testicles control the testosterone balance. Any interference at one level of this axis can lead to endocrine (hormonal) dysfunctions.

It is generally known that testosterone is responsible for the development of male sex characteristics during puberty. It ensures fertility and later the maintenance of male characteristics. It also fulfils many other tasks in the body. For example, it is involved in muscle and bone formation, blood formation, and psyche.

Early signs of testosterone deficiency include reduced libido and listlessness. Later on, erectile dysfunction, depression, anaemia, and weak bones, among other symptoms, can occur.

Low testosterone levels in the blood do not always necessitate treatment. It is important to determine whether typical symptoms of testosterone deficiencies are present before treatment. Contrary to common belief, a high testosterone level has little to do with particularly pronounced masculinity, sexuality, and libido. Therefore, testosterone levels should not be increased without an actual deficiency.

In particular, testosterone deficiency that occurs in old age (senile hypogonadism) is often associated with an unhealthy lifestyle (metabolic syndrome). It has been shown that a healthy lifestyle is at least as important as medication. Regular exercise and a healthy diet aiming for weight reduction play an important role. This can normalise testosterone levels and reduce symptoms of testosterone deficiency. Additional benefits of a healthy lifestyle include a lower cardiovascular risk and the prevention of diseases such as diabetes.
For other causes of testosterone deficiency, diet tends to play a subordinate role.

A comprehensive diagnosis is an important first step. Testosterone is subject to a complex regulatory mechanism between the hypothalamus in the diencephalon, the pituitary gland, and the testicles. A disturbance in any of these can cause a testosterone deficiency. However, genetic causes or disorders of other hormones can also cause testosterone deficiencies. Treatment is usually carried out with medication.

If it has been established that the testosterone deficiency is not caused to a disease that requires treatment, drug therapy can usually be administered. The treatment is precisely tailored to the patient. Testosterone can be injected into the muscle, administered as gel through the skin, or taken as a capsule. Other medications are necessary if the patient wishes to have children.

About this page:


Prof. Dr. med. Sven Lahme
Urology specialist

Medical director of the Goldstadt-Privatklinik.
Specialist for Urology, Mini-PCNL and robot-assisted da Vinci procedures.

Member in Scientific Societies and Reviewer of scientific journals.

Creation Date: 08.03.2020Modification date: 05.02.2024