Low Testosterone (Low-T) Symptoms, Causes, Treatment – What …

What are the causes of low testosterone?

Low testosterone levels may be caused by a number of factors. For example there may be a problem at the level of the hypothalamus or pituitary to produce appropriate amounts of LH and FSH to stimulate testosterone production. Another possibility is that the organs that make testosterone do not function normally or are not able to respond to stimulation by the brain. Also, as mentioned, changes in SHBG can affect for the amount of testosterone that is available to exert its effects.

Some common causes of primary hypogonadism or failure of the gonads (the medical term for the sex organs, or testes and ovaries) may include the following:

Secondary and tertiary hypogonadism may be due to damage of the hypothalamus or pituitary and/or the failure of the production of hormones (GRH, TSH and/or LH) to stimulate the gonads.

Causes of secondary and tertiary hypogonadism include:

It should be noted that obesity also can be a cause of low testosterone. While it can be associated with other causes, obesity specifically enhances the conversion of testosterone to estrogen. This is a naturally occurring process in both men and women, and this conversion occurs predominantly in fat cells. In the case of obesity, the large amount of fat cells enhances this process, and testosterone levels may fall due to excessive conversion to estrogen.

There are rarer causes of hypogonadism that can occur, dealing with cellular mechanisms and receptor binding. These are beyond the scope of this discussion.

Reviewed by Ruchi Mathur, MD, FRCP(C) on 9/12/2012

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