Men’s Health Conditions

Low Testosterone

Your questions answered on low testosterone in men. Including info about what levels are normal, signs of low testosterone and tips for prevention.

Medically reviewed by:

Dr. Larry Goldenberg
Dr. Larry Goldenberg


Dr. Ryan Flannigan
Dr. Ryan Flannigan

MD, B.Sc.

Low Testosterone

Testosterone production in men begins to decline in middle age, with significantly low levels present in up to 20% of all men over age 70. Low levels may affect as many as 7% of younger men as well.

What is low testosterone?

Testosterone is the main male hormone (“androgen”) responsible for development and maintenance of male characteristics and sperm production. Low testosterone is diagnosed through a combination of blood testing and related symptoms. In Canadian labs, the normal testosterone range is between 8.5 – 29.5 units.

If your body is not producing enough testosterone, it can lead to a decrease in energy, sex drive, strength and many other symptoms.

Low testosterone may also be referred to as testosterone deficiency or hypogonadism.

Signs & Symptoms

The signs and symptoms of low testosterone can be broad and overlap with many other medical conditions. Some men do not show any symptoms.

The most common symptoms are:

Decrease in:

  • Energy and/or mood
  • Exercise tolerance
  • Ability to develop muscle
  • Ability to lose fat tissue
  • Concentration and/or memory
  • Sex drive or libido
  • Strength
  • Increase in body weight or fat
  • Absence of morning or nighttime erections

In very low cases:

  • Hot flashes
  • Decrease in body hair (distribution or growth)

Risk Factors

There are many potential causes of low testosterone, however it can also occur without explanation.

Testosterone naturally decreases with age. Men in their 70s or older have a higher chance of developing it than men in their 40s or younger.

There are many other possible causative factors, including:

  • Trauma or injuries to the testicles
  • Infection to the testicles called orchitis
  • Chemotherapy
  • Alcohol abuse
  • Obesity or being overweight
  • Obstructive sleep apnea
  • Poor sleep or shift work
  • Some medications
  • Some chronic medical conditions such as type 2 diabetes, kidney dysfunction, cirrhosis of the liver, HIV/AIDs.

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Low testosterone is diagnosed by a physician through a blood test and a review of symptoms. The actual lab number that represents “normal” covers a large range, and so must be linked to the presence/absence of symptoms when considering if treatment is required.

Additional tests may be required to help determine the cause of low testosterone.


Get Active

Exercise can help improve and maintain the natural production of testosterone. An increase in muscle and a decrease in body fat and overall weight helps you maintain normal levels. Aim to work your way up to 30 minutes of resistance training three times per week.

Eat Healthier

Eating an anti-inflammatory diet and maintaining a healthy body weight are important for the production of testosterone. Aim for less ultra-processed foods like cakes, cookies and chips, and add in more vegetables, fruits, lean proteins and whole grains.

Sleep Better

Getting a regular, good night’s sleep can help prevent low testosterone and has been associated with better testosterone production. Aim for 7-9 hours of sleep per night.

Drink Less

Drinking heavy amounts of alcohol has been associated with lower testosterone production. Review Canada’s alcohol guidelines for the latest recommendations on consumption.


If you have modestly low testosterone, a healthy lifestyle that includes regular exercise, good sleep, and a healthy diet is recommended to promote natural testosterone production and to maintain healthy body weight.

If testosterone levels are still quite low even with healthy lifestyle changes, treatment may be recommended based on your general sense of well-being and your sexual and fertility goals.

Testosterone therapy is typically lifelong. It will likely stop sperm production and therefore is not administered to men trying to start a family. Some patients can also experience acne or oily skin, or male pattern hair loss.

Testosterone treatment may be provided in the form of medications, injections, gels or pellets. Any treatment needs to be carefully monitored. If testosterone levels get too high, it can cause your blood to thicken, putting you at risk for further complications.

Frequently Asked Questions

There are no medically recommended over-the-counter treatments for low testosterone.

Yes. Testosterone therapy will typically stop sperm production and is not recommended for men with desired fertility. There are drugs available that may stimulate testosterone production with minimal impact on sperm production.

No. In a vasectomy, the tubes transporting sperm are cut and blocked, which doesn’t impact testosterone levels. Testosterone is made inside the testicles and distributed into the blood.

Low testosterone is usually associated with a lower sex drive, and less so with erectile dysfunction. Only a very small amount of testosterone is needed to get an erection. Men who don’t respond to treatment for ED and have low testosterone may be candidates for testosterone therapy as a means to improve erectile function

Yes. Even though testosterone is incredibly important for sperm production, moderately low levels do not cause low sperm counts. Testosterone drug treatment, however, will shut down sperm production; it is never used when fertility is being considered.

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Last updated: September 15, 2023

Disclaimer: This resource is intended for informational and educational purposes only. It is not intended to provide diagnosis or be a substitute for professional medical advice from a healthcare practitioner. You should not use the information provided for diagnosing or treating a medical or health condition. If you have or suspect you have a medical or health problem, promptly consult your healthcare practitioner.

Medically reviewed by:

Dr. Larry Goldenberg

Dr. Larry Goldenberg, CM, OBC, MD, FRCSC, FACS, FCAHS

Dr. Goldenberg is a urologic surgeon and clinical scientist, who specializes in prostate cancer research and treatment.

More about Dr. Larry Goldenberg
Dr. Ryan Flannigan

Dr. Ryan Flannigan, MD, B.Sc.

Dr. Flannigan is director of the Male Reproductive and Sexual Medicine Research Program in the Department of Urologic Sciences, and fellowship director for Male Reproduction, Medicine and Microsurgery

More about Dr. Ryan Flannigan