If you’re tired, less interested in sex or just not feeling like yourself, testosterone is an obvious thing to wonder about. It’s also easy to jump to. A symptom quiz on your phone can’t tell you whether it’s the answer. A proper assessment can.
Key takeaways
- Low testosterone is diagnosed when symptoms that fit line up with levels that are low on a blood test, and the timing of that test matters.
- Sexual symptoms are the most closely linked. Tiredness on its own is much less specific.
- Treatment improved sexual function in trials, with a smaller effect on energy. Fertility and monitoring are worth raising early.
The diagnosisSymptoms and numbers have to agree
Be honest with your doctor about everything that’s changed, including sleep, weight, alcohol and medicines. You’re not trying to qualify for treatment. You’re trying to find out what’s actually going on.
The bigger pictureWeight is part of the picture
Carrying extra weight is linked to lower testosterone.3 That doesn’t mean every heavier man needs testosterone, or that weight is the only cause. It does mean your doctor should look at your metabolic health alongside the hormone result.
The evidenceWhat treatment has shown
In a large US trial, older men with low testosterone were given testosterone or a dummy gel for a year. Testosterone improved sexual function. Its effect on energy was smaller and didn’t meet the trial’s main target.4
If energy is your main hope, go in with realistic expectations. Which symptom are you trying to change, and when will you check whether it has?
On safety, the biggest trial so far followed over 5,000 men at higher risk of heart disease. Those on testosterone had no more heart attacks or strokes than those on a dummy treatment.5 That’s reassuring, but it applies to men with genuinely low levels on normal medical doses, not to the higher doses some people take for bodybuilding.
Before you startTwo things to raise early
How Oryx helpsAssessment first, then a decision
Our testosterone programme follows this route: the free eligibility check, one morning blood draw covering seven markers, a video consultation with a doctor who reads your results alongside your symptoms, and regular review if you start treatment.
If your results are normal, your doctor will talk you through what else might explain how you feel.
QuestionsFrequently asked questions
How is low testosterone diagnosed?
By two things lining up: symptoms that fit, and levels that are low on a blood test. Testosterone varies through the day, so the test should be taken in the morning.
Can tiredness alone mean low testosterone?
Tiredness on its own is much less specific. The symptoms most closely linked to low testosterone are sexual: a lower sex drive, weaker erections and fewer morning erections.
Will testosterone treatment give me more energy?
In a large trial, testosterone improved sexual function, but its effect on energy was smaller and didn’t meet the trial’s main target. It’s worth going in with realistic expectations.
Does testosterone therapy affect fertility?
Yes. It usually lowers sperm production, so it isn’t recommended if you’re hoping to have children soon.
What monitoring does testosterone therapy need?
Regular blood tests, including a check on your red blood cell count. Your doctor will tell you how often.
Wondering whether testosterone is part of the answer? Start with the free two-minute eligibility check.
The free eligibility check takes two minutes, it’s private, and there’s no obligation. If you’re a good fit, you’ll speak to one of our doctors.
References
- Bhasin S et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2018
- Wu FCW et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med 2010
- Wu FCW et al. Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging Study. J Clin Endocrinol Metab 2008
- Snyder PJ et al. Effects of testosterone treatment in older men. N Engl J Med 2016
- Lincoff AM et al. Cardiovascular safety of testosterone-replacement therapy (TRAVERSE). N Engl J Med 2023
