htpa axis

Signs of Low Testosterone in Men Under 40

shocked manLow testosterone and age

Key points:

  • While “low T” is more common among older men, it can also affect men under 40. Men in their 20’s and 30’s are not immune.
  • Low T can cause erectile dysfunction, muscle loss, weight gain, or other symptoms.
  • You may develop low T from unhealthy lifestyle habits or an underlying medical condition.

When you think of declining levels of testosterone, you might think of middle-aged or older men. But men under 40 can also experience low testosterone, or “low T.”

According to the Mayo Clinic, testosterone levels tend to peak in men during adolescence and early adulthood. Those levels typically decline by about 1-2 percent each year, starting around age 25. But in some cases, you may experience declining testosterone at a younger age.

Low T is a medical condition where your body doesn’t produce enough of the hormone testosterone. Both men and women produce testosterone, but it’s called the “male hormone” because men produce a lot more of it. It’s critical for many male characteristics, including the maturation of male sex organs, sperm development, muscle mass development, voice deepening, and hair growth. Low T can cause a variety of symptoms, including erectile dysfunction, infertility, muscle mass loss, fat gain, and balding.

What causes low T in young men?

Low T is less common among men under 40, but it can still occur.
Contributing factors include:


  • High cholesterol levels
  • High blood pressure
  • Being overweight or obese
  • Inflammation / Less Insulin Sensitive
  • Drinking excessive amounts of alcohol
  • Using illegal drugs
  • Using anabolic steroids
  • Taking certain prescription medications such as steroids and opiates, especially in excess


  • Some cases of low T may be linked to other medical conditions, such as:
  • Hypothalamic or pituitary disease or tumors
  • Injuries, tumors, or other conditions affecting your testicles including inflammation related to childhood mumps
  • Inherited diseases, such as Kallman’s syndrome, Prader-Willi syndrome, Klinefelter syndrome.
  • Diabetes, liver disease or AIDS
  • Cancer treatments such as radiation and chemotherapy


Contemplating good sexWhat should you do if you think you have low T?

If you suspect that you might have low T, make an appointment with your AVN doctor. They can use a simple blood test to determine your testosterone level.

If your doctor finds that your testosterone level is lower than normal, they may order additional tests or do an exam to investigate why. Your treatment plan will depend on your diagnosis and medical history. Your doctor may recommend lifestyle changes, Testosterone Replacement Therapy, or standalone HCG-Clomid Therapy.  If TRT is recommended, the concomitant use of HCG will generally be prescribed the day or two before weekly injections. Generally, AVN Physicians will recommend the Stand Alone protocol and recheck lab results periodically to assess if working; If not then TRT is the solution with HCG being utilized.

CASE for HCG being used while on Testosterone Replacement Therapy:

HCG is used to support testicular production of testosterone in males of childbearing age on TRT. Males even considering fathering children in the future will be prescribed HCG to prevent the natural shutdown of sperm production induced by testosterone (through the negative feedback loop on the HPTA Axis).

Case for HCG to be used in Stand Alone Therapy:

That said, males of childbearing age are often prescribed HCG and or Clomiphene Citrate as a primary therapy outside of TRT. If considering children, the first step is using the (stand-alone approach) in conjunction with lifestyle changes / Diet and Nutritional Changes (drop inflammation and address insulin sensitivity) to attempt to increase T levels naturally.

The purpose is two-fold:

  1. Increase testosterone production via normal mechanisms (testicular production) as opposed to undergoing injections of the bio-identical hormone (with its potential to suppress normal testosterone and sperm production)
  2. Stimulate spermatogenesis (sperm production).

So yes, the usage of HCG in the context of the above is warranted. Other compounds are being studied in conjunction with HCG for improving Spermatogenesis: HMG and FSH (If HCG alone is not enough) in the treatment of infertile men generally due to long duration Steroid Cycles without the use of HCG. Seek a referral from an AVN Health Care Fiduciary Physician if fertility is a concern.



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