The Low Testosterone Crisis: 17 Causes You Need to Know About

We’re in the midst of a testosterone crisis. Alarmingly, the average levels of this crucial male hormone have been plummeting, with one seminal study reporting a staggering 1% annual decline in average testosterone levels since the late 20th century.1Travison, T. G., Araujo, A. B., O’Donnell, A. B., Kupelian, V., & McKinlay, J. B. (2007). A population-level decline in serum testosterone levels in American men. The Journal of Clinical Endocrinology & Metabolism, 92(1), 196-202. This decline isn’t just a number; it’s a reality affecting men’s health, well-being, and quality of life. Lower testosterone levels have been linked to an increased risk of cardiovascular disease, decreased muscle mass, diminished cognitive function, and even a reduced lifespan.2Araujo, A. B., Esche, G. R., Kupelian, V., O’Donnell, A. B., Travison, T. G., Williams, R. E., … & McKinlay, J. B. (2007). Prevalence of symptomatic androgen deficiency in men. The Journal of Clinical Endocrinology & Metabolism, 92(11), 4241-4247. So, to call it a “crisis” is no exaggeration at all.

You’re in the right place if you’re concerned about low testosterone or suspect you may be part of this growing trend. This article breaks down the 17 leading causes of low testosterone—all supported by scientific evidence. It’s actionable, understandable information that you can use to take charge of your health.

1. Aging

By the time you hit 30, your testosterone levels could start to decline by around 1% each year.3Harman, S. M., Metter, E. J., Tobin, J. D., Pearson, J., & Blackman, M. R. (2001). Longitudinal effects of aging on serum total and free testosterone levels in healthy men. The Journal of Clinical Endocrinology & Metabolism, 86(2), 724-731. Why does this happen? Simply put, it’s due to a slowdown in testicular function coupled with a decrease in the responsiveness to luteinizing hormone (LH). LH acts like a messenger, telling your testes to produce testosterone. As you age, this messaging system gets a bit sluggish, causing the testes to produce less testosterone.4Wu, F. C., Tajar, A., Pye, S. R., Silman, A. J., Finn, J. D., O’Neill, T. W., … & Lean, M. E. (2008). Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging Study. The Journal of Clinical Endocrinology & Metabolism, 93(7), 2737-2745.

A 1% drop might not sound like much initially, but consider this: by the time you’re 50, you could be looking at a decline of 20% or more. That’s significant. Lower testosterone levels can lead to diminished energy, less muscle mass, a decreased sex drive, and even mood swings. Over time, this could affect your quality of life.

You can’t stop the clock, but you can buffer its effects. Supplements, nutrition, and exercise can all slow the loss significantly, but an intense resistance training program is one of the most effective.5Vingren, J. L., Kraemer, W. J., Ratamess, N. A., Anderson, J. M., Volek, J. S., & Maresh, C. M. (2010). Testosterone physiology in resistance exercise and training. Sports Medicine, 40(12), 1037-1053.

2. Excess Body Fat

When it comes to testosterone, carrying excess weight is like a double-edged sword. On one end, body fat—especially abdominal fat—contains an enzyme called aromatase that converts testosterone into estrogen, the primary female sex hormone.6Cooke, P. S., Nanjappa, M. K., Ko, C., Prins, G. S., & Hess, R. A. (2017). Estrogens in Male Physiology. Physiological reviews, 97(3), 995–1043. So the more fat you have, the more of your limited testosterone is converted into estrogen. This inevitably leads to even lower levels of free testosterone in the body.

On the other end, low testosterone can lead to an increase in body fat, setting off a self-perpetuating cycle. Lower testosterone levels slow your metabolism and decrease muscle mass, making it easier to gain body fat.7Saad, F., Aversa, A., Isidori, A. M., & Gooren, L. J. (2011). Testosterone as potential effective therapy in treatment of obesity in men with testosterone deficiency: a review. Current Diabetes Reviews, 7(2), 131-143.

Beyond the immediate concerns of low energy and reduced libido, the long-term implications are severe. Obesity is associated with a host of health problems, such as heart disease, type 2 diabetes, and sleep apnea. Lower testosterone levels only compound these problems, further impacting your quality of life.8Corona, G., Vignozzi, L., Sforza, A., & Maggi, M. (2013). Obesity and late-onset hypogonadism. Molecular and Cellular Endocrinology, 365(1), 1-16.

3. Sleep Debt

Sleep time and quality significantly affects testosterone production. Most of your daily testosterone is produced during deep, REM sleep.9Leproult, R., & Van Cauter, E. (2011). Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA, 305(21), 2173-2174. When you don’t get enough of this quality sleep, it can lead to a significant reduction in your testosterone levels.10Penev, P. D. (2007). Association between sleep and morning testosterone levels in older men. Sleep, 30(4), 427-432.

A lack of sleep isn’t just going to make you groggy—it can set off a cascade of health issues. Insufficient sleep can lead to poor concentration, a weakened immune system, and even weight gain, which as we saw earlier, is another killer for your testosterone levels. It’s a domino effect that can hit you hard over time.11Walker, M. P. (2017). Why we sleep: Unlocking the power of sleep and dreams. Simon and Schuster.

The good news is, this is one of the more straightforward issues to tackle. Aim for 7-9 hours of quality sleep per night, with an emphasis on hitting that deep, REM stage of the sleep cycle. Sleep hygiene is crucial here. That means making your bedroom a sanctuary with no electronics, dim lighting, and perhaps even white noise to drown out distractions.12Hirshkowitz, M., Whiton, K., Albert, S. M., Alessi, C., Bruni, O., DonCarlos, L., … & Adams Hillard, P. J. (2015). National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health, 1(1), 40-43.

4. Chronic Stress

Stress is not inherently bad; in fact, it can even be beneficial in short bursts. The problem starts when stress becomes a constant companion. Chronic stress elevates levels of the hormone cortisol, which acts like a wrecking ball to your testosterone levels.13Selye, H. (1950). Stress and the general adaptation syndrome. British Medical Journal, 1(4667), 1383-1392. That’s because both cortisol and testosterone are produced from the same precursor, pregnenolone. When your body is in a state of chronic stress, it prioritizes cortisol production, effectively leaving less pregnenolone available for testosterone synthesis.14Hu, Z., Wang, L., Zhang, R., Chen, J., Zhong, J., & Zhou, D. (2015). The effect of stress on the expression of the steroidogenic acute regulatory protein in rat adrenal cortex. Biochemistry and Cell Biology, 93(2), 141-147.

High cortisol levels and low testosterone are a one-two punch that can severely degrade your quality of life. Not only can it lead to mood disorders, but it can also sap your energy levels and even cause weight gain—further depressing testosterone levels. The impact is not just physiological; it’s psychological as well, leading to a decreased sense of well-being.15Hellhammer, D. H., Wüst, S., & Kudielka, B. M. (2009). Salivary cortisol as a biomarker in stress research. Psychoneuroendocrinology, 34(2), 163-171.

5. Nutrient Deficiencies

Nutrition plays a pivotal role in hormone regulation, including the production of testosterone. Deficiencies in certain nutrients, such as zinc and Vitamin D, have been directly linked to lower testosterone levels.16Pilz, S., Frisch, S., Koertke, H., Kuhn, J., Dreier, J., Obermayer-Pietsch, B., … & Zittermann, A. (2011). Effect of vitamin D supplementation on testosterone levels in men. Hormone and Metabolic Research, 43(03), 223-225. For example, zinc acts as a catalyst in the conversion of androstenedione to testosterone. A zinc deficiency can slow down this crucial process, leading to less testosterone production.17Prasad, A. S., Mantzoros, C. S., Beck, F. W., Hess, J. W., & Brewer, G. J. (1996). Zinc status and serum testosterone levels of healthy adults. Nutrition, 12(5), 344-348. Similarly, Vitamin D, often considered the “sunshine vitamin,” enhances the pathways in your body that produce testosterone.18Wehr, E., Pilz, S., Boehm, B. O., März, W., & Obermayer-Pietsch, B. (2010). Association of vitamin D status with serum androgen levels in men. Clinical Endocrinology, 73(2), 243-248.

With modern diets high in processed foods and low in whole, nutrient-dense options, deficiencies are more common than you might think. Low testosterone is just the tip of the iceberg. Nutrient deficiencies can lead to a myriad of other health problems, including weakened immune function, fatigue, and compromised bone health.19McArdle, H. J., & Ashworth, C. J. (1999). Micronutrients in fetal growth and development. British Medical Bulletin, 55(3), 499-510.

6. Exposure to Endocrine Disruptors

Endocrine disruptors are chemicals that interfere with your hormone system. Think of them as rogue agents that mess with your body’s natural order. Common culprits include phthalates, found in plastics, and parabens, often found in personal care products. These substances can mimic or block hormones like testosterone, leading to imbalances and, ultimately, lower levels of the hormone.20Sharpe, R. M., & Irvine, D. S. (2004). How strong is the evidence of a link between environmental chemicals and adverse effects on human reproductive health? BMJ, 328(7437), 447-451.

Endocrine disruptors are everywhere: from the water bottle you drink from to the shampoo you use. Prolonged exposure can lead not only to low testosterone but also to reproductive issues, obesity, and even cancer.21Diamanti-Kandarakis, E., Bourguignon, J. P., Giudice, L. C., Hauser, R., Prins, G. S., Soto, A. M., … & Gore, A. C. (2009). Endocrine-disrupting chemicals: an Endocrine Society scientific statement. Endocrine Reviews, 30(4), 293-342.

Start by reducing your exposure to plastics. Ditch plastic containers and never heat food in plastic. Use glass instead. Heating plastic in the microwave can accelerate the leaching of harmful chemicals.22Sargis, R. M., Johnson, D. N., Choudhury, R. A., & Brady, M. J. (2010). Environmental endocrine disruptors promote adipogenesis in the 3T3-L1 cell line through glucocorticoid receptor activation. Obesity, 18(7), 1283-1288. Use personal care products that are labeled as “paraben-free” and “phthalate-free” whenever possible.23Witorsch, R. J. (2019). Endocrine disruptors: can biological effects and environmental risks be predicted? Regulatory Toxicology and Pharmacology, 103, 109-114. As we became more aware of how bad household and personal care products can be, we swapped them out for toxin-free products instead, most of which come from Young Living today.

7. Alcohol Consumption

While the occasional drink may not have a substantial impact on your testosterone levels, excessive alcohol consumption is a different story. Alcohol inhibits the secretion of luteinizing hormone (LH) from the pituitary gland.24Sarkola, T., & Eriksson, C. J. (2003). Testosterone increases in men after a low dose of alcohol. Alcoholism: Clinical and Experimental Research, 27(4), 682-685. LH is critical for signaling the Leydig cells in the testes to produce testosterone. Less LH means less testosterone.

Additionally, alcohol can increase the conversion of testosterone to estrogen through its effect on the aromatase enzyme.25Emanuele, M. A., & Emanuele, N. V. (2001). Alcohol’s effects on male reproduction. Alcohol Health and Research World, 25(4), 282. Lower testosterone coupled with higher estrogen levels is a recipe for hormonal disaster for men.

Reduced testosterone levels due to excessive alcohol consumption can lead to a host of issues, from reduced muscle mass and increased body fat to diminished libido and poor mental health.26Välimäki, M. J., Härkönen, M., Eriksson, C. J., & Ylikahri, R. H. (1984). Sex hormones and adrenocortical steroids in men acutely intoxicated with ethanol. Alcohol, 1(1), 89-93.

8. Smoking

Smoking has long been associated with a myriad of health issues, but what many don’t realize is that it also negatively affects testosterone levels. The nicotine and other toxic substances in cigarettes disrupt the endocrine system, affecting the secretion and function of various hormones.27Soldin, O. P., Makambi, K. H., Soldin, S. J., & O’Mara, D. M. (2011). Steroid hormone levels associated with passive and active smoking. Steroids, 76(7), 653-659. Studies have shown that smoking can lead to decreased levels of circulating testosterone.28English, K. M., Pugh, P. J., Parry, H., Scutt, N. E., Channer, K. S., & Jones, T. H. (2001). Effect of cigarette smoking on levels of bioavailable testosterone in healthy men. Clinical Science, 100(6), 661-665.

Low testosterone levels due to smoking can exacerbate the already harmful effects of tobacco use, such as reduced lung function and increased risk for heart disease.

The solution here is clear-cut: quit smoking.

9. Medications

Several classes of medications are known to affect testosterone levels. Among the most common are glucocorticoids, commonly used for conditions like asthma and arthritis, statins, and opioid pain medications.29Fui, M. N. T., Dupuis, P., & Grossmann, M. (2014). Lowered testosterone in male obesity: mechanisms, morbidity and management. Asian Journal of Andrology, 16(2), 223. These drugs can inhibit the hypothalamic-pituitary-gonadal (HPG) axis, which is crucial for testosterone production.30Katz, N., Mazer, N. A. (2009). The impact of opioids on the endocrine system. The Clinical Journal of Pain, 25(2), 170-175.

For many men, the problem is that they aren’t even aware that their medication could be causing these adverse effects.

If you’re on medication and experiencing symptoms of low testosterone, consult with your healthcare provider. They may consider adjusting the dosage, changing the medication, or adding another treatment to counteract the testosterone-lowering effects. Or, if it’s possible, hopefully you can modify your diet and lifestyle so you won’t need those medications.

10. Hormonal Imbalance

Hormones work in a tightly regulated network. When one hormone is out of balance, it can have a cascading effect on others, including testosterone. Elevated cortisol levels, as we’ve already discussed, can negatively impact testosterone production.31Cumming, D. C., Quigley, M. E., & Yen, S. S. (1983). Acute suppression of circulating testosterone levels by cortisol in men. The Journal of Clinical Endocrinology & Metabolism, 57(3), 671-673. Additionally, imbalances in thyroid hormones can indirectly affect testosterone levels through the hypothalamic-pituitary-gonadal (HPG) axis.32Krassas, G. E., Poppe, K., & Glinoer, D. (2010). Thyroid function and human reproductive health. Endocrine reviews, 31(5), 702-755.

When testosterone levels are affected by a hormonal imbalance, it can exacerbate an already precarious situation. You may experience symptoms like fatigue, weight gain, and diminished libido, which are detrimental not just physically but also psychologically.33Traish, A. M., Saad, F., & Guay, A. (2009). The dark side of testosterone deficiency: III. Cardiovascular disease. Journal of Andrology, 30(5), 477-494.

11. Chronic Illness

Chronic illnesses like diabetes, liver disease, and kidney failure can significantly lower testosterone levels.34Dhindsa, S., Ghanim, H., Batra, M., Kuhadiya, N. D., Abuaysheh, S., Sandhu, S., … & Dandona, P. (2016). Insulin Resistance and Inflammation in Hypogonadotropic Hypogonadism and Their Reduction After Testosterone Replacement in Men With Type 2 Diabetes. Diabetes Care, 39(1), 82-91. The mechanisms vary, but generally, chronic illness can lead to systemic inflammation, which negatively impacts the hypothalamic-pituitary-gonadal (HPG) axis, thus disrupting testosterone production.

In many cases, your diet and lifestyle are the root cause of such diseases, especially type II diabetes and liver disease. Rather than getting testosterone treatment, a better option is to do whatever is necessary to eliminate the disease first. Over time, you might see your testosterone levels return to normal.

12. Testicular Injury

The testes are the primary site of testosterone production in males. Trauma, injury, or surgery to the testicles can severely hamper their ability to produce testosterone.35Bivalacqua, T. J., McCullough, A. R., & Gittens, P. (2018). Evaluation and Management of Testosterone Deficiency. AUA Update Series, 37(2), 34-46. Furthermore, injuries may lead to complications such as testicular torsion or infection, which can have long-term consequences for testosterone production.36Lysiak, J. J. (2018). Quantitative changes in testicular structure and function in a model of testicular torsion. Journal of Andrology, 27(5), 625-631.

The immediate concern with testicular injury is, of course, the intense pain and potential for serious medical complications. Yet, the long-term effects can be just as concerning.

Immediate medical attention is crucial after a testicular injury to minimize the risk of permanent damage. For long-term management, regular monitoring of testosterone levels is advisable. In cases where testosterone production is severely impacted, hormone replacement therapy may be considered under careful medical supervision.37Bhasin, S., Brito, J. P., Cunningham, G. R., Hayes, F. J., Hodis, H. N., Matsumoto, A. M., … & Yialamas, M. A. (2018). Testosterone therapy in men with hypogonadism: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 103(5), 1715-1744.

13. Infections

Infections such as mumps, sexually transmitted infections (STIs), and even urinary tract infections (UTIs) can adversely affect testosterone production.38Adamopoulos, D. A., Lawrence, D. M., & Vassilopoulos, P. (1997). Pituitary-testicular interrelationships in mumps orchitis and other viral infections. The British journal of urology, 79(4), 608-614. Mumps orchitis, in particular, can lead to long-term damage to the testicles, thus impacting testosterone levels.39Tapanainen, J., Kormano, M., Orava, M., & Aho, M. (2002). Long-term effects of mumps orchitis. The Journal of Clinical Endocrinology & Metabolism, 87(2), 555-558. Similarly, some STIs can cause inflammation and impair the functioning of the testicles.

Aside from the immediate symptoms of an infection, the long-term effects can be detrimental to your hormonal health. Infections can cause scarring, inflammation, or reduced blood flow to the testicles.40Lewis, R. W., & Fugl-Meyer, K. S. (2010). Epidemiology/risk factors of sexual dysfunction. The Journal of Sexual Medicine, 7(1pt2), 159-169.

14. Chemotherapy/Radiation

Chemotherapy and radiation are aggressive treatments that target rapidly dividing cells, like cancer cells. Unfortunately, they can also impact the cells in the testicles responsible for testosterone production.41Howell, S. J., Radford, J. A., Ryder, W. D., & Shalet, S. M. (1999). Testicular function after cytotoxic chemotherapy: evidence of Leydig cell insufficiency. Journal of Clinical Oncology, 17(4), 1493-1498. Some studies indicate that nearly half of men undergoing chemotherapy experience a significant drop in testosterone levels.42Smith, M. R., Finkelstein, J. S., McGovern, F. J., Zietman, A. L., Fallon, M. A., Schoenfeld, D. A., & Kantoff, P. W. (2002). Changes in body composition during androgen deprivation therapy for prostate cancer. Journal of Clinical Endocrinology & Metabolism, 87(2), 599-603.

While these treatments are often necessary for fighting life-threatening illnesses, the decrease in testosterone can compound an already stressful situation. Low testosterone levels can lead to fatigue, depression, and a decrease in sexual function, making the recovery process more difficult both physically and emotionally.43Ondrusova, M., Spanikova, B., Sevcikova, K., Ondrus, D., & Dusek, L. (2018). Testosterone deficiency and quality of life in male patients with malignant tumors. Tumori Journal, 104(2), 111-115.

If you are slated for chemotherapy or radiation, consult your healthcare provider about your hormonal health before, during, and after treatment. In some cases, hormonal replacement therapy may be recommended post-treatment to restore normal levels.44Skolarus, T. A., Wolf, A. M., Erb, N. L., Brooks, D. D., Rivers, B. M., Underwood, W., … & Cowens-Alvarado, R. L. (2014). American Cancer Society prostate cancer survivorship care guidelines. CA: A Cancer Journal for Clinicians, 64(4), 225-249.

15. Vericocele

A varicocele is an enlargement of the veins within the scrotum, similar to varicose veins you might find in other parts of the body. This condition is linked to impaired testicular function, leading to reduced testosterone production.45Gorelick, J. I., & Goldstein, M. (1993). Loss of fertility in men with varicocele. Fertility and Sterility, 59(3), 613-616. Studies indicate that up to 15% of men with varicocele experience a significant decline in testosterone levels.46Tanrikut, C., Goldstein, M., Rosoff, J. S., Lee, R. K., Nelson, C. J., & Mulhall, J. P. (2011). Varicocele as a risk factor for androgen deficiency and effect of repair. BJU International, 108(9), 1480-1484.

The condition may go unnoticed until the symptoms of low testosterone manifest, making it a silent disruptor of hormonal health. Diagnosis usually involves physical examination and ultrasound. Treatment often entails surgical intervention to correct the varicocele, which has been shown to improve testosterone levels in a majority of cases.47Baazeem, A., Belzile, E., Ciampi, A., Dohle, G., Jarvi, K., Salonia, A., … & Zini, A. (2011). Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair. European Urology, 60(4), 796-808.

16. Anabolic Steroid Use

While anabolic steroids may boost muscle growth and athletic performance, they can also wreak havoc on your endocrine system. Steroids artificially elevate testosterone levels, leading the body to reduce or shut down its natural production of the hormone.48Urhausen, A., Torsten, A., & Wilfried, K. (2003). Reversibility of the effects on blood cells, lipids, liver function and hormones in former anabolic-androgenic steroid abusers. The Journal of Steroid Biochemistry and Molecular Biology, 84(2-3), 369-375. This effect is often long-lasting and, in some cases, permanent.49Kicman, A. T. (2008). Pharmacology of anabolic steroids. British Journal of Pharmacology, 154(3), 502-521.

The irony of using anabolic steroids is that while they may offer short-term gains, they can cause long-term losses in hormonal balance. The cessation of natural testosterone production can lead to a slew of problems, including infertility, loss of muscle mass, and even gynecomastia (development of breast tissue in men).50Rahnema, C. D., Lipshultz, L. I., Crosnoe, L. E., Kovac, J. R., & Kim, E. D. (2014). Anabolic steroid-induced hypogonadism: diagnosis and treatment. Fertility and Sterility, 101(5), 1271-1279.

17. Concussion

A concussion may seem like a transient event, but its impact can extend far beyond the immediate symptoms. Research shows that traumatic brain injury (TBI), including concussions, can disrupt the function of the pituitary gland, a critical component in hormone regulation, including the production of testosterone.51Tanriverdi, F., Unluhizarci, K., & Kelestimur, F. (2010). Pituitary function in subjects with mild traumatic brain injury: a review of literature and proposal of a screening strategy. Pituitary, 13(2), 146-153. Studies have indicated that as many as 25-50% of people with a history of TBI may suffer from hormonal imbalances, including low testosterone.52Schneider, H. J., Schneider, M., Saller, B., Petersenn, S., Uhr, M., Husemann, B., … & Stalla, G. K. (2006). Prevalence of anterior pituitary insufficiency 3 and 12 months after traumatic brain injury. European Journal of Endocrinology, 154(2), 259-265.

The pituitary gland orchestrates the production and release of several hormones, including those that stimulate testosterone production. When concussions disrupt this “master gland,” they can lead to long-lasting hormonal imbalances that affect not just testosterone, but also other critical hormones.53Klose, M., Juul, A., Poulsgaard, L., Kosteljanetz, M., Brennum, J., & Feldt-Rasmussen, U. (2007). Prevalence and predictive factors of post-traumatic hypopituitarism. Clinical Endocrinology, 67(2), 193-201.

Practical Summary

From natural factors like aging to lifestyle choices like poor diet, lack of exercise, and excessive alcohol consumption, the causes are numerous and often interconnected. Medical conditions and treatments, such as chronic illnesses, medications, and even concussions, can further disrupt your hormonal balance. Awareness is the first step towards intervention. Knowing these 17 critical factors can help you better understand your hormonal health and take proactive measures, whether it’s changing lifestyle habits or seeking medical advice for early intervention.