Erectile Dysfunction
Low testosterone: symptoms, how it's properly diagnosed, treatment options, and what to know if you want children.
Written and reviewed by Shervin Badkhshan, MD · Last reviewed
November 2026
Part of:
Erectile dysfunction and implants
Office care
Fellowship-Trained Reconstructive Urology
AT A GLANCE
From symptoms to treatment
1. SYMPTOMS
• Low sex drive • Fatigue and low mood • Weaker erections
2. TESTING
• Two early-morning blood tests • LH, FSH, estradiol, blood count, PSA
Test result guides →
3. TREATMENT
• Treating the cause • Testosterone therapy, monitored • Fertility-sparing options
Surgical options →
Low testosterone (hypogonadism) means the body isn't making enough testosterone. It can cause low sex drive, weaker erections, fatigue, low mood, less muscle, and more body fat. Testosterone falls a little with age, but symptoms plus consistently low levels are what matter.
How I diagnose it
Two early-morning blood tests on different days, because levels vary through the day. I also check free testosterone, LH, FSH, estradiol, prolactin, a blood count, and PSA, which help find the cause and set a baseline before treatment.
First steps
Sleep apnea, weight, alcohol, some medications, and other health problems can lower testosterone. Treating those can raise levels on their own.
Treatment
I prescribe and manage testosterone therapy myself, as gels, injections, or pellets, and choose the form with you. Treatment means ongoing monitoring of your symptoms, testosterone levels, blood count, and PSA.
If you want children
Testosterone therapy lowers sperm production and can cause infertility. If you want children now or later, there are medications that raise your own testosterone without shutting down sperm production. Tell me before starting.
Related
Men's health · Testosterone results explained · Semen analysis explained
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Your results and questions
Your actual test results, visit notes, and messages with your care team are in your patient portal, the same one you use to book visits. Send questions through the portal or call the office at (516) 535-1900. For anything urgent, call the office or go to the nearest emergency room.