What is testosterone imbalance? Symptoms, causes and prevention

Testosterone is an androgen (male sex hormone) that plays a key part in the development of male sexual characteristics. It is mainly produced in the testicles, although females also produce a low amount. As we age, it is normal for testosterone to diminish. However, imbalances such as levels of testosterone that are too high or too low can have repercussions on the body. Low levels of testosterone (hypogonadism) is much more common than high levels of testosterone and can cause problems associated with masculinity and fertility. This guide will explore what testosterone imbalance means, highlighting the causes, symptoms and prevention/treatments available.

What is testosterone imbalance?

The pituitary gland is responsible for producing the correct amount of testosterone needed by the body. Testosterone imbalance refers to too much or too little testosterone being produced and released into the bloodstream.

Although it is normal for hormones to fluctuate as we age, persistent imbalances can have side effects affecting our bodies. Such side effects can affect the bodily functions that testosterone assist with, which include:

  • Libido
  • Bone mass
  • Muscle mass
  • Fat distribution
  • Sperm count
  • Red blood cell production

An imbalance can therefore affect the normal development and function of male characteristics, and can even lead to infertility if untreated.

What are the symptoms of testosterone imbalance?

Testosterone imbalance most commonly takes the form of testosterone deficiency. The symptoms vary depending on age and life cycle. As a general guideline, symptoms may include:

Symptoms of low testosterone
Pre-puberty Late puberty

Voice not deepening

Slowed genital growth

Adult males Decreased body and facial hair growth

Loss of muscle mass

Loss of bone density

Enlarged breasts



Reduced libido

Erectile dysfunction


Older males Fatigue

Decreased libido

Difficulties concentrating

Hot flushes

It is essential to note that such symptoms do not always indicate testosterone imbalance, therefore getting tested for testosterone levels can help rule out this reason. Diminished levels of testosterone can be associated with a medical condition. However, it is perfectly normal to experience the occasional imbalance and have diminished levels of testosterone as we age.

What are the causes of testosterone imbalance?

Hormones can fluctuate in our lifetime and occasional imbalances that occur along our life cycle are perfectly normal, particularly as we age. Testosterone deficiency can also be inherited from our parents, and injuries/trauma can also cause testosterone levels to temporarily be affected.

Low testosterone levels can also be caused by certain medical conditions, therefore low levels should be investigated to establish the root cause. Health conditions can cause primary or secondary testosterone deficiency.

Primary testosterone deficiency

Primary testosterone deficiency refers to low testosterone levels that are caused by the testicles not producing enough testosterone. This can be due to a number of medical conditions, including:

  • Undescended testicles
  • Klinefelter’s syndrome (extra X chromosomes)
  • Mumps orchitis (viral infections)
  • Haemochromatosis (excess iron absorption by the body)
  • Cancer treatment (radiotherapy and chemotherapy)

Secondary testosterone deficiency

Low testosterone levels can also be caused by problems affecting the brain, particularly the parts of the brain responsible for regulating the production of testosterone (pituitary gland and hypothalamus). The medical causes behind secondary testosterone deficiency can include the following:

  • Pituitary gland disorders
  • HIV and AIDS
  • Medications including certain painkillers and hormones.

How to prevent and treat testosterone imbalance


There are no known ways to prevent testosterone deficiency. However, living a healthy lifestyle and adopting certain new habits to cope with the symptoms of testosterone imbalance can help provide some relief. The following lifestyle changes can help:

  • Practice yoga to help relieve the overall symptoms of testosterone imbalance.
  • Lose weight if you are overweight or obese. This can help improve erectile function and improve fertility.
  • Eat a healthy, balanced diet to maintain good general health and aid normal body function.
  • Learn your triggers for hot flashes and avoid them.


Testosterone replacement therapy

Testosterone replacement therapy is the most common treatment for low testosterone levels and simply involves taking testosterone supplements. They are available in several forms including patches, gels, subcutaneous pellets and injections. They can relieve the symptoms of low testosterone in men, and your GP will be able to prescribe the best method for you to provide the necessary amount of the hormone. Your GP will also be able to discuss the effects of testosterone replacement therapy and whether these outweigh the symptoms experienced. Side effects can include prostate and breast enlargement, acne, and an increased red blood cell count.

Other treatments

Serious health conditions affecting the pituitary gland such as tumours will require further treatment such as surgery, chemotherapy and radiotherapy. Other treatments may also be required on top of hormone replacement therapy in order to counteract the most life-altering symptoms such as infertility. In fact, infertility treatments may help improve male fertility.

How can I get tested for testosterone imbalance?

At a clinic

You can opt for our male hormone profile health assessment package, as it assesses your levels of several hormones including testosterone and oestrogen. Our packages consist of in-depth, face-to-face health checks with a Health Assessment Specialist, which you can easily book online at one of over 2,000 mobile clinics available nationwide. You will receive a wide array of other key health markers and a detailed results report sent through the post.

At home

Alternatively, you can opt for our single Testosterone home test kit. All you need to do is order your kit, take your own sample, send it back in our pre-addressed return envelope, and wait to receive your results online within 8 days.