Hormone Imbalance in Men: Signs, Causes and Treatment

Hormone imbalance in men usually means one or more hormones sit outside their normal range, most often testosterone. It can show up as low energy, a lower sex drive, mood changes and shifts in body composition. The only way to know if a hormone is actually low is a blood test ordered and interpreted by a doctor, because everyday symptoms overlap with many other conditions.

This guide explains what a hormone imbalance is, the signs worth paying attention to, what can cause it, how doctors check for it, and the options available if a problem is confirmed.

What is a hormone imbalance in men?

Hormones are chemical messengers that travel in the blood and help control how your body works, from metabolism and mood to sex drive and bone strength. When a hormone is too high or too low for your age and health, the systems it regulates can be affected.

Testosterone is the hormone most people think of, and Healthdirect notes it helps regulate sex drive and bone strength Healthdirect, 2024. It is not the only one that matters. Thyroid hormones, cortisol, insulin and oestrogen all play a part, and a problem in one can influence the others.

Low testosterone specifically is called androgen deficiency, or hypogonadism. Healthy Male reports that androgen deficiency affects between 1 in 20 and 1 in 200 men, so it is not rare, but it is also not the explanation for every tired day Healthy Male, 2024.

Does testosterone naturally decline with age?

Yes, to a degree. Testosterone tends to fall slowly as men get older. The Cleveland Clinic notes that levels can drop by about 1% per year from the late 30s onwards Cleveland Clinic, 2024.

A gradual decline is a normal part of ageing and does not always cause symptoms or need treatment. What is worth checking is a larger or faster drop, or symptoms that interfere with daily life, because those can point to an underlying issue rather than age alone.

What are the signs of low testosterone?

Symptoms vary between individuals, and none of them confirm a diagnosis on their own. The signs doctors and the health services above commonly describe include:

• Persistent tiredness that good sleep does not fix
• Lower sex drive or difficulty getting or keeping an erection
• Loss of muscle mass or strength
• Weight gain, particularly around the middle
• Low mood, irritability or trouble concentrating
• Reduced facial or body hair, and in some cases hot flushes

Because these overlap with stress, poor sleep, depression, thyroid problems and other conditions, they are a reason to get assessed rather than proof of a hormone problem. For a fuller rundown, see our guide to the 12 key symptoms of low testosterone in men over 40.

What causes hormone imbalance in men?

Several things can lower testosterone or disturb other hormones. Understanding the cause matters, because the right response depends on it.

Lifestyle and general health

Carrying excess weight, type 2 diabetes, high stress, poor sleep and a very sedentary routine can all suppress testosterone. Better Health Channel lists obesity and chronic illness among contributing factors, and in many men addressing these improves how they feel Better Health Channel, 2024.

Testicular and pituitary problems

Doctors group causes into primary hypogonadism, where the testes do not produce enough testosterone, and secondary hypogonadism, where the pituitary gland or hypothalamus does not send the right signals. Causes include injury, undescended testes, previous mumps infection, pituitary conditions and some medications Healthdirect, 2024.

Genetic conditions

Klinefelter syndrome is the most common genetic cause of androgen deficiency. Healthy Male notes it goes undiagnosed in up to 75% of men who have it, which is one reason proper testing is important rather than assuming ageing is to blame Healthy Male, 2024.

How is hormone imbalance diagnosed?

Symptom quizzes and online screens can help flag whether testing is worthwhile, but they do not diagnose anything. A doctor makes the diagnosis, and it starts with a blood test.

Testosterone is usually measured in a morning blood sample, often fasting, because levels are highest earlier in the day. Levels also vary day to day, so Healthdirect advises that a low result on one test is confirmed with a second test before any diagnosis is made Healthdirect, 2024. Depending on the results, a doctor may check other hormones such as those from the pituitary gland, along with iron studies and other markers, to work out the cause.

If you use an online assessment, treat it as a first step that helps a doctor decide what to test, not as a result in itself.

What are the treatment options?

If testing confirms a genuine hormone problem, treatment depends on the cause, your health and what a registered doctor assesses is appropriate. Not everyone with symptoms needs or is suitable for medical treatment.

Lifestyle changes

For many men, the first focus is the modifiable factors: losing excess weight, resistance and aerobic exercise, better sleep, reducing alcohol and managing stress. These support healthy hormone levels and general health, and sometimes resolve borderline results without medication. Our guides on lifestyle changes that support testosterone and the link between sleep and testosterone go into more detail.

Testosterone therapy, in context

Testosterone replacement therapy is a recognised medical treatment for confirmed androgen deficiency, delivered as injections, gels, creams or patches. It is prescribed only where a doctor judges it clinically appropriate, and it is monitored over time. Healthdirect notes it is not suitable for everyone, including men with prostate or breast cancer or those trying to conceive, which is why suitability is assessed individually Healthdirect, 2024. Responses vary between individuals.

At Menova Health, our doctors review your symptoms and test results and discuss options through our hormone restoration service. You can also start with an online assessment, which helps our team decide what is worth investigating. It is a good idea to keep your regular GP informed so your care stays joined up.

When should you see a doctor?

Book a check if symptoms such as ongoing fatigue, low libido, erectile difficulties or mood changes are affecting your daily life, or if they came on quickly. A doctor can test for a hormone problem and, importantly, rule out or pick up other conditions with similar symptoms. Getting assessed is sensible rather than urgent, and it gives you an answer either way.

Frequently asked questions

Can hormone imbalance in men be reversed?

It depends on the cause. Imbalances driven by weight, sleep, stress or medication can often improve when those factors are addressed. Others, such as a testicular or genetic cause, may need ongoing medical management. A doctor can explain what is realistic for your situation after testing.

Is low testosterone the same as a hormone imbalance?

Low testosterone is one type of hormone imbalance, and the most common one discussed in men. Other hormones, including thyroid hormones, cortisol and insulin, can also be out of range and cause overlapping symptoms, which is why testing looks beyond testosterone when needed.

What testosterone level is considered low?

The Cleveland Clinic notes providers often consider a total testosterone below 300 nanograms per decilitre as low in adults, though the picture depends on symptoms and repeat testing Cleveland Clinic, 2024. Your doctor interprets your numbers alongside how you feel, rather than treating a single figure in isolation.

Do I need a blood test to check my hormones?

Yes. Symptoms and online quizzes can suggest testing is worthwhile, but a diagnosis needs a blood test, usually taken in the morning and confirmed with a second sample. A doctor orders and interprets the results and decides whether further tests are needed.

Can lifestyle changes improve my hormones?

Often, yes. Losing excess weight, regular strength and aerobic exercise, better sleep and lower stress all support healthy testosterone and general wellbeing. For borderline results these steps sometimes help without medication, and they benefit your health regardless of your test numbers.

Is testosterone therapy safe?

It is a recognised treatment when a doctor has confirmed androgen deficiency and judged it appropriate, and it is monitored over time. It is not suitable for everyone, including men with prostate or breast cancer or those trying to conceive. Suitability and safety are assessed individually before and during treatment.

Are the symptoms just part of getting older?

Some decline is normal with age, but tiredness, low libido and mood changes should not be dismissed as inevitable. They can signal a treatable problem or another condition entirely. Getting tested is the way to tell the difference rather than assuming it is age.

References

• Healthdirect. Testosterone. https://www.healthdirect.gov.au/testosterone
• Healthy Male. Low testosterone. https://www.healthymale.org.au/mens-health/low-testosterone
• Better Health Channel. Androgen deficiency in men. https://www.betterhealth.vic.gov.au/conditionsandtreatments/androgen-deficiency-in-men
• Cleveland Clinic. Low testosterone (male hypogonadism). https://my.clevelandclinic.org/health/diseases/15603-low-testosterone-male-hypogonadism