Hypogonadism is a condition in which the testes do not produce enough testosterone, the main male hormone. When this happens gradually in later life it is often called male andropause, or "male menopause". It can quietly affect energy, mood, muscle, libido and general wellbeing — and, once properly diagnosed, it is very treatable. Dr. Anish Gupta assesses and manages low testosterone discreetly across Delhi NCR.
What is hypogonadism?
Testosterone drives male sexual development and continues to support muscle, bone, red blood cells, mood, concentration and sex drive throughout adult life. In hypogonadism, testosterone levels fall below normal. The problem is described as primary when it arises in the testes themselves, and secondary (or central) when the pituitary gland or hypothalamus in the brain fails to signal the testes properly.
Andropause refers to the slow, natural decline in testosterone that can occur as men age. Unlike the menopause in women, it is gradual and does not affect every man — but where levels drop enough to cause symptoms, it deserves assessment and treatment rather than simply being put down to getting older.
Symptoms
Symptoms are often subtle and easy to miss, developing slowly over months or years. Common signs in adult men include:
- Persistent tiredness and low energy
- Reduced sex drive and erectile dysfunction
- Low mood, irritability or difficulty concentrating
- Loss of muscle mass and strength
- Increased body fat, particularly around the abdomen
- Reduced beard and body hair
- Breast tenderness or enlargement
- Poor sleep, and thinning of the bones over the longer term
- Reduced fertility
When low testosterone occurs before or during puberty, it can delay sexual development, beard growth and the deepening of the voice.
Causes and risk factors
Testosterone can fall for many reasons, affecting the testes directly or the brain signals that control them:
- Ageing, which causes a gradual natural decline
- Obesity, type 2 diabetes and metabolic syndrome
- Injury, infection or previous surgery affecting the testes
- Undescended testes or genetic conditions present from birth
- Pituitary or hypothalamic problems, including tumours and raised prolactin
- Certain medications, chemotherapy or radiotherapy
- Long-term illness, excess alcohol and chronic stress
When to see a urologist
See a urologist or andrologist if you have ongoing tiredness, low libido, erectile difficulties or mood changes — especially if several of these occur together. It is worth checking testosterone before assuming symptoms are simply "part of ageing", because a genuine deficiency responds well to treatment while an underlying cause, such as a pituitary problem, may need attention in its own right.
How it is diagnosed
Diagnosis combines your symptoms with blood tests, as symptoms alone are not enough. Dr. Anish Gupta may advise:
- A morning blood test for total testosterone, usually repeated on a second occasion to confirm a genuinely low level
- Additional hormone tests such as LH, FSH and prolactin to identify whether the problem is primary or secondary
- A general health assessment, including checks for diabetes and cholesterol
- Where relevant, a semen analysis if fertility is a concern, and bone-density testing where levels have been low for some time
Correctly distinguishing a true deficiency from normal levels is essential, because testosterone treatment is only appropriate when a genuine shortfall is confirmed.
Treatment options
Treatment aims to restore testosterone to a healthy level, relieve symptoms and address any underlying cause. It is always tailored to you and, where possible, begins with treating what is driving the problem.
Lifestyle and treating the cause
Losing excess weight, exercising, improving sleep, reducing alcohol and controlling diabetes can meaningfully raise testosterone in many men. Where a pituitary problem or another specific cause is found, treating it directly may resolve the deficiency.
Testosterone replacement therapy
Where a genuine deficiency is confirmed, testosterone replacement therapy can restore energy, mood, libido, muscle and bone strength. It is given as gels, injections or long-acting depot preparations, and requires ongoing monitoring to keep it safe and effective. It is generally not suitable for men who are actively trying to conceive.
Protecting fertility
Because testosterone treatment can reduce sperm production, men who wish to father children are managed differently, using alternative approaches that support the body's own hormone production. Dr. Anish Gupta will discuss this carefully where male fertility is a priority. You can read more in our guide on low testosterone in men — symptoms, testing and treatment.
Why choose Dr. Anish Gupta
Dr. Anish Gupta is a Consultant Urologist & Andrologist with over 20 years of experience and a particular interest in andrology and men's hormonal health. He confirms the diagnosis properly before recommending treatment, avoids unnecessary hormone therapy, and monitors care closely for safety. Discreet, thorough assessment is available across three locations in Delhi NCR.
Frequently asked questions
Is low testosterone just a normal part of ageing?
Testosterone does decline slowly with age, but a level low enough to cause symptoms is not something you have to live with. If a genuine deficiency is confirmed, it can be treated effectively, often with a marked improvement in energy, mood and libido.
Do I need more than one blood test to diagnose it?
Usually yes. Testosterone is measured on a morning sample and normally repeated on a second occasion, because levels vary through the day and from day to day. Additional hormone tests help identify the cause and guide the right treatment.
Will testosterone treatment affect my fertility?
Standard testosterone replacement can reduce sperm production, so it is generally avoided in men who are trying to conceive. If fertility matters to you, alternative treatments that support your own hormone production are used instead, which Dr. Anish Gupta will discuss with you.
Is testosterone replacement a lifelong treatment?
Often it is ongoing, particularly when the cause is permanent, and it needs regular monitoring to stay safe and effective. Where a reversible cause is found and treated, testosterone may recover on its own without long-term therapy.
Every treatment plan starts with a proper assessment, so you only get the care your condition actually needs — and if the honest answer is that you don't need a procedure, you'll hear that too.