Low testosterone, or hypogonadism, is a medical condition where the body doesn’t produce enough of the hormone testosterone. Testosterone is essential for many aspects of health, including muscle mass, bone density, mood, and sexual function. When testosterone levels drop below normal, it can lead to a variety of symptoms that affect overall well-being. Testosterone is a hormone produced primarily in the testicles in men and is responsible for a variety of functions including sexual function (sex drive, erection, sperm production), physical health (muscle mass, strength, bone density), mental health (mood, cognitive function, and overall energy levels). As men age, their testosterone levels naturally decline, but some men may experience a more significant drop leading to hypogonadism. Symptoms of low testosterone include fatigue, decreased libido, erectile dysfunction, mood changes, loss of muscle mass, increased body fat, decreased bone density, sleep disturbances, cognitive issues. Hypogonadism can be primary (when testicles fail to produce enough testosterone) or secondary (occurs when the brain fails to signal the testes to produce testosterone). Diagnosis is established by review of symptoms or measuring blood test (total testosterone level). Once a low testosterone level is detected in a test, typically your provider will repeat the level to confirm, in addition to obtaining other tests (LH, FSH, Prolactin) to identify whether the problem is primary (testicular) or secondary (pituitary or hypothalamic). Treatment aims to restore normal levels and alleviate symptoms. The main approach is testosterone replacement therapy (TRT). There are variety of TRT including injectable testosterone, topical gels or creams, transdermal patches, testosterone pellets, oral medications. After starting TRT its important to have your provider follow your levels and adjust dose as necessary. TRT can have potential side effects, such as increased red blood cell count which may lead to risk of clots or stroke, breast enlargement or tenderness, sleep apnea, testicular shrinkage, infertility, prostate issues. In addition to TRT lifestyle modifications can assist in maintaining a healthy testosterone level such as exercise, maintaining healthy weight, eating balanced diet, getting quality sleep and managing stress. Once you are on a TRT there is a good change you may need to remain on it lifelong or the levels may drop again. It is not recommended to take TRT for body building unless your level is low, as it can lead to side effects noted above and also leads to dependency by decreasing your endogenous production.