Erectile DysfunctionMale InfertilityMale Sexual HealthSexual concerns in young men – PDE5’s are not the answer!

Symptoms of Low Testosterone Levels

Testosterone, the male sex hormone is a very important hormone to have a healthy energetic sexual as well as normal life. Women do have this hormone but in very small quantities in their bodies. When the testosterone levels drop in a man, its not just erectile dysfunction caused but also results in reduced bone mass, loss of muscle, reduced sex drive, hair fall etc.

This hormone plays a significant role in developing healthy and strong bones and muscles, deepening of voice, good hair growth and production of sperms.  A level less than 300 nanograms (300ng) of testosterone per 1 deciliter of blood is considered as low level and nearly 2% of men face this problem.

Sexual concerns in young men – PDE5’s are not the answer!

Symptoms of Low Testosterone levels:


Problem having erections:

As mentioned already, testosterone is an important hormone for men to get or sustain erections. Low levels cause less frequent erections, having no erections even on stimulation and/or problem with maintaining the erections. Apart from the mental trauma that this may cause to any man, it also affects the sexual life of his partner, if she is still sexually active.

Erectile Dysfunction can be caused many other factors including:

  1. Smoking
  2. Thyroid related problems
  3. High cholesterol
  4. Stress and / or anxiety
  5. Alcohol Consumption
  6. Diabetes
  7. High blood pressure.


Hair loss:

This is a natural phenomena with age. Age related hair loss happens with women too. However, lower production of testosterone results in lesser hair growth. This was proved by a study where researchers did a hormone replacement therapy for men and women and noticed significant hair growth.


Reduced Bone Mass:

Lower testosterone levels decreases the strength of bones and their volume. This makes bones weak and they can break easily.


Smaller Testicle size:

The size of scrotum reduces and this can be noticed by the man on careful observation. The scrotal sack also feels soft than usual.


Lower semen levels:

Lower testosterone = lower levels of semen produced. Very low testosterone leads to infertility because, if not enough semen is produced, the sperms will not be able to swim to the egg to fertilize it.


Problems with sleep:

Men may find problems to fall asleep or stay asleep. With low testosterone levels, some men may experience sleep apnea. Sleep Apnea is a condition where a person stops breathing temporarily and this results in disruption of sleep.


Other symptoms of low testosterone may include:

Low libido or sex drive, lower energy levels, increase in body fat and changes in mood / mood swings


When should you see a sexologist or a sex specialist?

If you are not aged and feel that your sex drive has decreased, if your semen volume is lower than usual (check with an interval of 3 days), if your erections are not strong enough or if you are not able to have sustained erections, you must see a sexologist, preferably the best sexologist near you. Otherwise, this may ruin your personal and professional life too.

Treatment options for low testosterone levels:

TRT – Testosterone Replacement Therapy is the most common treatment for low testosterone levels. Our sexologist typically suggests this method only when there are multiple symptoms due to low testosterone levels. Testosterone serum tests and blood tests may be performed before adopting this treatment procedure.

How is testosterone delivered into a man’s body?

  1.  Skin patches – A patch will be applied on the skin and the skin absorbs the testosterone into the body.
  2. Gels
  3. Tablets that dissolve in mouth
  4. Injections
  5. Surgical implants that release the hormone into the body.

Relief from symptoms can be noticed with in 6 weeks time.  However, you must not self advocate any of these therapies to increase your testosterone levels.  Abuse of testosterone hormone can cause more damage to your body, fertility and testicles than you may expect.


  1. Hello Doc..warm greetings..I am taking T.Finasteride 1mg OD for 1.5 yrs for my androgentic alopecia..Will it cause erectile dysfunction in future?

    • Dear Vignesh,

      I cannot offer medical advise on our blog. You need to see me with your problem, prescription and test reports if available.

      Thank you,
      Dr. Karthik Gunasekaran.

    • Hello sir my T leval is 286 my hight 6.2 wight 105
      Problem ED how long treatment takes eny side effects,
      Then Maintain the t levels

        • Sir I need appointment for you sir please
          My problem is sustainable erection issues not strong erection,low desir and lot of fear please give online appointment.

    • Ranjith, where are you feeling the pain and when are you having the pain.
      I will have to see and examine you once before I tell you the reason why. Please call my office and take an appointment for evaluation.
      Hope, it won’t be any major problem.

      Dr. Karthik Gunasekaran.

    • Mr. Balaji, Please see me at my clinic, if needed, you may have to get some tests done.

      Thank you,
      Dr. Karthik Gunasekaran

  2. Hi sir does Testosterone boosters like D Aspartic acid or testogen restores normal testosterone level naturally?

    • Hello Rohit,
      Yes D Aspartic acid signals brain to release hormones that ultimately lead to generation of more testosterone by the body.
      Testogen claims that it can boost testosterone levels in the body. You can use either.
      As a safer bet, you can use ‘Gokshura’ that is widely available in India at much lower cost with near 0 side effects.

      Dr. Karthik Gunasekaran.

      • Hi sir, then young people with no bad habits but they only have Vitamin D deficiency with short term stress may cause low testosterone right. So, for those peoples these kind of booster (D Aspartic acid, testogen or Gokshura )can restore to normal testosterone level. If yes can it increases permanently? How much it will increase beyond 400 +

        • See, your question itself has the answer.
          What causes lack of Vitamin D? Lack of exposure to sunlight. Then why do you want to take supplement?
          First get right amount of sunlight everyday. Automatically things will become alright.

          If you still have low testosterone levels, then, we need to figure out the problem first.
          Only then actual medication can be started. If there is any other problem, supplements will be of little help.

          Thank you,
          Dr. Karthik

          • Okay sir In that is the case I need to consult with you online. Because I don’t have any bad habits ( neither smoking nor alcohol nor steroid) I even restored my vitamin D levels to normal. My zinc level is also normal.But I don’t know why my body’s testosterone production is not normal. I don’t even have B.P, sugar or cholesterol and I don’t have thyroid as well. Moreover Im only 24 years of age. So Is there any other reason that body not producing enough testosterone? I’ll consult online please help me to resolve this problem.

  3. Hi sir, I’m feeling pain on one side of testis. I’m not feeling pain all the time. If I touch the testis or if it touches our underware then I feel pain for the past 4 days.Why is that so? Do I need to take any test?

  4. Hi sir Is there any way that man’s fertility and hormone production reversed after testicular cancer treatment.

      • Then is there any way to increase a sperm count naturally. If we don’t had any illegal bad activities then its possible to increase the sperm counr right.

        • Eating right food, good exercise should keep your sperm count at optimum levels.
          If you have lower sperm count, you need to get some tests done to check if there is any other problem. There can be several reasons for lower sperm count.

  5. Hi sir what causes frequent urination. If I went urine test It says pus cells 3-5 but bacteria NIL and protein Nil. Is that a sign of any kidney problem?

    • Diabetes, Kidney stones problems, your existing medications (if any) etc.. any of these can be a reason for frequent urination.
      If your bladder is not emptying properly or if you are having an overactive bladder, this can happen.

      If this is concerning you, please see me at my clinic.
      Thank you,
      Dr. Karthik Gunasekaran.

  6. Hi sir I have four questions.
    1)What causes tiredness and weakness after masturbation. These weakness exist on one whole day after masturbation.
    2) What vitamins and minerals comes on sperm?
    3) my sperm looks white color is that a sign of healthy sperm.
    4) Is excessive masturbation is bad?

    • John, you should take some time to google the answers for these questions.
      Thank you,
      Dr. Karthik Gunasekaran.

      • Hi sir I googled about masturbation and its technique. It seems to be what I’m doing is wrong. I’m doing face down masturbation for 12 years. Some search saying face-down masturbation decreases aye sensitivity. If I change the technique it will not cause any problems right. Or do I need to take any medicines to overcome the effects of prone masturbation.

        • First try normal masturbation. If you have problems, see me or any good sexologist near you.
          Yes, prone masturbation is wrong.

  7. Hi sir I had testicle pain and went to urologist. After examination and urine test he said that is epididymitis. I have 3-5 pus cells on urine other than else everything normal. He prescribed me antibiotics ofloxacin 400 mg for 5 days. The pain went away in two days of medicine. I stopped taking those full course of antibiotics since i was allergic to ofloxacin. But the pain is starting again.
    I cannot take antibiotics again it is causing side effects to me. Suggest me some way to relieve from these.

  8. Hi sir I have a kidney stone of size 4mm. Is this is the main reason for urinary tract infection. Does it cause frequent urination? Is it curable without surgery?

    • Kidney stones can cause infection of kidneys and they have to be removed if they don’t go away with medication.
      Some times, the stones should be broken with shock waves or energy waves.
      Please take an appointment and see me as soon as possible.

      • Even a small kidney stone of 4mm can cause infection? Because while taking Antibiotics I feel better. But after completing the course its again coming. Is that due to kidney stones?

  9. Sir Doctor prescribed me the Flupen 0.5 (Anti depression) for 15 days. Does taking anti depression affects testosterone levels or sperm production? The side effects are temporary?

    • Yes, anti depression medication can cause infertility and it will be typically temporary. If you are facing Erection problems or ejaculation problems, please see me with your prescription.

  10. Sir my age is 20 but still I don’t have beard and body muscle, left side of my body is different from the right side one hair growth is different in both sides and left side chest is bigger then right side on and I have the problem of low testosterone what is reason behind this?

    • Mugesh, it is difficult to just tell the reason for your problems without examining you.
      If you are in Chennai, please take an appointment and see me if you are willing to. We can discuss your problems.

  11. Hi sir , I have a question.
    I have infection on testis. Is there any way to find type of infection either bacterial or worms?
    Does urine culture detects parasitic worms , filarial worms or any other worms infection?. If not then what test can detect that. I’m suspecting some mosquito infection on my testis. Or does USG scrotum shows such abnormalities?. Since I feel better with Diethyl carbamazine citrate (DEC) than antibiotics.

    • Too much of googling I guess, if you are not a doctor.

      Please see a good sexologist and leave it to his/her diagnosis.

      • Hi sir, yes I googled because even after completing the course of antibiotics after some days testis discomfort is starting. Is there any way to consult you online for my problem with my reports. Since I’m not from chennai.

  12. Sir I have low testosterone problem and also my body parts are different the right side is smaller then left side, left side chest bigger then right one and hair growth is high in right side compared to left side of my entire body what is the reason behind this?

    • Dear Mugesh,
      Please consult your family doctor or a good general physician. If they advise you to talk to a sexologist, please see me at my clinic.

      Thank you
      Dr. Karthik Gunasekaran

    • Vinoth, I cannot give you exact reason because, there can be many including an injury or infection or even kidney stones.
      Please come down for a checkup and get treated as early as you can.

      • I’m not from chennai so Is it possible see you in online with my all reports and will it works? I tested urine culture, stones etc.. Is it possible to consult you online and get rid of my problem?

  13. Hi,sir I’m just 24 years of age and I have Blood pressure of 130/110 and doctors prescribed me a propanorol Beta blockers and anti depressant SSRI. If they prescribed me to take any BP medicine then will this affects my future or sex life or how will I tackle this situation?

    • Side of SSRI related to sex life are low sex drive, erectile dysfunction (having difficulty in getting an erection), delayed ejaculation etc.
      If you are having any of these symptoms, you must tell your doctor right away and he/she may give different prescription.

      • Hi sir they changed the medicine and asked me to take only propanolol 40 beta blocker for high blood pressure. So is it safe for sexual functions. Having high blood pressure can cause any sexual problem?

    • Harish, Low sperm count is curable.
      Before treating it, we need to know the reason why it is happening. It can be due to low hormone levels or due to obstruction or even due to deficiency of some minerals.

      You will have to take some tests to determine the cause. Only after that, right treatment can be provided.

  14. Hi sir Does medication used to treat high blood pressure such as beta blockers cause sexual side effects? If so how can we marry by taking that medication. If we have high blood pressure we should not suddenly stop the medication right. So Is there any way we can live normal sexual life by taking beta blockers.

    • Rahul, many medicines have their own side effects. Depending on the patient’s lifestyle and circumstances, the medicine prescribed by doctors will change.
      If you are taking medicine whose side effects actually affect your sex life, please speak to your doctor. He/she will change the medicine.

  15. Sir Low testosterone curable. If yes like taking multi vitamin supplements increase testosterone levels and sexual health? I am having marriage at next year but I feel like I am so week and low sex drive and low semen volume and having weak or soft erections. I want to consult with you online. Is it curable?

    • Low testosterone is caused due to? That you need to find out.
      Without knowing the reason, you should not take supplements or hormone injections.

      Stress can cause a lot of problems, check if that is the reason.

  16. Hello sir, I have read your articles and seen some of your interviews in youtube. As per your article taking Vitamin D and zinc is good for sexual health. Yes it really helpful. But I’m consuming Vitamin D, Zinc, folic acid, L-Carnitine,L-arginine and calcium supplements for 1 year. So, taking those thing for a long time have any problem or side effects. Is it safe to take? Does taking multivitamin for a long time affects kidney functions?

    • Instead of taking Vitamin D, spend time in Sun light.
      You should not take Zinc for so long unless a doctor tells you to. Excess zinc will do more bad.
      Calcium supplements should be taken only if you are deficient, else, it can form stones in your kidneys.

      I suggest you stop all the supplements and take natural foods containing those minerals. Otherwise, you will damage your kidneys and body also.
      Unless a doctor advises you to take supplements, pls don’t take for so long.

  17. Hi sir covid patients are prescribed steroids. Does it decrease testosterone. Is it permanently or temporary testosterone? How can we over come the effects of steroids.

  18. Hi sir I have two questions.
    1) Does bacteria in motion area ( anus ) can reach urinary tract and cause UTI? .
    2) Does probiotics cure UTI? Can we take probiotics for UTI?

  19. Hi sir I have some kind of burning sensation when urinate and have ulcer like symptom on abdomen. This is happened due to I taken hotel food and water. Whenever I go urine symptoms ease but again starting.
    Is it food poisoning or any problem?

    • Burning sensation when peeing can be due to many reasons, not necessarily food poisoning.
      Excessive heat in body can also cause burning sensation when peeing but it should not last longer than a day. If you are having the sensation for longer, there may be different reasons including an infection.

      See a good sexologist near you or pls take an appointment. Remember, any doctor would do a couple of tests to determine the cause of the problem and most of the sexology procedures are diagnosed with tests.

  20. Hi sir one question I washed my penis and head of penis (inside foreskin) with hot water and applied lot of soap waters. Now it is causing me irritation on my penis tip due to this. No redness or swelling in penis hed but it is irritating. What should I do now. Is it curable?

  21. Hi sir I have a kind of urinary voiding symptoms like dribbling. Like whenever I pass the urine and when voiding urine I have to strain and pass and it cause pain in my pelvic area while straining otherwise remaining urine stays left over and cause infections. Even my age is 26 and unmarried. Is it a LUTS? If yes is it curable?

  22. Hi sir , does 5 alpha reductive inhibitors tablets cause sexual problems. Is it temporary and go away after stopping the medicine or how can we treat side effects.

  23. Hi sir, my body is not even absorbing nutrition. I consulted gastroenterologist they said its due to low stomach acid and enzymes. Im taking HCL and pepzyme supplements now. Does lack of nutrients cause low libido and less sexual desire?

    • Your doctor might have told you what to do. I would also recommend adding curd to your food in every meal and some buttermilk in between.
      If the bacteria in your gut isn’t good and if your intestines aren’t working like they should, absorption of nutrients can be a problem.
      Eventually you will become weak and may be sick. Works in your intestines can also be a cause. You can call us for an appointment with our gastroenterologists if you need.

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