The role of testosterone in male development is crucial. Thus, high levels of testosterone are found since the intrauterine life in male fetus. At this stage, testosterone dictates the formation and development of male genitalia (penis, scrotum, ducts). For this reason identification of genital abnormalities at birth, including penis less than 3 cm, requires identification of exact causes, not only the correction of them. Testosterone will remain high until the end of the first year of life, when begins a restful period. Starting with puberty testosterone levels begin to rise again, causing the appearance of secondary sexual characteristics.
They may be permanent (they do not regress if there is a further decrease in the level of testosterone), competitive (are dependent on normal level of androgen hormones) and mixed. Permanent characteristics determine by testosterone are: anatomical development of penis, scrotum, and voice changing (androgen effects on the larynx). Competitive features are: bone mineral density, muscle mass and the level of erythropoietin. A mixed character influenced by male hormone is beard and hair growth.
With age comes a decline in physiological (normal) level of testosterone, similar to menopausal women, but this decrease happens at a much slower rate and men do not experience neurovegetative phenomena like women (heat waves, facial flushing, sweating).
However such symptoms may occur in patients suffering from prostate cancer.
Testosterone may decrease, without any signs and symptoms, when there is a low sexual desire (libido) or men suffer from some sexual dynamic disturbances such as erectile dysfunction, incomplete erections, and premature ejaculation. Also the occurrence of gynecomastia (breast development in men) is accompanied by a decrease in androgen hormones.
When testosterone decreases at a young age the impact on quality of life is much more severe because sexual disorders like erectile dysfunction occur. These sexual disorders are accompanied by a marked fatigue and a decrease in muscle mass. Also lack of testosterone can determine a severe depression; the individual becomes irritable, nervous, frustrated. In many cases erectile dysfunction and other sexual disorder determine the occurrence of performance anxiety.
Because the individual often cannot define these conditions, family and sexual partner need to refer him to an endocrinologist specialist or urologist. The most important step in the diagnosis of sexual dysfunction is medical history – discussion with the patient. Also the doctor will perform various tests to determine the exact cause. The most common reasons for low testosterone in men are: exposure to various environmental factors, trauma, drugs, various systemic diseases or disorders of pituitary gland. Sexual dysfunctions are common affections; men should not be ashamed because they can be solved in the vast majority of cases.