Low Testosterone
Low testosterone is a hormone deficiency in men causing fatigue, low libido and reduced drive, confirmed with morning blood tests and treatable with monitored testosterone therapy.
Symptoms
- Persistent fatigue that sleep does not repair
- Low libido and fewer spontaneous erections
- Erectile difficulty
- Low or flat mood, irritability, poor concentration
- Reduced muscle mass and strength despite training
- Increased body fat, especially around the middle
Causes
Testosterone declines gradually with age, but clinically low levels can also stem from testicular conditions, pituitary problems, obesity, type 2 diabetes, chronic illness, certain medications and previous anabolic steroid use. Lifestyle factors such as poor sleep and heavy alcohol use lower it further.
How PVT tests for it
Diagnosis needs two things: symptoms and confirmed low levels on morning blood tests, since testosterone peaks early in the day. PVT uses a validated symptom questionnaire plus morning bloods at Lancet, repeated to confirm, along with the safety baseline required before any treatment.
Treatment
Where low testosterone is confirmed and therapy is appropriate, treatment with prescribed testosterone is started and monitored on a schedule: symptoms, hormone levels, red blood cells and prostate markers are all rechecked. Where fertility matters, alternatives that preserve sperm production are discussed instead. Weight loss, sleep and strength training meaningfully support levels too.
When to see a doctor
See a doctor if several of the symptoms above have persisted for months, particularly low libido plus fatigue. A morning blood test settles the question either way, and a normal result usefully points the search elsewhere.
Medically reviewed by Dr D. Moodley [DOCTOR_NAME_PLACEHOLDER], HPCSA [HPCSA_NUMBER_PLACEHOLDER]. Last reviewed 1 July 2026.
Questions about Low Testosterone
With at least two morning blood tests showing low levels, alongside genuine symptoms. Testosterone peaks before 10am and swings during the day, so afternoon tests and single readings are not enough to diagnose or treat.
Over-the-counter boosters have little credible evidence behind them, and some are contaminated with unlisted substances. If your testosterone is genuinely low there is an identifiable reason, and treating that properly under medical monitoring is safer and works.
Some decline is normal; symptomatic deficiency is not something you simply have to accept. If levels are clearly low and symptoms match, treatment is a legitimate medical decision, made with your doctor after a proper safety baseline.
Tell your doctor before starting anything. Standard testosterone therapy suppresses sperm production, so men who want children now or later are offered alternatives that stimulate the body's own production instead.
Book a private consult
Most patients are seen within the week at Milnerton or Table View. You can book by WhatsApp without saying why you are coming in.
R650 private doctor consult, paid upfront by cash or card. It covers the assessment, test selection, explanation of your first results, and a script where clinically appropriate. Lab tests are billed separately by the blood lab (Lancet). Medical aid is optional: you claim back yourself if you have it.