Lower libido
Lower libido, erectile dysfunction, chronic fatigue, poorer recovery or loss of muscle mass? These symptoms may — but do not have to — result from testosterone deficiency. Proper diagnostics begins with an andrological consultation, not just a blood test.
The first step is an andrological consultation — the doctor will assess the symptoms, order appropriate tests and explain whether the problem is caused by testosterone deficiency or another condition.
urologist, andrologist, aesthetic medicine doctor
dr n. med. Jakub Krukowski — consultations in Gdańsk
testosterone, LH, FSH, SHBG, prolactin and others
not just the result — clinical context and symptoms
Mon–Fri 9:00–20:00
What is testosterone and why is it important?
Testosterone is the main male sex hormone. It affects libido, sexual function, sperm production, muscle mass and strength, bone density, energy levels, mood and overall wellbeing. Its level naturally changes throughout the day and may gradually decline with age — but age-related decline alone does not always mean a condition requiring treatment.
Testosterone deficiency may have different causes: testicular dysfunction, pituitary or hypothalamic disorders, obesity, diabetes, sleep apnea, chronic stress, some medications or chronic diseases. That is why simply “raising testosterone” without prior diagnostics is not the right goal — first, the cause needs to be understood.
Important: testosterone deficiency is diagnosed only when symptoms consistent with deficiency are present and testosterone levels are repeatedly low in blood tests. A single “borderline” result without symptoms is not enough for a diagnosis.
Symptoms of low testosterone
Symptoms of testosterone deficiency are often non-specific — they may be caused by hormonal disorders, but also by exhaustion, depression, sleep disorders, thyroid disease, anemia, diabetes or chronic stress. The more the symptoms affect sexual function and persist over time, the more important andrological diagnostics becomes.
Sexual and andrological symptoms:
- lower libido — reduced interest in sex,
- erectile dysfunction or poorer erection quality,
- less frequent morning erections,
- fertility problems,
- change in testicular volume or consistency,
- gynecomastia — enlargement of glandular breast tissue.
General symptoms:
- chronic fatigue and lack of energy,
- poorer recovery after physical effort,
- decrease in muscle strength and muscle mass,
- increase in body fat, especially abdominal fat,
- low mood, irritability, reduced motivation,
- concentration problems and sleep disturbances,
- reduced bone density.
When should you see an andrologist?
An andrological consultation is recommended when symptoms persist for a longer time, reduce quality of life or involve sexual function and fertility. It is worth booking a visit when several of the above symptoms occur at the same time.
- decreased libido lasting several weeks or months,
- erectile dysfunction or poorer erection quality,
- fertility problems or abnormal semen analysis results,
- chronic fatigue without a clear cause,
- gynecomastia or changes in the appearance of the testicles,
- questions about testosterone therapy or its safety.
How is testosterone level tested?
Testosterone follows a daily rhythm, so it is usually measured in the morning. The result should be interpreted together with symptoms, the patient’s age, comorbidities and other hormonal parameters. A single result is not always sufficient — the test often needs to be repeated.
- total testosterone — usually in the morning,
- SHBG and free testosterone — when total testosterone is borderline,
- LH and FSH — helpful in assessing the cause of deficiency,
- prolactin, estradiol — in selected situations,
- complete blood count, glucose, TSH — assessment of conditions that may mimic symptoms,
- semen analysis — if the patient is planning fatherhood.
Low testosterone and fertility
This is a particularly important topic. Testosterone therapy may reduce sperm production and worsen fertility — therefore, in men planning fatherhood, the decision about hormonal treatment requires particular caution. If you are planning to have children now or in the future, tell your andrologist before making any decision about therapy.
What does an andrological consultation include?
The andrologist does not assess only the testosterone result — the doctor evaluates the whole clinical picture: symptoms, their duration, laboratory results, comorbidities, medications and lifestyle.
The doctor asks about libido, erections, energy, mood, sleep, muscle mass, previous results and comorbidities. The doctor assesses whether the symptoms fit testosterone deficiency or another cause.
The doctor selects the scope of tests according to the situation: testosterone, SHBG, LH, FSH, prolactin, estradiol — and interprets the results in clinical context, not only against reference ranges.
The doctor explains whether the symptoms require treatment, observation or further diagnostics. If testosterone therapy is being considered, the doctor discusses its benefits, limitations, impact on fertility and monitoring.
Therapy may be considered when symptoms of deficiency and repeatedly low testosterone are present, after assessing the cause and excluding contraindications. It is not a method for improving sports performance or an “energy treatment” for healthy men.
Testosterone therapy may suppress sperm production. If you are planning fatherhood, make sure to tell your doctor — the treatment decision will be different than in a man who is not planning children.
Erectile dysfunction may have many causes — vascular, metabolic, psychological, neurological and hormonal. The andrologist evaluates the entire health context, not just testosterone level.
Qualification for treatment and choice of method are always decided by the doctor after examination and analysis of results. This page is educational — it does not replace an andrological consultation.
How to prepare for an andrological consultation?
- write down your symptoms and how long they have lasted,
- bring previous results: testosterone, complete blood count, TSH, prolactin, LH, FSH,
- inform the doctor about medications, supplements, anabolic steroids and opioids,
- tell the doctor about chronic diseases: diabetes, hypertension, sleep apnea,
- say whether you are planning fatherhood now or in the future.
What not to do if low testosterone is suspected:
- do not start testosterone therapy without diagnostics and medical consultation,
- do not interpret a single result without clinical context and symptoms,
- do not buy testosterone or hormones from unreliable sources,
- do not start therapy if you are planning fatherhood — discuss it with an andrologist first.
Andrologist at Wyspa Medycyny Przyjaznej
urologist, andrologist, aesthetic medicine doctor
Dr Krukowski assesses symptoms, orders appropriate tests and explains whether the problem is caused by testosterone deficiency or another condition. Before possible therapy, he discusses an individual management plan.
The andrologist assesses whether the symptoms fit testosterone deficiency, whether the result was measured at the right time and whether it should be repeated, and whether the symptoms are not caused by another condition — for example thyroid disease, anemia, diabetes or sleep disorders. Improperly managed hormonal therapy may mask the real cause and do more harm than good.
Andrological consultation →Do you suspect low testosterone?
Do not interpret symptoms on your own. Dr Jakub Krukowski will assess the situation, order appropriate tests and explain what is really happening.
Frequently asked questions about low testosterone
How can low testosterone be recognized?
Possible symptoms include reduced libido, erectile dysfunction, less frequent morning erections, chronic fatigue, poorer recovery, loss of muscle mass, low mood or fertility problems. The symptoms are non-specific — an andrological consultation and appropriate tests are needed.
Is one low testosterone result enough for diagnosis?
Usually not. Diagnosis requires symptoms consistent with deficiency and repeatedly low testosterone levels. Repeating the test and assessing additional hormones — LH, FSH, SHBG — is often necessary.
When is the best time to test testosterone?
Testosterone is usually measured in the morning because its concentration changes during the day. The exact timing of blood sampling and the scope of tests are determined by the andrologist based on symptoms and the clinical situation.
Does testosterone therapy affect fertility?
Yes — testosterone therapy may reduce sperm production and worsen fertility. A man planning fatherhood should always discuss this with an andrologist before starting any hormonal treatment.
Does low testosterone always cause erectile dysfunction?
No. Erectile dysfunction may have many causes — vascular, metabolic, psychological, neurological and hormonal. The andrologist evaluates the whole health context, not only testosterone level.
Who consults low testosterone at Wyspa Medycyny Przyjaznej?
Patients with suspected low testosterone are consulted by dr n. med. Jakub Krukowski — urologist and andrologist. An appointment can be booked via ZnanyLekarz, by phone or through WhatsApp.
What do patients most often see an andrologist for?
You do not have to wait until symptoms become unbearable. An early consultation helps determine the cause faster and plan appropriate management.
Reduced libido and erectile dysfunction
This is the most common reason for a visit. The andrologist assesses whether testosterone is the cause or whether another factor is involved — vascular, metabolic or psychological.
Testosterone result “below normal”
The patient comes with a test result and wants to know what to do next. The andrologist interprets the result in the context of symptoms and decides whether treatment, repeat testing or observation is needed.
Questions about testosterone therapy
The patient is considering TRT or has heard about it from others. The andrologist explains who it is indicated for, what the risks are and what therapy means for fertility.
Related services — andrology at Wyspa Medycyny Przyjaznej
Full andrological offer of the clinic — services and doctor profiles.
Symptom assessment, diagnostics and management plan with Dr Krukowski.
Details →Recommended for men planning fatherhood or with questions about fertility.
Details →Urologist, andrologist and aesthetic medicine doctor — profile and appointment dates.
Profile and appointments →Book an andrological consultation in Gdańsk
Check whether your symptoms are caused by testosterone deficiency — and what to do about it. Dr Krukowski will explain everything step by step.
The information on this page is general and educational and does not replace medical consultation. Diagnosis of testosterone deficiency requires symptom assessment, appropriate laboratory tests and interpretation of results by a doctor. Self-directed hormonal treatment is dangerous. Wyspa Medycyny Przyjaznej, ul. Toruńska 15 lok. AU1, Gdańsk. Tel.: 600 006 913.