Though we do not fully understand the link between obesity and low testosterone, we do know that fat cells convert testosterone to oestrogen, lowering testosterone levels. Obesity also reduces the presence of proteins responsible for carrying testosterone in the blood.

Long-term opioid therapy use

Opioids affect the hypothalamus and pituitary gland, which are both key players in the production of testosterone. The impact of opioids can be rapid, with effects often seen within a week of starting to take them.

Erectile dysfunction

The relationship between low testosterone and erectile dysfunction is not well understood. However, erectile dysfunction can happen as a result of diseases/conditions other than low testosterone. Low testosterone levels appear to be linked to a number of the same chronic conditions that play a role in erectile dysfunction, such as type 2 diabetes and obesity.

Type 2 diabetes

A link between type 2 diabetes and low testosterone is well established, and it is estimated that approximately 50% of men with type 2 diabetes also suffer from low testosterone. Regardless of whether someone has been diagnosed as obese, diabetes is still a risk factor for low testosterone. Studies have shown that one-third of men with diabetes had low testosterone and pituitary hormone levels.

Increasing age

Testosterone levels usually decline with age, typically by 1% each year after the age of 40. However, as you age, the risk of having other medical conditions such as obesity and type 2 diabetes increases. This, in turn, increases the risk of having low testosterone.

Klinefelter syndrome

Klinefelter syndrome is a condition where men are born with an extra X chromosome (XXY). This added X chromosome prevents the testicles from growing properly, resulting in low testosterone production.

Cancer treatment

Chemotherapy or radiation therapy can disrupt testosterone and sperm production. The effects of cancer treatment do not usually last, though some may experience permanent infertility. People that have been treated for testicular cancer may have low testosterone months or years after they recover.

Undescended testicles

For some people, one or both of the testicles will not descend at birth. Often, this is naturally corrected in the first few years of life, without treatment. However, if this is not corrected early on, this could lead to the testicles not working properly and a reduced production of testosterone.


Having the mumps as a child can cause long-term damage to the testicles, resulting in low testosterone.

Are you worried that you may have low testosterone?

Low testosterone can be diagnosed by testing for abnormally low levels in the blood and discussing whether you have some of the tell-tale signs with your healthcare professional (HCP).

The ADAM questionnaire helps you determine whether you should see your HCP about your testosterone levels and can also be used as a starting point in your conversation. Complete the ADAM questionnaire and download a copy of your results so you can show them to your healthcare professional.

Please note that the ADAM questionnaire is not in itself a diagnostic tool. A blood test, conducted by a GP or specialist, is required to diagnose low testosterone and rule out other conditions that may present with similar symptoms.

Before I was diagnosed with [low testosterone] my kids used to call me a grumpy so-and-so. I’d completely lost my interest in everything. The only thing I did do a lot was argue with my family – always about stupid things.

Mike, 60


The cases are fictional but based on common scenarios that have been designed for educational purposes.
Any similarity to a real person is purely coincidental.

If the ADAM questionnaire shows that you may be experiencing low testosterone, take the first step and book an appointment with your HCP today.
Click here to find out more.