Testosterone and men’s vitality
Tired, flat and not yourself? Let’s look at the whole picture.
Low energy, a fading sex drive, poor sleep, weight gain around the middle and low motivation are often put down to “just getting older”. Sometimes testosterone is part of the story. Often sleep, stress, weight, blood sugar and lifestyle are too. At Sandton Men’s Clinic, George Mulaudzi, Naturopath, looks at all of it in a private, unhurried consultation.
What is low testosterone?
Testosterone is the main male sex hormone. It supports sex drive, erections, muscle, bone, mood and energy. Levels naturally drift down slowly with age, but a true deficiency (called hypogonadism) is diagnosed only when a man has both consistent symptoms and low levels on morning blood tests repeated on two separate days. Many men with typical symptoms turn out to have normal testosterone, and another cause, such as poor sleep, stress or blood sugar problems, is driving how they feel.
If you are in your 50s or 60s, read our guide to andropause and testosterone after 50. If you are younger, see signs of low testosterone in your 30s and 40s.
Common signs men notice
Sexual
Lower sex drive, fewer morning erections, weaker erections. See low libido and testosterone and ED.
Energy and mood
Fatigue, low motivation, irritability, poor concentration. See fatigue in men.
Body
Weight gain around the middle, loss of muscle and strength, slower recovery. See metabolic health and hormones.
See a doctor promptly if you have breast tenderness or swelling, a lump or pain in a testicle, very low sex drive together with headaches or changes in your vision, or if you are thinking about fertility. These need medical assessment. Never start testosterone, steroids or “booster” products bought online without medical advice.
Quick self-check
Five yes or no questions, adapted from the ADAM questionnaire clinicians use as a first screen. This is not a diagnosis.
1. Has your sex drive dropped noticeably?
2. Are your erections weaker, or are morning erections less frequent?
3. Do you feel tired most days, even after a full night’s sleep?
4. Have you lost strength or muscle, or gained weight around your waist?
5. Has your mood, motivation or enjoyment of life dropped?
What else can cause these symptoms?
Testosterone does not work in isolation. Short or broken sleep, including sleep apnoea, can lower testosterone within weeks. Carrying extra weight, insulin resistance, long-term stress and burnout, heavy drinking, some medications and thyroid problems can all produce the same tiredness and low drive. That is why we start with the full picture rather than a single number. Read more in low testosterone or just ageing?
How we help at Sandton Men's Clinic
1
A full history
Symptoms, sleep, stress, diet, alcohol, training, medications and any recent blood results.
2
The right tests
If testosterone may be low, we explain what to ask your doctor or lab for. See testosterone tests explained.
3
A natural plan
Sleep, weight, strength training, nutrition and stress, with follow-ups to track how you feel.
Natural support or TRT?
When low testosterone is linked to weight, sleep, stress or lifestyle, these changes can help levels and symptoms improve for some men. When it is caused by a problem with the testes or the pituitary gland, medical treatment such as TRT may be needed, and that must be prescribed and monitored by a doctor. We help you understand the options honestly. Compare them in natural testosterone support vs TRT, and read about ways to support testosterone naturally.
Be careful with over-the-counter "testosterone boosters". Most have little good evidence behind them, and some contain hidden ingredients. See our honest look at testosterone boosters.
Frequently asked questions
What are the signs of low testosterone?
The most common signs are a lower sex drive, fewer morning erections, weaker erections, tiredness, low mood or motivation, loss of muscle and strength, and weight gain around the waist. These signs are not specific, so they can also come from poor sleep, stress, weight or other health problems.
How is low testosterone diagnosed?
Through blood tests taken in the morning, usually repeated on two separate days, together with your symptoms and a medical examination. These tests are arranged through a doctor or laboratory. We do not run blood tests at the clinic, but we explain what to ask for and help you understand your results.
Can low testosterone improve naturally?
It depends on the cause. When low levels are linked to excess weight, poor sleep, stress, heavy drinking or inactivity, improving those areas can help some men. When the cause is a problem with the testes or pituitary gland, medical treatment may be needed. Results vary from man to man.
Do you offer testosterone replacement therapy?
No. Sandton Men's Clinic is a naturopathic practice and does not prescribe TRT or other medication. If TRT may be appropriate for you, we refer you to a medical doctor, and we can support you with lifestyle and natural care alongside it.
What happens at a consultation and what does it cost?
You meet one on one with George Mulaudzi, Naturopath, at 199 Vanessa Street, Buccleuch, Sandton. We go through your symptoms, history and lifestyle and agree a plan. Consultations start from R2,500, and the clinic is open 24/7.
Men visit us for testosterone and vitality concerns from Sandton, Johannesburg, Midrand, Fourways, Pretoria and across Gauteng. Read patient reviews or meet George Mulaudzi.
Ready to find out what is behind how you feel?
Private consultations from R2,500. Open 24/7, on-site parking.
Sources: Bhasin S et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab, 2018. Mulhall JP et al. Evaluation and management of testosterone deficiency: AUA guideline. J Urol, 2018. Morley JE et al. Validation of a screening questionnaire for androgen deficiency in aging males (ADAM). Metabolism, 2000. Leproult R, Van Cauter E. Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA, 2011.
This page is general information and is not a diagnosis or a substitute for medical advice. Reviewed by George Mulaudzi, Naturopath.