Testosterone deficiency:
understand it, then act.
Lower desire (libido), less reliable erections, fatigue, restless sleep, low mood… after 40, these signs can point to a hormonal decline. Start a coordinated pathway, from the “andropause” questionnaire to a full work-up at a partner centre, to understand the cause, then act.
ADAM questionnaire
Ten yes / no questions, online, in under 5 minutes.
Prescription
If appropriate, a prescription for a blood test and referral to a centre.
Blood test
At the laboratory of your choice, close to home.
Work-up at the centre
Half a day at an AndroAct partner centre, with a personalised treatment plan.
Doctors registered with the Medical Council
What is
testosterone deficiency?
“Andropause”, or testosterone deficiency, sometimes called late-onset hypogonadism, refers to a progressive decline in testosterone production when it is accompanied by clinical symptoms.
- 01A progressive, partial decline in testosterone with age, to be distinguished from normal ageing without symptoms.
- 02Many men have a low testosterone level without meeting all the criteria for deficiency; conversely, some meet the clinical criteria with low-to-average testosterone levels.
- 03Mixed symptoms: sexual (desire, erections), physical (fatigue, muscle mass) and psychological (mood, irritability).
- 04The diagnosis combines symptoms AND a blood test confirming a low level: neither is enough on its own.
- 05A full blood test, taken in the morning after fasting, is essential.
- 06Effective care exists, from lifestyle changes to supervised hormone therapy.
The deficiency combines clinical symptoms with a low testosterone level.
Average decline in testosterone from the age of 30.
Most men going through andropause are never assessed or diagnosed.
An isolated symptom or a genuine deficiency?
Passing tiredness or an occasional dip in desire do not indicate andropause. We speak of deficiency when several symptoms set in for the long term and a low level is confirmed on two blood tests. It is this double condition, clinical and biological, that distinguishes andropause from a simple bout of fatigue.
How is testosterone produced?
Testosterone is produced by the testicles, under the control of the pituitary gland. With age, production falls and the truly active fraction decreases. This is why measuring total testosterone alone is not enough: interpretation requires a full blood test.
How
common
is testosterone deficiency?
The exact prevalence of testosterone deficiency remains difficult to establish, but the orders of magnitude found in the literature agree on one point: the proportion of men affected rises markedly with age. Very few are diagnosed, and even fewer are treated.
What are the
symptoms
of testosterone deficiency?
Taken individually, the symptoms are rarely specific: it is their accumulation, and their gradual onset, that should raise concern. The ADAM questionnaire (Androgen Deficiency in the Aging Male) offers an initial screen in a few minutes.
Reduced stamina, unusual energy slumps.
Reduced sexual desire, fewer sexual thoughts.
Less firm erections, especially in the morning. Usual treatments become less effective.
Less restorative sleep, waking during the night.
Lower motivation, low spirits, irritability.
Loss of muscle, increased waist circumference.
If erection problems are the main concern, they call for dedicated care: see our erectile dysfunction pathway. Andropause and erection problems are often linked, but they are assessed differently.
When can testosterone
be too low?
We distinguish age-related deficiency (the most common, and progressive) from secondary causes, where a medical condition or a lifestyle factor drives testosterone down. Identifying the origin is essential: some causes are reversible.
Age- and lifestyle-related factors
- Ageing
Physiological decline of 1 to 2% per year in testicular production.
- Overweight and obesity
Fatty tissue converts testosterone into oestrogens: a common vicious circle.
- Metabolic syndrome and diabetes
Strongly associated with testosterone deficiency.
- Sleep and chronic stress
Lack of sleep and stress can affect testosterone.
- Alcohol, sedentary lifestyle
Aggravating factors that can be reversed through lifestyle.
- Overtraining, extreme sports
A very high training load can also affect the level.
Medical causes
- Primary hypogonadism
Direct damage to the testicles: medical history, trauma, chemotherapy.
- Pituitary cause
An abnormality of the pituitary gland, which controls testosterone production.
- Medications
Opioids, corticosteroids, psychotropic drugs, anti-androgens…
- Hyperprolactinaemia
A high prolactin level can explain reduced desire and a deficiency.
- Chronic conditions
Kidney disease, liver disease, chronic inflammatory diseases, cancers…
Is this the right time
to seek an explanation?
Many men live with these changes without daring to talk about them, putting them down to age, work or tiredness. That is a natural reaction, and often a few adjustments are enough. But when several signs set in and weigh on daily life, seeking to understand the cause is not an overreaction: it is legitimate, and it is what allows you to act wisely rather than put up with it. A medical approach makes sense when several of these situations ring true for you.
- Several symptoms (energy, desire, mood, sleep) have been present for more than 3 months and are not improving on their own.
- They are starting to weigh on your daily life, your relationship or your morale.
- You have a risk profile: overweight, diabetes, metabolic syndrome.
- The ADAM questionnaire is positive, or fatigue persists despite a normal basic blood test.
- You simply want to know where you stand, with clear answers rather than guesswork.
What are the
care options
for testosterone deficiency?
There are two main approaches, often complementary. They are decided after your blood test and the work-up at the centre, according to the cause and severity of the deficiency. This information is provided for medical, objective purposes.
In cases of overweight or metabolic syndrome, acting on lifestyle may be enough to improve testosterone levels. It is almost always the first step.
- Weight loss: reduces the conversion of testosterone into oestrogens.
- Strength training and regular physical activity.
- Sufficient sleep: testosterone is mostly produced at night.
- Cutting down on alcohol, managing stress.
- Reviewing a medication that may be responsible (opioids, corticosteroids).
In cases of confirmed, symptomatic deficiency, testosterone therapy may be indicated. It is initiated and monitored by the AndroAct partner centre after the work-up at the centre, in one of several possible forms:
- Transdermal gel (e.g. Androgel): applied to the skin daily.
- Injections: short-acting, or long-acting (every 10 to 14 weeks).
- The form is chosen according to profile, lifestyle and tolerance.
What should you remember about hormone therapy?
Testosterone therapy is a long-term intervention that is not without risk (monitoring of haematocrit and the prostate, contraindications to rule out). It is never prescribed on the basis of a single blood test, nor as self-medication. That is precisely the purpose of our pathway: to objectively establish the deficiency and secure the decision before any treatment.
Testosterone replacement therapy is subject to prescription and medical supervision. The molecule, form and dosage are determined by the doctor after the full work-up at the centre and according to contraindications.
A coordinated
pathway,
from questionnaire to treatment.
Four stages that follow on seamlessly: the assessment and prescription with Kano, the blood test at the laboratory of your choice, then the full work-up and treatment plan at an AndroAct partner centre. The aim: to avoid back-and-forth and repeated tests.
ADAM questionnaire
Ten yes / no questions to identify signs that may be associated with testosterone deficiency.
- Online assessment of your symptoms
- Creation of your medical file
- No commitment
Prescription and referral
A doctor reviews your file, calls you for a short conversation and prescribes your blood test if appropriate.
- Blood-test prescription from a doctor, if appropriate
- Then access to the AndroAct app to choose a partner centre and book an appointment
Blood test at a laboratory
You have your blood test in the morning after fasting, at the laboratory of your choice.
- Laboratory of your choice
- Results in hand for the work-up at the centre
Work-up at the centre and plan
With your results in hand, the clinical team carries out the full work-up, makes the diagnosis and defines your plan.
- Full work-up at an AndroAct partner centre
- Treatment plan defined with the doctors
- Long-term medical follow-up
What changes: understanding the cause before treating.
No treatment on the basis of a single blood test. A doctor opens the pathway, a specialist centre makes the diagnosis and defines the plan with you.
€35 for the first step.
The €35 covers the initial medical act: the review of your ADAM questionnaire by a doctor, the prescription for your blood test and the referral to a partner centre. It is this medical step that opens and secures the rest of the pathway: a blood test prescribed by a doctor on justified grounds, then the full work-up at the centre. The work-up at the centre and any treatment are not included in this price.
- Review of your ADAM questionnaire by a registered doctor
- A short phone conversation with the doctor
- Prescription for your blood test (if appropriate)
- Referral to an AndroAct partner centre near you
Supervised by
specialists
in men’s health.
AndroActDr Carole Burté
“Testosterone deficiency affects many men. Yet, through lack of awareness and taboo, it remains one of the most under-diagnosed medical conditions of our time.”
This pathway brings together two French men’s health players: the Kano.care doctors for the assessment and prescription, and the AndroAct clinical team for the work-up and follow-up.
Your questions about
testosterone deficiency.
Yes, but the term is misleading. There is no exact male equivalent of the menopause: the decline in testosterone is progressive and partial, not an abrupt stop. More precisely, we speak of age-related testosterone deficiency (or late-onset hypogonadism) when symptoms are accompanied by a biologically confirmed low level. Without that confirmation, andropause cannot be diagnosed in the medical sense.
The diagnosis rests on two conditions: suggestive symptoms (reduced desire, fatigue, erection problems, muscle loss…) AND a low testosterone level, confirmed on two blood tests taken in the morning after fasting. A questionnaire such as the ADAM provides an initial screen, but only a full blood test, interpreted by a doctor, can confirm the deficiency and look for its cause.
Hormone replacement therapy, when indicated and properly supervised, is effective and generally safe. It does, however, require certain situations to be ruled out before starting (breast cancer, active prostate cancer, high haematocrit, wish to father a child, recent acute cardiovascular event) and regular monitoring. That is why it is never prescribed on the basis of a single blood test or as self-medication, but after the full work-up at the centre and under medical follow-up.
Yes, in most cases, combined with lifestyle measures. When a deficiency is confirmed and symptomatic, hormone therapy is the standard treatment, always accompanied by work on lifestyle (weight, physical activity, sleep, alcohol) and a review of any medication that may be responsible. The decision, the form of treatment and the follow-up are defined by the centre’s clinical team at the end of the full work-up.
A blood test limited to total testosterone is not enough: interpretation requires a full blood test, a clinical examination and an assessment of your overall health (metabolic, prostate). The work-up at the partner centre brings these elements together in half a day, which allows a reliable decision, far more so than an isolated blood test interpreted on its own.
The network of partner centres is still limited and is expanding gradually. During your assessment, we check whether a centre is close to you and show you the nearest one. If no centre is accessible yet, you can be notified when one opens in your region; talking to your GP about your symptoms remains a good option in the meantime.
Disclaimer: the information on this page is provided for information purposes and does not replace medical advice. Testosterone treatment is subject to prescription and medical supervision. In an emergency, call 112 (or 15 in France). Pathway offered in partnership with AndroAct.
