Some men first notice it in the bedroom. Others on their weighing scale. Many don’t notice it at all, until blood work or burnout forces a reckoning. Low testosterone, or hypogonadism, was once considered a fringe concern, tied to old age or rare hormonal disorders. But in 2025, it’s something different entirely: a modern male health issue with surprisingly mainstream roots.
Whether it’s dropping energy levels, fading libido, or unexplained weight gain, the effects of low testosterone (or “low T,” if you’re particularly fond of bro science) are being noticed by more Indian men than ever before. And not just noticed—they’re being Googled, tested for, and in some cases, overcorrected with questionable remedies. That’s where clinicians like Dr. Suraj Pinni come in.
As a consultant urologist and andrologist with the Asian Institute of Nephrology and Urology, Hyderabad, Dr. Pinni is part of a growing number of specialists seeing testosterone-related cases spike across age groups. “The testing for testosterone has been on the rise,” he says. “Many people do it without actually having an indication to do it.”
But the problem isn’t just over-testing. It’s under-understanding. “If you just focus on the report itself, without correlating it with symptoms, you’re not treating the actual issue,” he explains. “Low testosterone isn’t a number. It’s a lived experience.”
Fat, Frustration and Falling Hormones
Modern lifestyles are doing Indian men no favours. A lack of physical activity, poor-quality diets, and ballooning midsections have created the perfect storm for hormonal disruption. “Fat is the enemy of testosterone,” Dr. Pinni says. “Any fat deposit in the body can convert testosterone to estrogen, which lowers testosterone further.”
The link between testosterone deficiency and lifestyle diseases is becoming impossible to ignore. A 2017 cross-sectional study published in the Indian Journal of Endocrinology and Metabolism found that one in five Indian men with type-2 diabetes showed signs of hypogonadism . The pattern is vicious and circular: abdominal obesity drives down testosterone levels, which worsens insulin sensitivity, which worsens fat deposition, and so on.
“Low testosterone has been closely associated with metabolic syndrome—diabetes, high cholesterol, cardiovascular risk,” Dr. Pinni says. “It’s not always clear which came first, but they feed into each other. And that’s what makes lifestyle such a key intervention.”
From Libido to Loneliness
Beyond the waistline, testosterone dips often come with psychological weight too. Dr. Pinni sees this regularly in his practice, particularly among men between 40 and 60. “They’ll come in with complaints of low libido, erectile dysfunction, fatigue, sometimes even depression. But they may not connect it to hormones at all.”
Younger men, by contrast, are more aware—sometimes too much. “The younger generation is very proactive,” he notes. “Sometimes they assume something is wrong when everything is actually normal. They’ll chase a ‘fix’ for something that’s psychological or situational, not biochemical.” Part of the problem, he adds, is widespread confusion around how testing should be done. “People walk into my clinic with one random blood report and think they’re doomed. But testosterone follows a circadian rhythm. It has to be tested early morning, ideally fasting, and repeated at least twice to be accurate.”
Even when a genuine diagnosis is made, treatment isn’t always as simple as popping a vial of TRT. For younger men, testosterone therapy can actually worsen fertility by suppressing sperm production. “It’s a common misconception,” says Dr. Pinni. “Testosterone doesn’t help you have kids—it can do the opposite. We have to be very clear about the patient’s goals before recommending anything.”
A Gendered Health Gap
Despite rising awareness, stigma continues to cloud the conversation, especially among older men. “Many patients won’t bring it up with their family doctor,” Dr. Pinni says. “They’ll look for someone far away from home. Or worse, they’ll turn to the internet.” He’s seen firsthand how misinformation can mislead men into self-diagnosing or self-medicating, often with poor results.
So what does the average man need to know? First, don’t panic at one lab report. Second, don’t assume that tiredness or low mood is just psychological. And third, don’t wait for things to spiral. “If you’re feeling off—if your sex drive has dropped, if you’re gaining weight despite exercise, if you’re just not feeling like yourself—it’s worth having a conversation,” says Dr. Pinni. “It doesn’t mean you need medication. It means you deserve to be taken seriously.”
Testosterone might not be the catch-all explanation for every male woe, but it’s increasingly clear that it’s part of the picture. And in a country grappling with diabetes, metabolic syndrome, and an epidemic of male burnout, that picture is starting to look very familiar.
