Low testosterone can stem from a variety of factors, often categorized into primary and secondary hypogonadism. Primary hypogonadism originates in the testicles themselves, where damage or dysfunction impairs hormone production. This might result from congenital conditions like Klinefelter syndrome, where an extra X chromosome affects testicular development, or from physical injuries such as trauma to the groin area during sports or accidents. Infections like mumps orchitis can also inflame the testicles, leading to long-term reduced function. Chemotherapy or radiation treatments for cancer often target rapidly dividing cells, inadvertently harming testicular tissue and causing testosterone deficiencies. Secondary hypogonadism, on the other hand, involves issues with the pituitary gland or hypothalamus in the brain, which signal the testicles to produce testosterone. Pituitary tumors, even benign ones, can disrupt this signaling pathway. Chronic illnesses such as type 2 diabetes or obesity create a vicious cycle, as excess body fat converts testosterone into estrogen, further lowering levels. Sleep disorders like obstructive sleep apnea deprive the body of restorative rest, during which testosterone is primarily produced. Certain medications, including opioids for pain management or glucocorticoids for inflammation, suppress the hormonal axis. Environmental factors play a role too, with exposure to endocrine-disrupting chemicals in plastics or pesticides potentially interfering with hormone balance. Aging remains the most common cause, with levels dropping about 1% per year after age 30, but lifestyle choices like poor diet, lack of exercise, and high stress can accelerate this decline. Identifying the root cause is key to tailoring effective management strategies.