Low-T (Testosterone)

Testosterone is a male hormone (androgen) produced by the testicles and is responsible for the proper development of male sexual characteristics. Testosterone is also important for maintaining muscle bulk, adequate levels of red blood cells, bone density, sense of well-being, and sexual and reproductive function.

Inadequate testosterone production is not a common cause of erectile dysfunction (ED). When ED does occur with decreased testosterone production, testosterone replacement therapy may improve the ED.

 

What is Hypogonadism?

Hypogonadism (hi-po-go-na-dizm) is a medical condition in which the body does not produce enough testosterone. Men with hypogonadism have low levels of testosterone (Low T). Some men are born with hypogonadism, while others develop it later in life.

There are two basic types of male hypogonadism:
Primary hypogonadism: Low T due to a dysfunction or defect in the testes.
Secondary hypogonadism: Low T due to a dysfunction or defect in the pituitary gland or hypothalamus (the parts of the brain that signal the testicles to produce testosterone).

Symptoms of Low Testosterone

• Decreased energy & motivation
• Increased Fatigue
• Changes in sleep patterns – insomnia or other sleep disturbances
• Emotional changes – decrease self-confidence, depression or sadness.
• Reduced muscle mass and strength
• Trouble concentrating
• Decreased libido
• Increased body fat
• Irritability
• Decreased bone density
• Swollen and/or breast tenderness (gynecomastia)
• Hair loss is possible
• Memory loss

What causes Low Testosterone?

• Normal Process of Aging
• Chronic Illness
• Diabetes – Some studies have shown that men who have diabetes may be more likely to have hypogonadism. Between 33% and 50% of men with diabetes may also be diagnosed with Low T
• Obesity – Some studies suggest that excess weight may be linked with Low T. These studies have shown that obese men are more likely to have Low T compared to those at a healthy weight.
• Cirrhosis
• Chronic Kidney Failure
• Inflammatory disease such as sarcoidosis (a condition that causes inflammation of the lungs and other organs)
• Chronic Stress
• Alcoholism
• HIV
• Hemochromatosis
• Use of Certain Medications (Corticosteroids, Chemotherapeutic Rx’s, Radiation)
• Trauma
• Many different conditions or scenarios (Tumors, Environmental Toxins, Genetic Deficiencies)

 

Benefits of Low Testosterone Treatment

• Reduce fat and increase muscle
• Improve your concentration
• Maintain sleep and feel more rested
• Maintain bone density/strength
• Increase strength and athletic performance
• Improve mood
• Improve insulin sensitivity
• Improve erectile function
• Heighten your motivation
• Increase your sense of well-being

 

How do I find out if I have a testosterone deficiency?

The only accurate way to detect the condition is to measure your hormone levels including testosterone in your blood.   It is vital to test for other hormones to isolate the actual cause of your Low T. 

  Your measurements should be done in the morning, as testosterone is generally higher in the morning.

 

What options are available for testosterone replacement?

• Intramuscular injections
• Testosterone patches
• Testosterone gels & creams

 

Who shouldn’t take testosterone replacement therapy?

Testosterone replacement therapy may stimulate growth of the prostate. If early prostate cancer is present, testosterone may stimulate the cancer’s growth. Therefore, men who have prostate cancer should not take testosterone replacement therapy. It is important for all men considering testosterone replacement therapy to undergo prostate screening before starting this therapy.

Although it is a rare condition, men who have breast cancer should not take testosterone replacement therapy.

 

What are the side effects of testosterone replacement therapy?

In general, hormone replacement therapy is safe. It is associated with some side effects, including:

• Acne or oily skin
• Mild fluid retention
• Stimulation of prostate tissue, with perhaps some increased urination symptoms such as decreased stream or frequency
• Breast enlargement
• Worsening of sleep apnea
• Decreased testicular size
• Changes in cholesterol concentrations
• Increased in red cell count
• decrease in sperm count, producing infertility (especially in younger men)

Many of these side effects are not common.

 

What testosterone replacement therapy options are available?

FDA approved treatment options include:

• Gels and Solutions – Testosterone gels and solutions are applied daily. The testosterone in the gel or solution is absorbed into the body through the skin.
• Patches – Patches allow testosterone to be absorbed by the skin. Patches are applied daily.
• Injections – Testosterone injections, usually in the upper buttock.
• Buccal Tablet – In your mouth, the tablet is applied to the gum, where testosterone is absorbed over a 12-hour period.
• Pellets – Pellets are placed under the skin near the hip by a doctor during a surgical procedure.

Each of these treatment options can help men with Low T achieve adequate levels of hormone replacement. Only your doctor can decide if testosterone replacement therapy is right for you.