Should I seek treatment for low testosterone?

Male patient talking with a doctor

You may have heard or seen ads warning men that they may be suffering from “low T,” or low testosterone.

As a urologist who specializes in male sexual and reproductive medicine, I often treat men who are experiencing a decrease in their testosterone levels. These lower testosterone levels can be a normal, natural part of aging, and a simple blood test is all it takes to detect this.

In fact, more than 30% of men under the age of 60 (or roughly about 6 million men in the United States) have low testosterone levels. Men with testosterone levels below 300 ng/dL may experience low T symptoms to some degree, and even men as young as 25 can experience low testosterone levels.

What are the symptoms of low testosterone?

Often men will come to my office complaining that they have erectile dysfunction and are feeling excessively fatigued, weaker or depressed. Another major complaint is a marked decrease in their sexual desire.

Other symptoms may include insomnia, weight gain, reduced muscle mass and strength, heart problems, osteoporosis and difficulty concentrating. The problem is that many of these same symptoms can also be signs of other health issues.

For instance, your chronic fatigue and lack of energy could be caused by depression instead of low testosterone levels. That’s why it’s important to undergo a physical exam and testosterone evaluation first. If your testosterone isn’t low, your doctor may determine that low T isn’t really the issue at hand.

What are the treatment options for low testosterone?

There are several treatment options for low testosterone, and medications aren’t always necessary. Changing certain lifestyle factors, such as exercising, reducing stress, improving sleep and improving dietary habits, will help significantly. Many people benefit from losing weight or getting a sleep study and using a CPAP machine, which delivers steady air through a hose connected to a mask or nosepiece to help you sleep.

Others may find benefit from hormone therapy using testosterone gels, patches, injections, pellets or alternative hormone medications. The majority of low T patients use injections for treatment. Injections are typically performed weekly or twice weekly to keep levels stable.

Testosterone gels are usually applied to the chest, upper arms, underarms or inner thigh once a day.

Pellets are placed under the skin during an office visit and re-done every three to five months. There’s also an oral option, but this medication is newer and often not covered by insurance.

Risk factors for all testosterone therapy include: elevation in red blood cell count, elevation in estrogen, acne, skin reactions, testicular atrophy, blood clots and cardiovascular risk.

I’d encourage all men to a see a doctor if they think they may have low T symptoms. This is a real medical issue that can safely be helped by a primary care physician, an endocrinologist or a urology provider to improve quality of life.


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