Low Testosterone
Low Testosterone (Low T)
Hypogonadism, or Testosterone Deficiency (Low T), affects two to four million men in the U.S., and the prevalence increases with age. It is estimated that while testosterone deficiency can affect up to 38 percent of the population, only five percent of affected men receive treatment.
Men who have any of the following symptoms should be evaluated by a male sexuality expert. The goal of our physicians at Urology Associates is to diagnose and treat men suffering from any of the below symptoms.
Symptoms
Common symptoms of low testosterone may include:
- Decreased energy
- Decreased libido (sex drive)
- Erectile dysfunction
- Loss of muscle mass
- Decreased exercise tolerance
- Change in mental acuity or cognitive function
Low testosterone has also been linked to metabolic syndrome (obesity, high blood pressure, diabetes, and high cholesterol) as well as decreased bone density, or osteoporosis.
Diagnosis
Low testosterone is often underdiagnosed because other psychiatric and medical conditions, as well as medications, can cause these same symptoms. The diagnosis of low testosterone should be considered if a man scores poorly on standardized questionnaires such as the Sexual Health Inventory for Men (SHIM).
A simple measure for hypogonadism is a blood test to check an early morning testosterone level. A general recommendation is that a testosterone level less than 300 is considered low. Low testosterone levels combined with clinical symptoms may warrant Testosterone Replacement Therapy (TRT).
Treatment
Accepted methods of TRT in the United States include:
- Oral replacement
- Skin patches
- Topical gels
- Injectable medications
- Implants
Oral testosterone medications are currently not FDA approved due to potential liver toxicity. Your testosterone level and other factors will determine which therapy is used.
Testosterone treatment can decrease sperm counts and even render men sterile (which is usually reversible), and so men desiring fertility should be given alternative medications to help boost their own natural testosterone levels. Testosterone replacement therapy should never be used in men desiring fertility, and other treatments may be indicated such as an aromatase inhibitor or HCG.
TRT requires close monitoring for changes in blood count, Prostate-Specific Antigen (PSA) level, and liver enzymes. This blood testing should take place two to four times per year, and a digital rectal examination may be needed every 6 months for prostate cancer screening.