Low testosterone, also called hypogonadism or hypotestosteronemia, is a medical condition where the body does not produce enough of the hormone testosterone. This can occur in both men and women and has several potential causes including:
Aging - Testosterone levels peak in the late teens to early 20s then slowly decline with age. By the age of 60, testosterone levels are typically only 40-50% of peak youth levels.
Medical conditions - Certain illnesses and health problems can impact testosterone production such as obesity, diabetes, infections, hormone disorders, and genetic conditions.
Medications - The use of corticosteroids, opioid pain medications, and treatments for prostate cancer can influence testosterone levels.
Lifestyle factors - Poor diet, lack of exercise, chronic stress, and excessive alcohol use are linked to decreased testosterone.
Injury or damage to the testes - Trauma, infection, surgery or radiation treatment to the testes can temporarily or permanently impact testosterone production.
Low testosterone should not be ignored as it can significantly reduce one’s vitality and quality of life. Symptoms of low testosterone include:
If low testosterone levels are detected, testosterone replacement therapy (TRT) can help restore healthy testosterone levels thereby relieving symptoms.
Benefits of TRT include:
For aging men, testosterone therapy has also been shown to provide cardiovascular benefits by reducing risk factors for heart disease like cholesterol levels and high blood pressure.
Testosterone replacement therapy (TRT) is the medical treatment of low testosterone (hypogonadism) through the administration of testosterone medication. The goals of TRT are to return testosterone levels to a healthy physiologic range thereby reducing symptoms and improving quality of life.
There are several delivery methods for TRT including:
Injections - Testosterone injections, typically administered weekly or biweekly, directly supply the body with testosterone. This allows for precise dosage titration and steady hormone levels.
Transdermal gels/creams - Testosterone gels or creams are applied daily to the upper arms, shoulders or thighs supplying testosterone through the skin.
Oral capsules - Modified testosterone molecules can be taken orally in capsule form, however absorption rates tend to vary.
Pellets - Testosterone pellets are implanted under the skin every 3-6 months to release hormones steadily over time.
Nasal gels - Special testosterone gel formulations can be administered nasally providing for easy, convenient dosing.
The method chosen depends on the patient’s preference, needs and goals. TRT dosing is customized for each patient taking into account age, symptoms, and baseline testosterone blood levels. Follow up blood work helps guide and adjust dosing to keep levels optimized.
Since low testosterone shares symptoms with several other medical conditions, accurate diagnosis is important. A full history, physical exam and appropriate lab testing help identify cases of true testosterone deficiency.
Diagnosis involves:
Symptoms combined with consistently reduced total, free and/or bioavailable testosterone levels confirm hypogonadism and need for treatment.
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For those in the Boerne area interested in learning more about testosterone replacement therapy, here are some local resources that provide testing, treatment or support services:
Seeking timely medical treatment for low testosterone is important for several reasons:
The good news is that benefits from TRT develop gradually over the first year with improved energy, mood, strength, body composition, and libido. Consistent long term therapy preserves these benefits.
Managing low testosterone through hormone testing, treatment and healthy lifestyle habits allows for restoring vibrancy and optimizing well-being. Consider speaking to your healthcare provider if you have any symptoms or questions about testosterone levels.
