Low Testosterone in Men
One form of hypogonadism is manifested by low serum testosterone levels. This occurs when the body fails to produce an adequate supply of this hormone. This condition is much more common as men age, occurring in about 1/5 of men age 60 and older and increasing to as much as ½ of men age 80 and older. While testosterone is thought of as a male hormone, it is necessary for female functioning as well, and women may also suffer from low testosterone levels. For females, it is generally treated through the gynecologist.
Testosterone is a sex hormone naturally produced within the body. In men, this hormone helps to maintain sperm production, control sex drive, improve mood and regulate muscle mass and bone health. The pituitary gland and the brain control the production of testosterone which is secreted through the testicles. When the levels are low, men may feel a wide range of symptoms.
Symptoms of Low Testosterone
Symptoms of low testosterone in men may include a combination of the following:
● Increased body fat or inability to lose weight
● Lower bone density
● Reduced muscle mass
● Fatigue or decreased energy
● Low libido (sex drive)
● Inability to reach orgasm
● Erectile dysfunction
● Low sperm count
● Diminished volume of seminal fluid
● Smaller or softer testicles
● Mood changes
Causes of Low Testosterone
The causes of low testosterone in men can vary greatly and may include the following:
● Injury or infection of the testicles
● Treatment for testicular cancers
● Hormonal disorders
● Chronic diseases
● Nutritional deficiencies
● Use or drugs including marijuana
● Andropause (male menopause) due to natural aging
Diagnosing Low Testosterone
To diagnose low testosterone, the provider will perform a physical examination and review all of the patient's symptoms. Labs will be ordered to check hormone levels including testosterone and estrogen levels.
• Sperm count
• PSA test for prostate cancer
Complications of Low Testosterone
In addition to affecting quality of life and intimacy, low testosterone can also impact chronic health conditions. Recent research suggests that men with low testosterone are at increased risk of developing diabetes, osteoporosis, and cardiovascular disease as well as impacting mental health.
Treatment of Low Testosterone
Treatments for low testosterone involve replacing the hormone in the body. Often referred to as testosterone replacement therapy, these methods include administering the hormone through:
• Gel, cream, or patches applied to the skin
• Nasal spray
• Long acting supplements
• Medications to stimulate the body to produce testosterone
• Oral inserts (sublingual or buccal)
This treatment is effective in restoring normal testosterone levels in the male body and reducing symptoms. Testosterone replacement therapy is considered a lifelong treatment option. It is important that men taking testosterone be carefully monitored by their providers to make sure levels are stable and to monitor for side effects.
Risks of Testosterone Treatment
Men treated with testosterone are at an increased risk of developing enlarged prostate symptoms or urinary tract symptoms. Patients may have their mood affected by increasing testosterone. Those who have kidney, liver, or heart problems may increase their risk of edema (fluid retention) by taking testosterone. Testosterone can also exacerbate sleep apnea. Testosterone in many forms may decrease fertility. . Testosterone treatments are not usually recommended for men who have been treated for prostate or breast cancer. It can also increase the risk of blood clots, heart attack and stroke.