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Low Testosterone Therapy

What are the signs of low testosterone in men?

There are both sexual and non-sexual signs associated with low testosterone. Sexual symptoms include poor erectile function, low libido (desire for sex), weaker and fewer erections, and reduced sexual activity. Nonsexual symptoms include increased body fat, decreased energy and fatigue, reduced muscle mass, and depression.

View slides from CBS News for the warning signs. 

What is the treatment for men with low testosterone (hypogonadism)?

Testosterone replacement is an excellent treatment option for symptomatic low testosterone. We offer therapy in the form of topical skin gel and injections.  Read the steps you can take to feeling better.

Testosterone Replacement Works.What should you expect after treatment?

Testosterone replacement has been shown to improve a man’s libido (sex drive), muscle mass, sleep, erections, energy level and depressed mood. Testosterone replacement has been shown to also decrease body fat in men. There is data now to support that giving testosterone to a patient with low testosterone may increase their bone mineral density and decrease their risk for a bone fracture. It is important to realize that testosterone treatment is considered lifelong therapy, just like in other chronic conditions. Stopping testosterone replacement will result in a decline in a man’s testosterone level.

How is low testosterone diagnosed? 

The signs and symptoms of low testosterone in men may be difficult to tell from the changes that occur with normal aging, or may be assumed to be caused by other medical conditions. Talk to Dr. Schmidt about your symptoms and ask if you should be tested for low testosterone. He can take your medical history, give you a medical exam to assess your symptoms and determine if you should be tested. If testing is necessary, we will order blood tests to determine your testosterone level.

We will also check a PSA (a screening test for prostate cancer) and a hematocrit (a measurement of red blood cells in your body). A PSA is checked to make sure that the patient does not have prostate cancer and a hematocrit is checked because men receiving testosterone may experience an increase in their red blood cell count.

Potential Benefits
Studies are being conducted regarding hormone replacement therapy in men, but we are about 20 years behind studies of hormone replacement therapy of postmenopausal women. However, while many of the men’s studies are preliminary, they show the potential benefits of testosterone replacement:

  • Improved sexual function: In general, testosterone has proved relatively effective for men who have low libidos (desire levels). Libido is believed to be significantly hormonally dependent.
  • Improved erectile function: Erectile function is a bit more complicated. There is a proven significant interaction between the hormonal level and sexual functioning, but many other factors are involved. Newer studies seem to show that men and women will respond more effectively to traditional treatments for sexual dysfunction (including oral medications and injections) if they have adequate testosterone levels.
  • Improved mood: In recent studies, older men on testosterone seem to report an improved sense of well-being and an overall improvement in mood when compared with similar men who have received a placebo. Energy levels often also improve.
  • Improved body composition and strength: Interestingly, when we look at studies of the body, we see that with testosterone therapy, there is a decline in body fat, an increase in lean body mass (largely muscle mass), or an improvement in both. Several studies indicate that muscle strength improves, affecting the upper and lower extremities such as hands, arms, and legs.
  • Increased bone density: Low bone density or osteoporosis is an increasing problem in men. Men with osteoporosis have a relatively high incidence of bone fractures and, most significantly, hip fractures. Hip fractures in older men are closely associated with disability and death. Testosterone therapy has been shown to increase bone mineral density, especially in the spine. It has been shown to decrease the rate at which bone is lost.
  • Improved cardiovascular system: Yes, men do get more cardiovascular disease and have more cardiovascular-related deaths than women. It is not known whether this is due to the beneficial effects of female hormones (estrogens) or lifestyle patterns of women, or whether male hormones play a negative role in the cardiovascular system. However, it is believed that androgens may help lower the risk factors for cardiovascular disease, including serum lipoprotein profiles, vascular tone, platelet and red blood cell clotting parameters, and the process of atherosclerosis.

It is important to know that if you are a man with a history of prostate cancer or breast cancer you are absolutely not a candidate for testosterone therapy. The testosterone can make both of these hormonally sensitive cancers grow more rapidly.

Other uncommon side effects include sleep apnea, acne, and breast enlargement. All such side effects go away if treatment is stopped.  As with any medical treatment, you must have a complete physical examination and speak with your doctor about the benefits and risks.

Read studies on Low Testosterone and Therapy:

Testosterone Replacement in Men with Andropause: An Overview

Testosterone replacement therapy patterns for aging males in a managed care setting – Abstract

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