Low Testosterone Overview
Testosterone levels can decrease as men age, starting at age 30, and this can result in a variety of symptoms, including fatigue, decreased sex drive, erectile problems, weight gain and difficulties with exercising and muscle gains, among others. Although many people think of testosterone as a sex hormone, it is much more complicated than that, and is essential for normal male body development and function.
Testosterone: How Do I Know If I Have Low Testosterone?
Testosterone levels decrease with age, but more significant decreases or sudden changes can be detrimental. You may have low testosterone, or “hypogonadism” if you experience the following:
- Fatigue or low energy
- Lowered sex drive or libido
- Worse erections (erectile dysfunction)
- Weight / fat gain
- Loss of muscle mass or difficulty with your workouts
- Memory changes
- Depressive symptoms
- Changes in memory
If you are experiencing any of the above symptoms, you may be a candidate for testosterone therapy. When you visit with us, we will ask you to fill out a questionnaire and describe your symptoms. You will also be asked to take a blood test to measure your testosterone and other hormone levels, and during the visit you will have an exam. Based on this information and our discussion, we will together determine whether you are a candidate!
Treatment Options For Low Testosterone
There are a number of ways to give either testosterone or medications that help your body make more testosterone in orderto improve your hormonal function. These include:
- Injectable Testosterone: Injectable testosterone preparations –testosterone cypionate or testosterone enanthate –can be injected into your thigh or buttocks, or in some cases subcutaneously. These injections are given every 1-2 weeks and in some patients, can result in elevated red blood cell counts, estrogen levels, and irregular lipid ratios as side effects.
- Topical Testosterone: These include testosterone gels, creams, and patches. Testosterone gels and creams are often applied daily or twice daily, with a large number of options available (generics, Testim, AndroGel, Axiron, Fortesta, Natesto).
- Testosterone Pellets: Small testosterone pellets can be inserted under the skin of the buttocks or “love handles”every 3-4 months in a simple, 5-10 minute clinic procedure. The number of pellets inserted can be adjusted to meet your needs.
- Clomiphene Citrate, HCG, and Anastrozole: These drugs may be recommended to you if you are going to be trying to achieve a pregnancy in the near future, as well as if you are trying to stop testosterone therapy. These drugs, rather than providing testosterone, help your body make more testosterone. It is important to know that testosterone in any form can lower your sperm count.
While each type of testosterone has its own side effects (i.e. skin irritation for patches, transference for gels / creams), the most common side effects of all testosterone products include increases in red blood cell count and elevated estrogen levels, as well as infertility and irregular lipid ratios.
We will see you within 4-5 months of your first treatment, which will allow us to modify your therapy as needed. You will also need to come in for follow-up appointments 1-3times per year, which will involve discussion, examination, and blood testing. Once you are on a stable regimen, the frequency of follow-up will decrease to 1-2 times per year.
Testosterone & Prostate Cancer
It has been long known that prostate cancer can respond to androgens, which include testosterone. As a result, there has been a fear that giving men testosterone may either cause prostate cancer, or giving testosterone to men with a history of prostate cancer testosterone may make their prostate cancer worse. However, a number of studies have shown that having low testosterone may be related to having more aggressive prostate cancer, and that having normal testosterone levels does not cause prostate cancer. Furthermore, a number of studies, including several published by the faculty of Utah Men’s Health, have shown that giving men with a history of prostate cancer testosterone does not make the prostate cancer recur or make it worse. While it is important to look for evidence of prostate cancer when starting testosterone treatment, it is possible to treat men with a history of prostate cancer and low testosterone levels with testosterone.
Can Testosterone Therapy Help You?
Many men have low testosterone without knowing it. We at Utah Men’s Health can provide clear guidance by helping you understand your symptoms and hormone levels, and can provide the right treatment for you, at the right time, to restore your body’s hormonal function. Contact Utah Men’s Health today to learn more about testosterone therapy and to schedule a consultation!