Low testosterone, which is also called male hypogonadism, is a condition where the testes don't produce a sufficient amount of testosterone. Keep reading to learn more about low testosterone, common causes, and effective treatments.
Understanding Low Testosterone
In men, testosterone is what helps to maintain and develop muscle mass, sexual features, sufficient levels of red blood cells, reproductive function, a sense of well-being, and bone density. More about the specific role of testosterone can be found by visiting risemenshealth.com/trt-basics.
Is Low Testosterone Common?
Low testosterone is a condition that affects up to 40% of men age 45 or older. It is challenging to create a specific definition of what normal testosterone levels are. That is because levels will vary during the day and can be affected by factors like BMI (body mass index), alcohol consumption, nutrition, age, illness, and medications.
Common Causes of Low Testosterone
When a man gets older, the amount of testosterone in their body will drop gradually. The natural decline of this hormone will begin after a man reaches the age of 30 and continues approximately one percent per year for the rest of his life. There are multiple causes of low testosterone. Some of the most common include HIV/Aids, chemotherapy for cancer, renal failure, metabolic disorders, alcohol abuse, chronic or acute illness, medications, injuries, obesity, and more.
Common Symptoms of Low Testosterone
The symptoms of low testosterone depend on a person's age. They include irritability, low sex drive, fatigue, erectile dysfunction, issues with memory, depressed mood, reduced sense of well-being, and a loss of muscular strength. Some of the other issues that may arise when someone has low testosterone include a reduction in body hair, reduction in hemoglobin, infertility, development of breasts, increased body fat, and thinning of the bones.
Options to Diagnose Low Testosterone
It is possible to diagnose low testosterone by measuring how much is in a man's blood. It can take a few measurements to figure out if someone is dealing with low testosterone because the levels will change during the day. Usually, the highest levels are seen in the morning, around 8 AM. That is why most doctors want to test someone's testosterone levels in the morning.
Treatment and Management of Low Testosterone
Low testosterone is a condition that can be treated with something called testosterone replacement therapy. This can be administered in a few ways. It can be an intramuscular injection, where it is put directly into the muscle. This can be done every 10 to 14 days.
Another option is testosterone patches. These are used daily and applied to different parts of the body, which include the abdomen, back, arms, and buttocks. Testosterone gels are another treatment option, which is applied to dry, clean skin on the upper back and arms. This type of gel requires care to make sure the hormone is not transferred to another person or the individual's partner. Pellets can also be used. These are inserted as implants under the skin, every two months.
While oral testosterone exists, it is not approved for use in the U.S.
Benefits Offered by Testosterone Replacement Therapy
There are several benefits offered by testosterone replacement therapy. For example, in younger boys, it can help to prevent cases of delayed puberty. It can also result in the loss of excess body fat. Other benefits of this treatment include improved physical performance and muscle strength, improved mental sharpness, improved sexual function, improved sense of well-being and mood, increased bone density, and protection from cases of osteoporosis.
Potential Side Effects of Using Testosterone Replacement Therapy
There are several potential side effects caused by testosterone therapy. One is oily skin and acne. A person may also experience ankle swelling, which is caused by fluid retention. Other issues include breast tenderness or enlargement, the stimulation of the prostate, smaller testicles, and cases of sleep apnea.
Some of the laboratory issues that may arise when testosterone replacement is administered include an increase in a person's red blood cell count, an increase in prostate-specific antigen, and a reduction in sperm count, which can result in infertility. If someone is using hormone replacement therapy, they should make sure to keep regularly scheduled appointments with their doctor.
Guidelines have suggested that talking about the potential risk versus the benefit of evaluating prostate cancer risk and ongoing prostate monitoring is a top priority. By doing this, patients and their doctors can decide what type of monitoring is needed related to prostate cancer. For individuals who select ongoing monitoring, doctors need to assess the risk of prostate cancer before they start treatment for the condition and three to 12 months before starting the testosterone.
It is best to have PSA levels checked at the three, six, and 12 month point in the first year and then each year after that. Also, a digital rectal exam of a person's prostate is needed at three to six months and then a year after starting therapy. This is something that is recommended even for individuals who are not undergoing testosterone replacement therapy. Usually, this will begin at the age of 50. A person's hematocrit levels are going to be checked prior to starting testosterone therapy, too, and then it will be done regularly to ensure the red blood cell levels stay normal.
Who Should Avoid Testosterone Replacement Treatment?
In some situations, testosterone replacement therapy will cause the prostate to grow. If a man is dealing with early prostate cancer, there is the worry that testosterone will stimulate the growth of cancer. As a result, any man who is diagnosed with prostate cancer should avoid testosterone replacement therapy. It is essential for men who are considering this therapy to have prostate screening before they begin this treatment.
Other individuals who should avoid this treatment include those with breast cancer, an enlarged prostate, a PSA that is four or above, or a lump on their prostate. When it comes to low testosterone, it is necessary to make sure that the proper treatment is sought, which is going to help handle the issue and ensure it does not return.