Low Testosterone: Causes, Symptoms, and Treatment

Low Testosterone: Causes, Symptoms, and Treatment

In addition to issues relating to the reliability of compounded products themselves, appropriate clinical studies on pharmacokinetics are lacking. There are limited data in men on active surveillance who are candidates for testosterone therapy. Establishing total testosterone thresholds for a diagnosis of testosterone deficiency is challenging considering the heterogeneity that exists in the testosterone deficiency literature. The most accurate testosterone measurements are obtained in the early morning and on more than one occasion, which is not uniform across testosterone trials. Low testosterone, a form of hypogonadism, occurs when the body fails to produce an adequate supply of this hormone. This condition is more prevalent as men age, occurring in about 20 percent of men age 60 and older and increasing to as much as 50 percent in men age 80 and older.

The use of certain drugs, such as opiate pain medications and some hormones, can affect testosterone production. HIV/AIDS can cause low levels of testosterone by affecting the hypothalamus, the pituitary and the testes. Severe hypogonadism can also cause mental and emotional changes. As testosterone decreases, some men have symptoms similar to those of menopause in women. If, on the other hand, it is due to the aging process, a testosterone replacement treatment can be prescribed, which could be every 6, 12, or 14 weeks, varying from patient to patient and seeking to cover their unique needs. Something to keep in mind, and in contrast to women’s menopause/climacteric, is that while any man can experience a drop in hormone levels, it doesn’t happen for everyone, compared to women who will all reach this stage of life.

These agents share the common overall treatment effect of increasing intrinsic production of testosterone, but there are substantial differences in pharmacologic characteristics and mechanisms of action between them. Given these pharmacologic and mechanistic differences, combinations of these alternative therapies might, in some instances, be clinically appropriate. Other population-based studies have attempted to measure prevalence, but have not used standard methodology, which makes arriving at a definitive number of testosterone deficiency difficult. Where gaps in the evidence existed, the Panel provides guidance in the form of Clinical Principles or Expert Opinion with consensus achieved using a modified Delphi technique if differences of opinion emerged.

More research is needed into the connection between consumption of soy products such as edamame and tofu and testosterone levels. Dairy products can also contain synthetic or natural hormones which could have an impact on hormone levels. More surprisingly, mint and spearmint, because of their menthol content, may reduce testosterone levels. Following a discussion with your physician, you could be prescribed testosterone replacement therapy. This would come in the form of skin patches, topical gels/creams, injections, or implantable pellets. Testosterone replacement has risks and side effects, so make sure you meet with your Urologist first.

Frequency can vary from one injection every week to one injection every 10 weeks. (Most men have an injection every 2 weeks.) Shots may be placed just under the skin or directly into a muscle. If a man has shown some breast development, doctors may check his levels of estradiol, a form of estrogen.

Even men with low or borderline T levels may have sufficient T levels for sperm production, but it may contribute to lower counts or less healthy sperm. Certain health conditions, medicines, or injury can lead to low testosterone (low-T). Low testosterone can affect sex drive, mood, and changes in muscle and fat. Low testosterone (male hypogonadism) is a condition in which your testicles don’t produce enough testosterone (the male sex hormone).

Your doctor can check for testosterone imbalances and help you fix them so that these signs and symptoms go away. Before your test, your doctor may tell you to stop taking some drugs that could affect your testosterone levels. You should also tell your physician about all the medicines you are taking. Testosterone helps build new bones and keep the mass you already have.

Our urologists can prescribe Testosterone Replacement Therapy (TRT) through pills, shots, creams, or patches to increase the levels of testosterone in your body. However, compared to other agents, short-acting injections can result in longer times in the supra-therapeutic and sub-therapeutic ranges, which may impact overall efficacy and rates of adverse events. This may be overcome by altering injection dose and frequency. The categorization of evidence strength is conceptually distinct from the quality of individual studies.

The cause of hypogonadism can be investigated further by your doctor. This might include additional blood tests, and sometimes imaging such as a pituitary MRI. Because of circadian variations in testosterone levels, serum testosterone measurement should occur in the morning, or within two hours of awakening in shift workers (Figure 19 ). Although there is no universal laboratory definition of hypogonadism, in most laboratory reference ranges, the lower limit of normal is between 250 and 350 ng per dL (8.7 to 12.2 nmol per L).

Acne, an enlarged prostate, breast enlargement, and even a decreased sperm count can all occur during TRT. Depending on the cause of TD, there might be other medications a man can take to raise his testosterone levels. Some examples are aromatase inhibitors (AI), human chorionic gonadotropin (hCG), and selective estrogen receptor modulators (SERM). If TRT raises testosterone levels but does not improve symptoms, providers may recommend that men stop TRT. It’s possible that the symptoms are not related to TD, and further evaluation could be necessary. Hematocrit is a measure of the percentage of red blood cells on the blood. As mentioned earlier, polycythemia— excess amounts of red blood cells—is testicular shrinkage from trt permanent (https://wehrle.de) a possible side effect of TRT.