As men age testosterone levels can decrease, this is called hypogonadism or low-T.Symptoms of low testosterone include loss of libido, lack of energy, loss of muscle mass, erectile dysfunction and depression. A man's testosterone level normally decreases with age. After age 40, a man’s testosterone level decreases by 1-2% annually. About 4 out of 10 men over the age of 45 have low testosterone. Risk factors for low levels of testosterone include high blood pressure, high cholesterol, diabetes, overweight, HIV, and long term opioid use. Low testosterone causes reduced insulin sensitivity and carbohydrate metabolism, increased bone turnover, impaired cognitive function, reduced motivational drive, fatigue and lethargy.
Testosterone replacement therapy is safe and effective. If replaced to physiological levels, it can have major clinical effects on a range of factors that improve well being and quality of life.
Low testosterone is a clinical syndrome complex characterized by low testosterone levels and clinical signs and symptoms. Signs of low testosterone include:
The guidelines for the diagnosis of low testosterone can very between international and national societies. The normal range of testosterone levels for a healthy young man can actually vary between countries and laboratories. The Endocrine Society Guidelines state “ The threshold testosterone levels below which symptoms of androgen deficiency and adverse health outcomes occur is not known and may be age dependent.” These guidelines have advised a cut off for total testosterone level of 300 ng/dl. The ultimate decision on the diagnosis of low testosterone should be made by an experienced clinician in the field. Once the diagnosis has been made, investigation in the underlying cause and ruling out more serious medical conditions should be established.
There are a variety of causes of low testosterone that include age, genetics, environmental exposures and association with medical conditions. Proper medical evaluation of the hypogonadal male before replacement therapy has been instituted, is advised.
There are a variety of testosterone replacement regiments available on the market today. They include topical gels, injectables, nasal sprays, and time release implants. Each medium of testosterone replacement is tailored to a patients lifestyle and needs. Our practice specializes in all aspects of testosterone replacement therapy and monitoring prostate health and fertility during treatment.