Overview
Testosterone is the hormone required to make sperm and therefore is integral to sexual development, function, and interest. Testosterone also contributes to the growth of muscles and bones. It is produced by three glands: the hypothalamus in the brain; the anterior pituitary gland, at the base of the skull; and the testicles.
As men age, testosterone levels tend to decline, which is normal. In fact, after age 30, most men begin to experience the symptoms associated with this gradual decrease. However, men of all ages may experience low testosterone due to other causes. The American Urology Association gauges low testosterone, or low T, as less than 300 nanograms per deciliter.
Causes of Low T
The most common conditions that contribute to low T, after aging, include the following :
- Obesity
- Heavy, prolonged alcohol consumption
- Autoimmune or inflammatory diseases
- Injury to, infection of, or the loss of a testicle
- Chemotherapy or radiation treatment (for cancer)
- Genetic abnormalities, such as Klinefelter Syndrome (an extra X chromosome)
- A dysfunction of the pituitary gland or hypothalamus
Certain medications, including antidepressants and pain narcotics, as well as those prescribed to treat prostate cancer, can lower testosterone levels.
Symptoms of Low T
When testosterone levels decline, the effects can be both physical and mental. Here are some of the most common signs:
- Diminished sex drive
- Erectile dysfunction
- Depression
- Fatigue and/or trouble concentrating
- A decrease in muscle mass with an increase in body fat
- Loss of body hair
- Weakening bones
- A change in cholesterol levels
Diagnosing Low T
If symptoms of low T are detected during an examination, the physician will likely run one or more blood tests to measure the total blood testosterone level. This might include a test of the luteinizing hormone, which controls how testosterone is made. Other tests might include:
- Follicle-stimulating hormones (FSH) – This test, which may require a semen sample, gauges sperm-making functions and is typically for men who want to have children.
- Imaging – An MRI may be ordered to get an image of the pituitary gland, while a bone density (dual X-ray) test would measure if bones are weakened.
- Chromosome tests – Here, blood samples are taken to detect genetic defects, such as Klinefelter Syndrome .
- A hormone test – This test is performed if there are signs of breast development.
Treating Low T
Many low T patients are prescribed testosterone therapy, or medications designed to elevate hormone levels. It can take two to three months for the benefits of these medications to take full effect.
Therapies may include:
- Kyzatrex oral pill – An oral prescription medication for adult men who have low or no testosterone levels due to certain medical conditions (testosterone undecanoate).
- Clomiphene oral pill – Often taken three days of the week. This is not a testosterone replacement but encourages your body to increase the production of its own testosterone. This is best if someone wants to maintain fertility and is still planning a family.
- Topical creams and gels – Typically applied to the upper body every morning. Often formulated for you at a compounding pharmacy.
- Injection – A subcutaneous or intra-muscular injection that slowly releases testosterone and is administered either weekly, biweekly, or every 10 weeks.
- Pellets – A small pellet that is inserted under the skin of the upper hip or buttocks, under a local anesthesia such as Lidocaine. The medication is slowly released over three to six months, before the next pellets are implanted.
*Patients who have been prescribed medication for low T can pick it up at The Urology Group Pharmacy in Norwood or have it shipped directly to their homes. CLICK HERE to learn more about our pharmacy.
