What is it?
Testosterone is the “male” hormone that plays a role in male sexual function, fertility, mood and body composition. In some men as they age, the body’s ability to produce normal testosterone levels declines. If you are experiencing any of the symptoms listed below please inform your urologist as it may be signs of low testosterone (hypogonadism).
Symptoms of low testosterone:
- Erectile dysfunction
- Low sex drive
- Breast development
- Reduced body hair
- Decreased muscle mass
- Increase body fat
- Decreased bone density (osteoporosis or osteopenia)
- Mood changes
Why does it occur?
It is unclear why testosterone levels decline in some men. Below are some risk factors associated with low testosterone.
- Chronic Kidney Disease
- Chronic Obstructive Pulmonary Disease (COPD)
- Chronic opiod (e.g. Percocet, Vicodin, Oxycontin, Morphine, illicit drugs) use
How is it evaluated and why?
Low testosterone is diagnosed with a blood test to evaluate several forms of testosterone in the blood stream. This test is ideally performed in the morning between 7AM and 11AM but is not essential to be drawn at this time. However, a low testosterone without any symptoms typically does not require treated. It may be difficult sometimes to distinguish signs of low testosterone from medication side effects or other medical conditions. It is important to discuss your symptoms in detail with your physician to see if you are a candidate for testosterone therapy.
Replacement therapy for low testosterone can be administered easily in several forms:
- Topical gel
- Skin patches
- Testosterone gum-thin patch of testosterone absorbed through the cheek/gum
Your urologist will follow your therapy and progress by periodically monitoring your testosterone levels, PSA, liver function, red blood cell count, cholesterol levels. He may also perform biannual prostate examinations.
Considerations for testosterone therapy:
- Side effects: acne, infertility, testicular shrinkage, elevated red blood cell count, abnormal liver function
- If you have any of the following conditions, you may not be a candidate for testosterone replacement therapy: prostate cancer, breast cancer, severe liver disease, congestive heart failure, severe sleep apnea.
- In some medical studies, having a low natural testosterone has been shown to increase risk of death from cardiovascular events (e.g. heart attack, stroke, abnormal heart rhythm). In other studies there may be an increased risk of serious cardiovascular events from giving supplemental testosterone replacement. Therefore it is important to discuss it with your physician based on your personal medical history.