low
testosterone
After age 30, most men experience a gradual testosterone decline.
A decrease in sex drive sometimes accompanies a drop in testosterone, leading many men to mistakenly believe that their loss of interest in sex is simply due to aging. However, many men do not notice that other symptoms may accompany their low sex drive, such as fatigue, mood irregularities and sleep disturbances. All these symptoms can be attributed to something called “hypogonadism” or low testosterone.
Listening and understanding your body can be confusing and difficult to manage. Symptoms of low testosterone can be easily confused with other conditions, which is why it is important to seek a medical professional for a diagnosis. Dr. Draelos specializes in men’s health and will provide quick and easy testosterone replacement treatment options. Contact Draelos Metabolic Center today, and we will get you back to being your best self.
What are the Symptoms of Low Testosterone?
Fatigue/weakness
Increased body fat
Loss of sexual desire (libido)
Loss of endurance
Loss of muscle
Loss of hair
Loss of drive to work
Young men or boys with low testosterone during their teens may fail to go through puberty normally. Infertility can also occur with low testosterone. Over time, low testosterone can cause bone weakness (osteoporosis).
What Causes Low Testosterone?
Aging: A man’s testosterone production decreases by approximately 25% between 20 and 80 years of age.
Obesity: In the Heritage Family Study, increasing total body fat content and visceral fat were associated with decreased plasma levels of Sex Hormone Binding Globulin (SHBG). As a result, total testosterone is frequently low, but free testosterone measures as normal.
Testicular problems: These include damage from injury, infection or medications (such as chemotherapy), and certain inherited genetic abnormalities, such as a condition called Klinefelter’s syndrome.
Brain/pituitary problems: Potential problems include benign pituitary tumors, other tumors/growths near the pituitary, inflammation, high iron levels and medications.
How is Low Testosterone Evaluated?
Low testosterone is evaluated by asking three main questions:
Is testosterone low? Testosterone levels vary daily and change throughout the day, particularly in younger men. Levels are highest in the morning when testosterone should ideally be measured (8 a.m. - 10 a.m.).
Why is testosterone low? Once testosterone is confirmed to be low, the next step is to try and understand why this has occurred. Measurements of LH and FSH will show if the problem originates with the testicles (LH/FSH levels elevated) or the problem originates with the brain/pituitary (LH/FSH not elevated). If the lab values indicate a problem with the brain or pituitary, your doctor may ask you to have a pituitary MRI scan. Additionally, blood testing for prolactin and iron may be needed.
How should testosterone be treated? If the cause of low testosterone cannot be fixed, which is common, testosterone therapy should be considered.
Types of Testosterone Therapy
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Gel
• Types of gel: Androgel, Axiron, Fortesta, Testim
• With Testosterone gels, it is important to remember that after applying, you may not shower, swim, sweat excessively or have skin-to-skin contact with your significant other for at least 4 hours.
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Patch
• Androderm
• In about 25% of patients, a mild skin reaction may occur at the patch site. This is easily treated with hydrocortisone cream.
• Gels and patches are the more expensive forms of testosterone therapy, but give even levels of testosterone. Despite applying properly, about 20% of patients do not achieve adequate levels.
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Injectable
• Testosterone Cypionate: injected every 7-10 days into muscle.
• AVEED® testosterone replacement therapy.
• Instruction/education is given for patients to self-injection or for someone of their choice to administer the shot.
• Trough lab levels are essential for accurate treatment.
• Typically this is the most affordable. However, it does involve frequent needle sticks.
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Pellet
• Implantation is a simple procedure that typically takes only 10 minutes.
• The skin of the upper hip or buttocks is thoroughly cleaned, then injected with a local anesthetic to reduce discomfort. A small incision is made.
• Tiny testosterone pellets are placed under the skin with an instrument called a trocar. Typically, 10 to 12 pellets are implanted during the procedure. The effects generally last around four months, after which the procedure must be repeated.
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Oral
• Jatenzo