UCI-Mens-Health-Center-Newport-Beach-CA

Testosterone deficiency refers to low levels of the male hormone testosterone.

In addition to regulating sexual functions, this hormone also plays a role in fat distribution, bone mass, muscle strength, and the production of red blood cells.

  • It's believed that more that 15 million men in the United States suffer from what's also referred to as "low T" or hypogonadism.
  • A problem sometimes related to underlying health issues and medications being taken for other conditions, testosterone deficiency is often treatable or manageable.

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Reasons for Testosterone Deficiency

Over time, the production of testosterone, which mainly occurs in Leydig cells in the testicles, slowly decreases. Other than age-related changes, T levels may also drop due to health issues such as type 2 diabetes, hypertension (high blood pressure), and asthma. Higher than normal cholesterol levels and excess weight can also be contributing factors. Some men have testosterone issues due to side effects of certain medications. If this is the case, adjustments to doses or medication used may minimize or reverse symptoms.

Symptoms Associated with Hypogonadism

A reduction in sex drive is one of the most common symptoms men generally first notice when testosterone levels are lower than normal. Some men may find it more difficult to retain their muscle mass, while others may experience depression and changes in mood. Some men also experience:

  • A reduction in body hair
  • Anemia caused by a low red blood cell count
  • Erectile dysfunction
  • General fatigue or loss of energy
Blood-Test-to-Diagnose-Testosterone-Deficiency
Testosterone-Replacement-Therapy

Diagnosing Testosterone Deficiency

Testosterone deficiency is only positively diagnosed with a blood test. Specifically, a urologist may look at overall testosterone levels and sex hormone-binding globulin (SHBG) that helps bind sex hormones. Multiple tests are typically done since hormone levels can change throughout the day.

Testosterone Replacement Therapy (TRT)

The most common treatment for testosterone deficiency is testosterone replacement therapy (TRT). Treatment usually begins with gel applications through the skin once a day. Simply having low testosterone doesn't mean TRT will be recommended or necessary since there are potential side effects, although they are usually mild ones.

Improvements with TRT are typically seen within a week or so after starting treatment. TRT can be done in several ways other than the application of skin gel after showering. Some men see better results with transdermal skin patches, tablets taken orally, or injections.

If low testosterone levels are causing significant symptoms, pellets may be implanted in soft tissues so the hormone can be released slowly into the bloodstream. A urologist can help you weigh your options based on your symptoms and how hypogonadism is affecting your overall quality of life.

After the age of 30, most men begin to experience a gradual reduction in testosterone levels. Some older men may think that changes due to hypogonadism are a normal part of the aging process. While this is true to some extent, abnormally low hormone levels can increase the risk of bone fractures and reduce muscle strength. The effects of a natural drop in testosterone can sometimes be countered with adjustments to diet and lifestyle habits. If such efforts aren't effective, a urologist can recommend more specific treatment options.

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Joel Gelman, M.D.
Male Urology
HS Clinical Professor-VCF
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Faysal A. Yafi, M.D., F.R.C.S.C.
Male Urology
Associate Professor of Urology, Director of Newport Beach Urology, Director of Men's Health, Chief, Division of Men's Health and Reconstructive Urology

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