You have probably seen any number of ads on the television and online about low T. They seem to indicate that this is a growing national problem and that all men should begin taking medication to correct their testosterone deficiency and become more “manly men.” It might be time to slow down this growing snowball down the mountain and look carefully to evaluate when men need testosterone treatment.
Some Facts First
Because requests for testosterone treatment have tripled in the last decade, the AUA, or the American Urological Association, has issued guidelines for the diagnosis and management of testosterone deficiency.
Testosterone is a hormone produced in the testicles of men and is necessary for physical, sexual, cognitive, and many metabolic functions. The hormone testosterone gives men their deep voice, body hair, and muscular body. The sexual component peaks in adolescence and young adulthood.
A man’s ability to produce testosterone starts to decline at about 40 years of age, and levels continue to drop 1 – 3% a year thereafter. It is important to note that just because the levels are dropping after 40 doesn’t necessarily mean that all men require therapy. There must be certain symptoms present.
Confirmed Symptoms Of Low Testosterone in Men
To be clinically diagnosed as having low T, a man must have low testosterone levels and exhibit some of the following signs or symptoms: low sex drive, low sperm count, trouble getting an erection, hair loss, hot flashes, and low bone density.
In addition, men may also exhibit the following signs or conditions:
- Diminished muscle mass
- Increased body fat
- Elevated hemoglobin A1C
- Changes in testes
- Lack of motivation and concentration
- Low-trauma bone fractures
Confirmation of low T requires two separate blood tests on non-consecutive days taken early in the morning. Testosterone is highest in the early part of the day.
The blood must be tested by labs certified by the CDC.
Monitoring Low Testosterone Treatment
The guidelines emphasize the importance of checking T levels during the treatment process to make sure the hormone eventually falls within the desired range. It is also important to monitor sexual issues, plus heart and bone health.
There are .
Risks Of Testosterone Replacement Therapy
It is important to talk to Dr. William Brant about your specific risks, but common risk factors include the following:
- Worsening sleep apnea
- Stimulates noncancerous growths in the prostate gland (BPH)
- Enlarged breasts
- Limits sperm production and shrinking testicles
- Too much red blood cell production which can lead to a clot
- Historically, there have been concerns about the use of testosterone after treatment for prostate cancer. This is a nuanced issue, but generally testosterone treatment is safe in this situation.