Should men with symptoms of low testosterone but without hypogonadism be prescribed testosterone therapy?

Low Testosterone Symptoms, Diagnosis, & Treatment

However, a man’s PSA levels might increase during testosterone therapy, so it is important to monitor them. A urologist may also conduct a PSA (prostate-specific antigen) blood test to check for signs of prostate cancer. He/she may also measure the red blood cells in the body (hematocrit) to keep a baseline record of red blood cell counts, because they can go up after taking testosterone.

A pituitary mass may cause visual field deficits, and prolactinomas specifically can cause galactorrhea (11, 12). You should discuss the risks of each treatment method with your healthcare provider before deciding. Many well-respected medical societies and healthcare experts advise against treating low testosterone in women unless specific criteria are met. Routine screening for hypogonadism in asymptomatic men is not recommended, except in certain conditions (Supplementary Figure S1). Clinical features of hypogonadism are not limited to sexual symptoms — reduced libido, erectile dysfunction (ED), and loss of waking erections. Anaemia, osteoporosis, and vasomotor sweating or flushing are frequently present; indeed, older men may not volunteer sexual symptoms, having ascribed them to ageing.

Healthy hormonal levels also help ensure that your body can effectively turn food into energy. A testosterone deficiency can interfere with this function and lead to weight gain. Occasional difficulty achieving or maintaining an erection is also normal, but if it happens frequently, this is considered erectile dysfunction. Testosterone stimulates the production of nitric oxide in penile tissue, which makes erections possible. So the lower your levels, the less likely you’ll be to get or keep an erection.

While hair loss can be due to aging, low levels of testosterone can also play a part. You might notice bald spots you hadn’t had before or an increase in thinning hair in multiple areas or your body. Low testosterone is something that 19 to 39 percent of older men deal with. And while low testosterone can lead to several health issues, the opposite can also be true in that certain conditions can lead to low levels of testosterone.

A slow drop in testosterone is a normal part of aging, sometimes called “andropause” or “male menopause.” For many men, this doesn’t cause any significant problems or symptoms. Others may notice a decline in muscle mass, depression, or less interest in sex. You may have low testosterone if you’re experiencing a reduction in your sex drive, difficulty achieving or maintaining an erection, hair loss, and fatigue. A doctor can conduct tests, such as a serum testosterone test, to diagnose low testosterone.

Low testosterone can cause side effects like decreased sex drive, depression and weakness in females. Testosterone may cause erythrocytosis,6 which can increase the risk of cardiovascular events, so haematocrit should be checked before initiation and annually during therapy. The role of digital rectal examination continues to be debated,6 but a urology referral should be considered for those men with a rising PSA. In men with verified hypogonadism, testosterone therapy maintains secondary sexual characteristics, improves psychological and sexual function, bone and muscle health, and reduces anaemia and frailty. The only contraindications are baseline erythrocytosis, a desire to father children, active prostate or breast cancer, decompensated cardiac or liver disease, and imminent end-of-life.

If lifestyle changes don’t work for you, you may need to begin testosterone replacement therapy (TRT) for treatment of low T. TRT can be very important for helping teenage males with hypogonadism experience typical masculine development. Sufficient testosterone levels help maintain health and well-being in adult males. The American Urological Association estimates that 20 to 50 percent of men have cutting edge testosterone therapy llc deficiency. No randomized controlled trial has demonstrated decreased cardiovascular events or mortality with testosterone therapy.

This might include additional blood tests, and sometimes imaging such as a pituitary MRI. Testosterone is a hormone responsible for many important functions, including bone and muscle development, emotional regulation, red blood cell production, sex drive, and sperm production. In people with testes, testosterone levels increase dramatically during puberty but gradually decrease in mid-adulthood as a part of the aging process. Testosterone levels decline on average about 1% a year after age 30.