310-299-2040 [email protected]

The Truth About Low Testosterone

by | Aug 6, 2020 | MENS HEALTH

This is a picture of a clip board with a diagnosis on it that reads "low testosterone."

Hypogonadism or low testosterone is a common condition seen in men as they age. Testosterone is the male sex hormone produced primarily by the testicles. The testicles are stimulated by secretion of LH and FSH by the pituitary gland to produce testosterone (T) and sperm respectively. Women also have testosterone, but in much lower levels.

What are the Symptoms of Low Testosterone?

Signs and symptoms of low T in older men include lack of energy, focus, increased body fat, depression, diminished muscle mass and most commonly low libido and poor erectile function.

The Endocrine Society and AUA guidelines define Hypogonadism as T levels less than 300 ng/dL and symptoms consistent with low T. The diagnosis needs to be confirmed with two morning blood tests, on different days. Low T is defined as primary or secondary depending on the source of the problem. Primary Hypogonadism, being testicular dysfunction, is seen with testes cancer, or genetic conditions such a Klinefelter’s. Secondary Hypogonadism is due to pituitary dysfunction. The vast majority of hypogonadal men have a hybrid form commonly called Hypogonadism of aging men. This has also been referred to as andropause or male menopause. It differs from menopause in that in men the hormone levels drop much more gradually over time and many men maintain normal levels. Conditions that are associated with low T include Type 2 Diabetes, obesity, HIV disease, metabolic syndrome, and opioid use.

Do Effective Treatments Exist?

There are many treatments for low T that can either stimulate the pituitary gland (Clomid, HCG) or replace T directly. The first oral T, Jatenzo was recently approved, other treatments include weekly injections, long acting pellets or daily gels. The T Trial published in the New England Journal of Medicine was the largest placebo controlled trial, and it looked at the benefits of T replacement. It showed improved aspects of sexual function, improved walking distance, and slightly improved mood.

Testosterone therapy is not without potential risks and men on testosterone must be monitored. While men with low T have many increased risk factors for cardiac disease, several retrospective trials have shown increased adverse cardiac events in men on T replacement. Despite the many questions about the veracity of these trials, the FDA released a warning statement about the potential cardiac risk associated with testosterone replacement. A large randomized trial, the traverse trial, is presently underway to evaluate potential cardiac risk.

There is a black box warning on labels of recently approved T products regarding increased blood pressure seen in a small number of men receiving T replacement. The gels have a black box warning about possible transference of the gel to others.

Other concerns or side effects of T replacement include decreased fertility, as exogenous T suppresses testicular function including sperm production. There is potential for increased red blood cells which can thicken the blood. There is a theoretical concern of increased prostate cancer or enlargement of the prostate. Morgentaler et al has written extensively about this potential risk and has largely debunked this concern. That said, men on testosterone replacement should have regular PSA blood tests and digital rectal exams.

Who Should get Screened for Low T?

According to the aforementioned guidelines, men with erectile dysfunction, infertility, low libido, Type 2 diabetes, obesity, depression and atrophic or small testicles should be screened with a morning T level.

Men should speak to their doctor about what treatment for low T is most appropriate for them. Non-pharmacological ways to boost testosterone include weight loss, healthy diet, improved sleep, and weight training. Long distance running, some medicines such as statins, and diets high in estrogenic foods, such as soy products, can in some cases lower T levels.

Testosterone should always be administered by a medical practitioner trained and focused on men’s health and never use testosterone obtained in the gym or from friends or trainers.

While T is not a panacea or fountain of youth, it can be transformative in many men if used properly. It can boost libido, improve sex drive and erections and improve the quality of orgasm. Many men report improved energy and vigor. Levels should be followed and dosage changed according to levels and improvement of symptoms.

******

The content provided in this article is provided for information purposes only and is not a substitute for professional advice and consultation, including professional medical advice and consultation. It is provided with the understanding that Modern Intimacy is not engaged in the provision or rendering of medical advice or services. The opinions and content included in the article are the views of the author only, and Modern Intimacy (or Dr. Kate Balestrieri) does not endorse or recommend any such content or information, or any product or service mentioned in the article. In reading this, you acknowledge and understand that Modern Intimacy shall not be liable for any claim, loss, or damage arising out of the use of, or reliance upon any content or information in the article.

Modern Intimacy is a group therapy practice, founded by renowned Psychologist and Sex Therapist, Dr. Kate Balestrieri. This inclusive blog is designed to provide a wealth of information and resources for mental health, relationships, and sexuality. Subscribe today to get the latest information from our expert contributors from all around the world.

FOLLOW

Subscribe

Author Bio

Dr. Jed Kaminetsky is a Board Certified Urologist on the faculty of NYU School of Medicine. He has been recognized annually by Castle Connelly as one of the top doctors in NYC. As Medical Director of Manhattan Medical Research. He has been a principle investigator in over 100 clinical trials, has co-authored many papers in medical journals and has presented his research at national and international meetings. Dr. Kaminetsky is widely recognized as a key opinion leader in various areas on men’s health including sexual dysfunction, hypogonadism and benign diseases of the prostate. For more information, see www.Universityurology.com.

FREE 30 MIN INITIAL CONSULTATION WITH

MODERN INTIMACY …

You May Also Like…

13 Comments

  1. forexopsies.com

    Simply want to say your article is as astonishing. The clearness in your post
    is just great and i can assume you’re an expert on this subject.
    Well with your permission allow me to grab your feed to keep updated with forthcoming
    post. Thanks a million and please carry on the enjoyable work.

    • Kate Balestrieri

      Thank you. We’re so glad you enjoyed this article!

  2. forexopsies.com

    Thank you for every other fantastic post. Where else may anyone get that type of information in such a perfect manner
    of writing? I’ve a presentation next week, and I am at the look
    for such info.

  3. forexopsies.com

    Way cool! Some extremely valid points! I appreciate
    you writing this post plus the rest of the website is really good.

    • Kate Balestrieri

      Thank you! We are so glad you liked this piece!

  4. forexopsies.com

    Hiya! Quick question that’s completely off topic. Do you know how to make
    your site mobile friendly? My web site looks weird
    when browsing from my iphone 4. I’m trying to find a theme or plugin that might be able to correct
    this problem. If you have any suggestions, please share.
    Appreciate it!

    • Kate Balestrieri

      Thank you for letting us know it is not coming through well on mobile. We’ll ask our web developers to investigate!

  5. forexopsies.com

    Hey there would you mind letting me know which webhost you’re working with?

    I’ve loaded your blog in 3 different internet
    browsers and I must say this blog loads a lot faster
    then most. Can you suggest a good hosting provider at a
    fair price? Thanks a lot, I appreciate it!

  6. coat

    Eⲭcellent blog you havе got here.. It’s hard to fіnd quality writing like yours these
    days. I truly apρreciate individuals like you!
    Тake care!!

    • Kate Balestrieri

      Thank you. We appreciate knowing that this article was helpful.

  7. forexopsies.com

    I think the admin of this website is in fact working hard in favor of his web site, as here every
    data is quality based material.

  8. forexopsies.com

    Its like you read my mind! You appear to know so much about this,
    like you wrote the book in it or something. I think that you can do with some pics to drive the message home a little bit, but instead of that,
    this is wonderful blog. A fantastic read. I will certainly be back.

    • Kate Balestrieri

      We’re so glad you enjoyed the blog!

LET’S WORK TOGETHER

WANT TO WRITE FOR MODERN INTIMACY?