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Get the facts. And the help you need.

Read the "Patient Update on Testosterone Replacement Therapy (TRT)"

Read "Testosterone Replace Therapy: Is It Right For You?" an article from the UrologyHealth extra Summer 2014 edition for more infomation.

Low Testosterone (Hypogonadism)

Low serum testosterone, also known as hypogonadism or Andropause, affects roughly 39% of men over the age of 45. The prevalence of low testosterone increases with age. Researcher have found that the incidence of low testosterone increases from approximately 20% of men over 60, to 30% of men over 70 and 50% of men over 80 years of age.

What are the signs of low testosterone in men? 
There are both sexual and non-sexual signs and symptoms associated with low testosterone. Sexual symptoms include poor erectile function, low libido (desire for sex), weaker and fewer erections, and reduced sexual activity. Nonsexual symptoms include increased body fat, decreased energy and fatigue, reduced muscle mass, and depression.

Roughly 40% of men with high blood pressure and 40% of men with high cholesterol levels will have low testosterone levels. Additionally, approximately 50% of men with diabetes and 50% of obese men will have low testosterone. And we know that 30% of men with HIV and 50% of men with AIDS will have low testosterone. Surprisingly, almost 75% of men with a history of chronic opioid use will have low testosterone levels.

What are the treatment options for men with hypogonadism?

There are many treatment options for symptomatic low testosterone. Testosterone replacement therapy may be in the form of skin gel, injections, long acting pellets, patches or oral inserts. The most common type of therapy is gel therapy, which is used by approximately 70% of patients. Men simply rub a gel onto their shoulders or upper arms after taking a shower. Roughly 17% of patients are using testosterone injections and 10% of men are using testosterone patches. Approximately 3% of patients are using other forms of testosterone, such as oral testosterone or implantable testosterone pellets.

What to expect after treatment

Testosterone replacement has been shown to improve a man's energy, libido (sex drive), muscle mass, sleep, erections, energy level, and depressed mood. Testosterone replacement has been shown to also decrease body fat in men. There is data now to support that giving testosterone to a patient with low testosterone may increase their bone mineral density and decrease their risk for a bone fracture. It is important to realize that testosterone treatment is considered lifelong therapy, just like in other chronic conditions. Stopping testosterone replacement will result in a decline in a man's testosterone level.

Frequently Asked Questions:

How is low testosterone diagnosed?

Low testosterone is diagnosed by a blood test. In order to treat a man for low testosterone, he should also have the signs and symptoms of low testosterone. Physicians will also likely check a PSA (a screening test for prostate cancer) and a hematocrit (a measurement of red blood cells in your body). A PSA is checked to make sure that the patient does not have prostate cancer and a hematocrit is checked because men receiving testosterone may experience an increase in their red blood cell count.

What important safety information do you need to understand when using testosterone?

Testosterone should not be used in men with known breast cancer or known or suspected prostate cancer.

Men treated with testosterone may be at an increased risk for the development or worsening of urinary (benign prostatic hyperplasia or BPH) symptoms.

Patients with kidney, liver, or heart problems may be at an increased risk of developing edema, or water retention. Testosterone replacement may result in worsening of sleep apnea. Finally, long-term treatment with testosterone may impair a man's fertility.

What about the relationship between testosterone and prostate cancer?

A common question among patients has been does testosterone replacement therapy cause prostate cancer or more rapid prostate cancer growth.

All studies thus far have found no greater prostate cancer risk among men who receive testosterone compared to men who receive placebo or no testosterone at all. However, this remains an issue that warrants further research.

Reviewed: January 2011

Last updated: June 2014

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Low Testosterone Glossary
  • benign: Not malignant; not cancerous.

  • benign prostatic hyperplasia: Also known as BPH. An enlarged prostate not caused by cancer. BPH can cause problems with urination because the prostate squeezes the urethra at the opening of the bladder.

  • BPH: Also known as benign prostatic hyperplasia. An enlarged prostate not caused by cancer. BPH can cause problems with urination because the prostate squeezes the urethra at the opening of the bladder.

  • cancer: An abnormal growth that can invade nearby structures and spread to other parts of the body and may be a threat to life.

  • cholesterol: A fat-like substance important to certain body functions but which, in excessive amounts, contributes to unhealthy fatty deposits in the arteries that may interfere with blood flow.

  • chronic: Lasting a long time. Chronic diseases develop slowly. Chronic renal (kidney) failure may develop over many years and lead to end-stage renal (kidney) disease.

  • depression: A disorder characterized by feelings of extreme sadness, guilt, helplessness and hopelessness, and thoughts of death.

  • diabetes: A medical disorder of increased blood sugar levels that can cause bladder and kidney problems.

  • edema: Swelling caused by too much fluid in the body.

  • erectile: Capable of filling with blood under pressure, swelling and becoming stiff.

  • erection: Enlargement and hardening of the penis caused by increased blood flow into the penis and decreased blood flow out of it as a result of sexual excitement.

  • erection: Enlargement and hardening of the penis caused by increased blood flow into the penis and decreased blood flow out of it as a result of sexual excitement.

  • fertility: The ability to conceive and have children.

  • gonad: The organ that forms the reproductive cells. In females, this is the ovary. In males, it is the testicles.

  • hematocrit: A measure that tells how many red blood cells are present in a blood sample. Low hematocrit suggests anemia or massive blood loss.

  • high blood pressure: Medical term is hypertension.

  • hyperplasia: Excessive growth of normal cells of an organ.

  • ions: Electrically charged atoms.

  • IV: Also referred to as intravenous. Existing or occurring inside a vein.

  • kidney: One of two bean-shaped organs that filter wastes from the blood and discharge these waste products in urine. The kidneys are located on either side at the level of the 12th ribs toward the back. The kidneys send urine to the bladder through tubes called ureters.

  • libido: Sexual desire.

  • liver: A large, vital organ that secretes bile, stores and filters blood, and takes part in many metabolic functions, for example, the conversion of sugars into glycogen. The liver is reddish-brown, multilobed, and in humans is located in the upper right part of the abdominal cavity.

  • placebo: Drug with no active ingredients.

  • prostate: A walnut-shaped gland in men that surrounds the urethra at the neck of the bladder. The prostate supplies fluid that goes into semen.

  • prostatic: Pertaining to the prostate.

  • PSA: Also referred to as prostate-specific antigen. A protein made only by the prostate gland. High levels of PSA in the blood may be a sign of prostate cancer.

  • retention: In ability to empty urine from the bladder, which can be caused by atonic bladder or obstruction of the urethra.

  • serum: Clear, watery body fluid.

  • symptomatic: Having to do with a symptom or symptoms that arise from and accompany a particular disease or disorder and serves as an indication of it.

  • testosterone: Male hormone responsible for sexual desire and for regulating a number of body functions.

  • urinary: Relating to urine.

  • urology: Branch of medicine concerned with the urinary tract in males and females and with the genital tract and reproductive system of males.

Low Testosterone Anatomical Drawings

click images for a larger view
 

 

 

 

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