Testosterone is the main male hormone which can be considered as the body’s “fuel” for many important functions. A man’s testicles have two primary functions, the production of sperm for reproduction, and the secretion of Testosterone. Sperm tends to be produced in lower amounts as a man ages. As men get older, their levels of Testosterone also decline. In many cases, this lower level of Testosterone causes no ill effects.
However, many men may suffer from dramatic consequences when their Testosterone levels drop below normal ranges. These men may experience life-altering lack of energy, sex drive (libido), erectile dysfunction, as well as an inability to concentrate and even depression.
Low Testosterone can be easily diagnosed by considering a man’s symptoms, examining his genitals and performing a blood test to assess the levels of Total and Free (active form) of Testosterone in his bloodstream. Testosterone levels in men may vary widely depending upon the patient’s age, time of day and may even vary with the season. Testosterone blood tests should be performed in the morning when a man’s testosterone levels tend to peak. Fasting is not required prior to having the blood test.
If a man is diagnosed with low Testosterone, careful consideration needs to be made to assess the risks and benefits of starting Testosterone Replacement Therapy (TRT). If a man has heart disease or a history of prostate cancer, starting TRT may worsen these conditions; however, some studies about these increased risks are still considered controversial. If TRT is started, regular testing of Testosterone levels, complete blood count (CBC) and prostate specific antigen (PSA) should be performed. A side effect of testosterone therapy is increased blood thickness which could lead to blood clots. CBC is a test which measures blood thickness among other blood parameters. If the blood is thickening to a risky level, a man’s physician may reduce the dose of Testosterone or recommend that the man donate blood on a regular basis to decrease his blood thickness.
TRT is currently available in the United States in two major forms: injection therapy and topical gels. Patients who choose injection therapy are taught to inject themselves every week or every other week. There are also long-acting injections lasting up to 10 weeks which are given in the physician’s office. Testosterone gels need to be applied by the man to his upper arms and shoulders every day. There is now one FDA-approved oral form of TRT which is not yet available in the U.S. Regardless of form of Testosterone supplementation, successful and safe TRT requires regular physical exams and blood tests to make sure that levels are appropriate.
When prescribed for appropriate patients, TRT may be life-changing for the man and his partner in terms of improvement of energy levels, sex drive, erectile function and overall mood. Other benefits of TRT are preservation of muscle mass and bone density as a man ages.
If you are interested in learning more about Testosterone Deficiency and TRT, please call Dr. Jeffrey Steinberg of Urology Specialists of Milford LLC. at (508)-473-6333 for an appointment. Our offices are located at 18 Asylum St., Milford, Massachusetts.