Low Testosterone is a condition in which the body doesn’t produce enough testosterone, the hormone that plays a key role in masculine growth and development during puberty. Low testosterone (Low T) has become an issue of increased concern among men with recent mass media advertising the advantages of hormone replacement.
Signs/Symptoms:
- Erectile dysfunction
- Infertility
- Decrease in beard and body hair growth
- Decrease in muscle mass
- Development of breast tissue (gynecomastia)
- Loss of bone mass (osteoporosis)
- Fatigue
- Decreased sex drive
- Difficulty concentrating
- Hot flashes
Causes
There are two main causes for Low T, primary or secondary. This helps to determine if the cause of Low T is from the testes (primary hypogonadism) or from the hypothalamus/pituitary in the brain (secondary hypogonadism). Either type of hypogonadism may be caused by an inherited (congenital) trait or something that happens later in life (acquired), such as an injury or an infection. Common causes are:
- Mumps
- Hemochromatosis or too much iron in the blood
- Injury to the testicles
- Cancer treatment
- Pituitary disorders
- Inflammatory disease
- HIV/AIDS
- Medications such as opiates
- Obesity
- Normal aging
Diagnosis
Diagnosis is based on blood tests as well as clinical signs/symptoms. The blood tests should be fasting and in the morning.
Hormone Replacement Therapy
There are many options for Testosterone replacement. They are all effective and all have advantages and disadvantages. The most popular include:
- Injectable Testosterone
- Transdermal Patch/Gel
- Testosterone Pellets
Assessing Efficacy
The goal of Testosterone replacement is improvement in a patient’s symptoms not just blood levels. Since many of these are subjective, blood test are performed to assist with overall monitoring and evaluation after 3 months, 6 months, and 12 months.
Contraindications of Hormone Replacement Therapy
- History of Prostate or Breast cancer
- Severe Prostate swelling
- Elevated blood count
- Congestive heart failure
Adverse Reactions to Hormone Replacement Therapy
- Acne, oiliness of skin
- Increased blood count
- Breast enlargement/tenderness
- Testicular atrophy/shrinkage
- Increased risk of prostate cancer
- Aggressiveness or bossiness
- Hair loss
Low T is a growing problem due to an aging population. It is easily diagnosed and can be easily treated but a patient must be aware of the relative risks and benefits associated with treatment. Hormone Replacement Therapy has been proven to be effective in treating Low T with remarkable improvement in a patient’s quality of life.