Overview of low testosterone
Testosterone is the male sex hormone that is made in the testicles. Testosterone hormone levels are important to normal male sexual development and functions.
During puberty (in the teen years), testosterone helps boys develop male features like body and facial hair, deeper voice, and muscle strength. Men need testosterone to make sperm. Testosterone levels generally decrease with age, so older men tend to have low blood testosterone levels.
Some men have low testosterone levels. This is called Testosterone Deficiency Syndrome (TD) or Low Testosterone (Low-T). Deficiency means that the body does not have enough of a needed substance. A syndrome is a group of symptoms that, together, suggest a disease or health condition.
What are the symptoms of low testosterone?
There are many signs and symptoms of TD. Some are more related to lower T levels. Your doctor will help you understand your own situation.
The specific characteristics are more or less directly related to TD:
- Reduced sexual desire
- Decreased erectile function
- Loss of body hair
- Low beard growth
- Loss of lean muscle mass
- Feeling very tired at all times (fatigue)
- Symptoms of depression
Nonspecific signs/symptoms of testosterone deficiency (TD):
- Low level of energy, endurance and physical strength.
- Bad memory
- Difficulty finding words to say
- Bad vision
Just because you have any of the specific or non-specific characteristics does not mean you have TD.
What causes low testosterone?
The amount of testosterone in his body gradually drops. This natural decline starts after age 30 and continues (about 1% per year) throughout his life.
There are many other potential causes of low testosterone, including the following:
- Chemotherapy for cancer
- Metabolic disorders such as hemochromatosis (too much iron in the body).
- Dysfunction or tumours of the pituitary gland.
- Medications, including opioids, hormones used to treat prostate cancer, and steroids (such as prednisone).
- Acute (short-term) or chronic (long-term) illness
- Alcohol abuse
- Cirrhosis of the liver
- Chronic renal (kidney) failure
Treatment for low testosterone
Low testosterone treatment in hypogonadism is a fully approved treatment. Treatment in the elderly has become even more controversial. Talk to your doctor about your testosterone levels, symptoms, and treatment side effects, whether or not you need treatment.
There are several ways to administer low testosterone treatment:
Transdermal (skin patch) – usually applied once a day. There is an oral patch available that is attached to the upper gums and applied twice a day.
Gels: Applied directly to the skin and then absorbed through the skin (for example, Androgel and oxymoron). Although these gels are available in single-application packets, dosing is more difficult.
Oral/buccal (by mouth). The buccal dose comes in a patch that is placed over the incision (canine or “tooth”). The medicine looks like a tablet, but you should not chew or swallow it. The drug is released over 12 hours. This method has less damaging side effects to the liver than ingesting the drug, but it can cause headaches or irritation where it is placed.
Injections: Testosterone can be given by direct injection.
Capsules: Capsules can be implanted in soft tissues and release testosterone.
Are there side effects of testosterone therapy (TT)?
There are some side effects of TT. Some side effects are mild while others are more serious. You should ask your doctor or pharmacist about these side effects and watch for them while you are taking TT. Some of the side effects are as follows:
- For gels and liquids, there may be some redness at the skin site. With patches, you may have itching and a rash around the area. A very small number of patients report back pain.
- For short-acting injections, you may have some reaction at the injection site. Some persons have had serious allergic reactions to the long-acting injection. Because of this, when you get the long-acting injection they will watch you closely for a while afterwards in the medical office.
- For testosterone pellets, possible adverse effects include swelling, pain, bruising and, rarely, hematoma (clotted blood under the skin).
- During TT, there is an increased risk of erythrocytosis (abnormal raising of blood haemoglobin and hematocrit).
- TT may interrupt normal sperm production. You should not have a TT if you plan on having children soon. If you are being treated for Low-T your doctor may suggest added treatment for sperm production.
- Topical testosterone, specifically gels, creams and liquids, may transfer to others. Women and children are most at risk of harmful effects from contact with them. You should take care to cover the area and wash your hands well after putting on the medication. Be careful not to let the site with the topical TT touch others because that could transfer the drug.
Remember that each person is unique and each body responds differently to a treatment. TT can help with erectile dysfunction, low sex drive, bone marrow density, anaemia, thin body mass, and/or depressive symptoms. However, there is no strong evidence that TT can help with memory recall, diabetes measurements, energy, fatigue, lipid profiles, or standard of living. You need regular check-ups to see if your testosterone level.