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What is Testosterone Deficiency?

Testosterone deficiency syndrome, also known as hypogonadism, is a condition in which a man does not create enough testosterone, the primary male hormone. While this condition usually affects older men, younger males can also be affected. In fact, this condition can begin during fetal development, before puberty, or during adulthood.

Testosterone (T) is the primary male hormone that is made in the testicles.  This hormone has many functions that include:

  • Male characteristics – low voice, facial hair, baldness
  • Libido or sex-drive
  • Muscle mass
  • Bone mass
  • Red blood cell production

Testosterone deficiency syndrome, also known as hypogonadism, is a condition where a man does not create enough T. While this condition usually affects older men, younger males can also be affected. In fact, this condition can begin during fetal development, during puberty, or during adulthood.

How Do We Measure Testosterone Levels

It is important to document low T levels before starting T treatment.  There are two important levels – total T and free T.  Free testosterone is biologically active while total T is only partially active.  Therefore, the free T level is a more accurate test.  Testosterone levels are most accurate when they are drawn in the morning.

Symptoms of Testosterone Deficiency

There are many symptoms associated with T deficiency in men, including:

  • Decreased libido or sex drive
  • Increased body fat
  • Loss of bone density
  • Loss of lean muscle mass
  • Erectile dysfunction (ED) – only if the T level is very low
  • Infertility
  • The development of breast tissue -gynecomastia

This condition may also have a psychological impact. As testosterone levels decrease, men may experience symptoms that are similar to menopause in women. These symptoms may include:

  • Fatigue
  • Reduced sex drive
  • Hot flashes
  • Trouble concentrating
  • Depression
  • Poor work performance

What Causes Testosterone Deficiency?

In some situations, a specific cause for testosterone deficiency may be found. However, in many men, no specific cause is identified. In these cases, testosterone replacement therapy is often an effective treatment option.

The most common causes of low T include the following:

  • Over the counter vitamin supplements – number one cause
  • Diabetes
  • Obesity
  • Drugs and alcohol
  • Liver disease including cirrhosis

Why Do Over the Counter Supplements Lower My Testosterone?

Over the counter supplements often contain chemicals that are similar to T. Consequently, they turn off your own production of testosterone.  In my practice, over the counter supplements are the number one cause of low T.  Once you stop taking these supplements, it can take several months for your own production of T to turn back on.

Treatment for Testosterone Deficiency

In cases where a specific cause for testosterone deficiency is identified, treatment can be focused on that cause. If you are taking supplements, you should stop them.  However, in cases where there is no specific cause, T replacement therapy is the most commonly used treatment option. This therapy is available in many forms, including:

  • Patches– Testosterone patches deliver a regulated amount of testosterone daily but must be replaced every day. They should be applied each night to the back, abdomen, upper arm, or thigh.
  • Gels– These work very similarly to testosterone patches, and require daily application. Depending on the brand of gel, this medication can either be applied to the skin on the upper arm or shoulder, or the front and inner thigh. With gel applications, be sure that skin-to-skin contact is avoided until the gel is completely dry, as the medication can be transferred to another person.
  • Pellets– Testosterone pellets are implanted underneath the skin and provide a stable amount of testosterone for 4-6 months.
  • Intramuscular Injections– This is an injection that is given every 3 – 4 weeks. Men can learn to give the injections to themselves at home, however, they can also be given by a nurse or doctor.

Side-Effects of Testosterone Therapy

 It is important to understand the risks associated with testosterone therapy.  While this topic is controversial, possible side effects include:

  • Blood clots
  • Elevated red blood cell count
  • Heart problems
  • Infertility
  • Prostate problems
  • Swollen breasts also known as gynecomastia
  • Liver damage

While testosterone therapy is highly effective for men who need it, it is critically important to document low T levels first.  If the free T level is low, then testosterone therapy is justified.  It is important to understand that this treatment is a life-long commitment. You should also know that there are potential side effects and so you should be monitored by your doctor.

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Contact Us

If you believe that you may be suffering from testosterone deficiency and are looking to improve your quality of life, Dr. Lazare can help. Contact our Brooklyn, New York office today to get started on your individualized treatment program.