Low Testosterone Symptoms, Diagnosis, & Treatment

Low T Symptoms in Men Rebalance with TRT

The Evaluation and Management of Testosterone Deficiency AUA Guideline provides guidance to the practicing clinician on how to diagnose, treat and monitor the adult male with testosterone deficiency. Guidance is also given on the management of patients with cardiovascular disease, men who are interested in preserving their fertility and men who are at risk for or have prostate cancer. Testosterone is a hormone found in both men and women, but it is the primary sex hormone in males. It is responsible for deepening the voice and developing body hair and muscle mass of boys during puberty. As men age, testosterone levels typically decrease, but in some cases, men develop a testosterone deficiency called Testosterone Deficiency Syndrome (TD) or simply Low Testosterone (LT). Low testosterone affects nearly 40% of men aged 45 and older.

Researchers have found that the amount of testosterone in your body can testosterone be injected in the arm affect your sexual fantasies and even your daydreams. If you don’t have enough testosterone, you might not be able to come up with sexual fantasies or desire to masturbate. Some people’s sex drive goes down as they get older, but those with low testosterone are more likely to notice a significant change. It starts the development of a man’s external and internal reproductive organs when he is still in the womb, and it is necessary for the production of sperm when he is an adult. It’s when the testosterone level is below 300 that we begin to think about treatment options for most men. The unique pharmacokinetic profile of testosterone pellets is due to their crystalline structure, which dissolves slowly in SQ spaces. Individual pellets consist of 75 mg of testosterone and may be combined to deliver variable doses of testosterone therapy.

Testosterone is produced in the adrenal glands and testes of males. The release of testosterone is regulated by the brain (hypothalamus and pituitary glands). Testosterone is a sex hormone essential for boys during puberty for development. Testosterone allows for the development of male physical features and sexual function. As boys exit puberty and enter adulthood, testosterone maintains muscle strength and mass, hair growth, bone density, sexual functions, energy and mood levels.

More specifically, the Leydig cells in your testicles make testosterone. If you start seeing changes in your weight and energy level despite maintaining your same diet and activities, it’s a good idea to call your doctor. If you start feeling tired despite getting a full night’s sleep or you’re gaining weight but haven’t made any significant changes to your diet, these are signs that your testosterone levels may be low. And if you have a personal or family history of endocrine problems, you may be at higher risk for low testosterone. Your physician will want to discuss any of these symptoms you may be experiencing and measure your blood levels, usually with two separate blood tests taken early in the morning on non-consecutive days. This is because testosterone levels typically fluctuate throughout the day but are at their highest in the early morning.

This document was written by the Evaluation and Management of Testosterone Deficiency Guideline Panel of the American Urological Association Education and Research, Inc., which was created in 2016. The Practice Guidelines Committee (PGC) of the AUA selected the committee chair. Membership of the Panel included specialists in urology, cardiology, family medicine, and psychology with specific expertise on this disorder. The mission of the Panel was to develop recommendations that are analysis-based or consensus-based, depending on Panel processes and available data, for optimal clinical practices in the treatment of muscle-invasive bladder cancer. Each member of the Panel provides an ongoing conflict of interest disclosure to the AUA. While these guidelines do not necessarily establish the standard of care, AUA seeks to recommend and to encourage compliance by practitioners with current best practices related to the condition being treated.

The Panel recommends that clinicians use the same laboratory with the same method/instrumentation for serial total testosterone measurement. Where possible, clinicians should use LCMS to measure total testosterone levels to maximize accuracy and limit CV between tests in men undergoing testing, particularly in men with very low total testosterone levels. The Panel recognizes that not all laboratories use LCMS technology, and immunoassays may be the only measurement tool available to clinicians. Some authorities have advocated that free testosterone should be the primary measure used to define testosterone deficiency. This is based on the concept that the free testosterone fraction is believed to be the most biologically active component. Although direct measurement of free testosterone has a generally good correlation with equilibrium dialysis, it is not reliable because of high CV.

About 15% of men with fertility problems have low testosterone levels. The most common treatment is testosterone replacement therapy (TRT). In males, hypogonadism, a condition where the testicles produce little or no testosterone, may occur at any age.

If you do not notice any change in symptoms after treatment for 3 months, it is less likely that TRT treatment will benefit you. LOH and low testosterone are more common in men who have Type 2 diabetes, overweight and/or obesity. Causes of primary and secondary hypogonadism are also divided into either congenital (at birth) or acquired (developed later in childhood or adulthood). And other studies have estimated that more than 8% of men aged 50 to 79 years have low testosterone.

The American Urological Association defines low testosterone as less than 300 nanograms (ng) of the hormone per deciliter (dl) of blood. They also report that about 2 in every 100 men have low testosterone. ASRM produces a series of fact sheets and booklets on various topics related to infertility, reproductive health, and family planning. The fact sheets and booklets are available in English, Spanish, and Chinese.

Low testosterone levels may lead to an increase in body fat mass. Research suggests that up to 35% of men with erectile dysfunction have low T. However, research is inconclusive on whether testosterone replacement therapy could successfully treat erectile dysfunction. It is possible to have low levels and not experience symptoms.