TRT in the UK and EU   |
  Contact: +44 (0) 203 9003 209My account

By Mike Kocsis | 7 minutes read | Last updated: February 24, 2022 |
  • Categories:
  • Medically Reviewed by Dr. George Touliatos

    Evidence Based Research

    Testosterone is the main sex hormone that is important for sexual function and overall health in men. Men experience fluctuation in their testosterone levels throughout their lives.

    Some men develop a health condition called hypogonadism, during which gonads fail to produce testosterone in sufficient amounts. Its symptoms include lack of energy, change in mood, trouble in getting an erection, low sperm count, a decline in bone density and muscle strength.

    If you have been diagnosed with hypogonadism, your doctor will design a testosterone boosting treatment plan to help you restore your testosterone levels. For this, he will first have to determine the real cause of low testosterone.

    Once the real issue is found out, he may prescribe different medications, each having its particular effect. In this article, we have talked about popular medications used to increase testosterone.

    Take Hormone Quiz

    What can cause low testosterone in men?

    Testosterone levels decline in men as they age. They are the highest when men are in their late teens and then start declining as they hit 30.

    Testes produce testosterone in response to LH (luteinizing hormone) synthesised by the pituitary hormone. Sometimes, testes fail to produce sufficient testosterone, which is categorised as hypogonadism. It can happen during any phase of life and can be divided into three types. More than 4 million American men suffer from hypogonadism. [1]

    Primary hypogonadism

    It occurs when your gonads do not produce sufficient testosterone even after receiving brain signals. As a result, the serum testosterone level gets low, but the level of FSH and LH stays high. Its origin can be acquired or congenital.

    Examples of possible inherited causes are chromosomal abnormalities, nutation in FSH/LH receptor gene, and Klinefelter syndrome.

    Examples of the possible acquired conditions that contribute to primary hypogonadism are chemotherapy, injury to testes, and testicular torsion.

    Secondary hypogonadism

    Secondary hypogonadism occurs due to damage to the brain part that sends signals to testes to produce testosterone. In this condition, the serum FSH and LH level may also be low, like testosterone. It can also be congenital or acquired.

    A few examples of inherited causes are Kallmann syndrome, pituitary disorder, and genetic abnormalities.

    A few examples of acquired causes are trauma, sleep deprivation, and pituitary tumour.

    Mixed primary and secondary hypogonadism

    As the name suggests, it is a mixture of both the above-mentioned types of hypogonadism, meaning it happens when there is a defect in testes as well as pituitary. It occurs only due to acquired reasons. The person suffering from this issue has a decreased testosterone level and variable levels of LH and FSH.

    A few examples of mixed primary and secondary hypogonadism are cancer, cirrhosis, obesity, and hemochromatosis.

    Screening for hypogonadism

    The serum total testosterone level test is an inexpensive test performed in the morning to measure the total amount of protein-bound testosterone plus free testosterone. Testosterone levels lower than <300 ng/dL (10.4 nmol/L) indicate hypogonadism. A second assay is performed to confirm the condition.

    Once hypogonadism is confirmed, a luteinizing hormone (LH) test is performed to determine whether it is primary or secondary hypogonadism. Results of LH test indicate:

    Test component Serum level Condition
    LH >10 ng/mL Primary hypogonadism
    <2 ng/mL Secondary hypogonadism
    Within normal range Age-related testosterone decline

    Medications to increase testosterone

    Your doctor will design a testosterone boosting treatment plan for you based on the cause of low testosterone. The purpose of the treatment or prescribed medication will be to balance your hormones and reduce low testosterone symptoms. These medications will help you to:

    Book Free Consultation

    Bio-identical hormones

    Bio-identical hormones are duplicated or synthetic forms of natural human hormones. They are provided to help men and women restore their testosterone or estrogen levels. Their prescriptions can either be pre-made (by the manufacturing company) or custom-made (by a pharmacist), and they are used during testosterone replacement therapy.

    They come in different routes of delivery and doses. Your doctor will choose the dose that best suits your condition. He may also change the dose from time to time according to how your body responds to the treatment.

    Medication to increase testosterone can be divided into the following categories based on their route of delivery.

    Injectable testosterone: This form is injected directly into the muscles, from where it slowly gets absorbed into the blood.

    Testosterone gels: This is a topical form of testosterone. It is applied directly to the skin, from where it gets absorbed into the blood.

    Testosterone creams: It is another form of topical testosterone. It works like testosterone gel.

    Oral androgens: These bio-identical hormones come in the form of tablets and capsules. Their main goal is to reduce the concentration of SHBG protein that binds to the testosterone and makes it unavailable for tissues. It is used when your level of SHBG protein is higher than the normal level.

    Here are the popular medications used in testosterone replacement therapy.

    Form of medication Medication More info
    Injectable testosterone Sustanon®(Aspen)

     

    Contains testosterone propionate 30 mg, testosterone phenylpropionate 60 mg, and testosterone isocaproate 60 mg
    Nebido®(Bayer) Contains testosterone undecanoate 250 mg/mL in a 4ml amp
    Testosterone Enantate (Non-proprietary) Contains testosterone enantate 250 mg/mL
    Virormone®(Nordic) Contains estosterone propionate 50 mg/mL, 2-mL amp Short Acting Testosterone ester
    Topical testosterone TESTIM®(Ferring) gel Testosterone 50 mg/5 g tube
    TESTOGEL®(Besin) gel Testosterone 50 mg/5 g sachet
    TOSTRAN®(ProStrakan) gel Testosterone 2%
    Lipoderm based Testosterone creams Generally applied to the scrotum
    Oral androgen Tablet/capsule Reduces SHGB protein

    Other medications

    HCG: Human Chorionic Gonadotrophin is used for delayed puberty or low sperm count. It is also used to supplement testosterone replacement therapy. It signals testes to keep producing testosterone.

    Aromatase inhibitors: When you start testosterone replacement therapy, you may notice an increase in the serum concentration of estrogen. It happens when aromatase enzymes start converting testosterone into estrogen. That is where aromatase inhibitor comes to help. It is given in minute amounts to inhibit the aromatase enzyme effect and restore estrogen and testosterone levels in the body.

     

    How does a doctor determine testosterone dose?

    Your doctor will determine the testosterone dose based on how low your normal testosterone levels are. Once your testosterone replacement therapy starts, it is important to have follow-up sessions to monitor the effect of the dose and its side effects.

    Your doctor may adjust your testosterone dose depending on your body’s changing hormone needs. He will try to keep it to the minimum required to get the desired results.

    Book Free Consultation

    Other ways of increasing testosterone levels

    If you do not have hypogonadism but want to naturally boost your testosterone levels, here are the best methods that can help you improve testosterone levels.

    Get plenty of sleep

    During sleep, your body recharges and heals different organs and tissues. But when you do not get enough sleep, your normal hormonal balance gets disturbed. Studies also show that men experience low testosterone when they do not get proper sleep at night. [2]

    It is suggested to get 7 to 9 hours of sleep every day. If you have any problem falling asleep, it is better to get help from a doctor.

    Maintain your bodyweight

    Overweight people tend to have low testosterone levels. Research also says that young overweight males have around 50% low testosterone levels than normal-weight males of the same age. [3] You should keep a healthy lifestyle and try maintaining a healthy body weight if you want to boost your testosterone levels naturally.

    Relieve stress

    Prolonged stress increases cortisol hormone levels. When cortisol level rises, testosterone naturally declines. That is why you should try your best to stay out of stressful conditions and adopt a healthy lifestyle.

    Get more physically active

    Getting more physically active is one of the most effective ways of increasing testosterone levels naturally. You should make exercise a part of your lifestyle. Resistance training and high-intensity interval training (HIIT) is very beneficial in bringing testosterone levels back to normal.

    Avoid alcohol abuse

    There are many adverse effects of alcohol abuse, and one of them is the reduction in testosterone levels. When you drink alcohol frequently, it starts interfering with your body hormones, including testosterone, and causes hormonal imbalance.

    Take Hormone Quiz

    Summary

    Testosterone medications have unique effects and come in different doses. Your doctor will prescribe medication according to the cause of low testosterone. He may use a combination of different medications to achieve goals.

    Testosterone medications are commonly used in oral, injectable, and topical forms. Each form has its own effect and takes a different time to show results. Talk to your doctor about the effect of each form of medication before you select one.

    Book Free Consultation

     

    References/Scientific Studies/Further Reading/Bibliography/Study Material 

    1. Seftel, A.D., 2006. Male hypogonadism. Part I: Epidemiology of hypogonadism. International journal of impotence research, 18(2), pp.115-120. 
    2. Leproult, R. and Van Cauter, E., 2011. Effect of 1 week of sleep restriction on testosterone levels in young healthy men. Jama, 305(21), pp.2173-2174.
    3. Mogri, M., Dhindsa, S., Quattrin, T., Ghanim, H. and Dandona, P., 2013. Testosterone concentrations in young pubertal and post‐pubertal obese males. Clinical endocrinology, 78(4), pp.593-599.
    Was this article helpful?
    YesNo

    Evidence Based Research

    This article has been researched and written based on scientific evidence and fact sheets that have then been crossed checked by our team of doctors and subject matter experts.

    References, sources and studies used alongside our own in-house research have been cited below, most of which contain external clickable links to reviewed scientific paper that contain date stamped evidence.

    Our team of healthcare experts and GMC registered doctors are licensed to UK GMC standards. We strive to provide you with the latest evidence based, researched articles that are unbiased, honest and provide you with accurate insights, statistics and helpful information on the discussed topic to ensure you gain a better understanding of the subject.

    We value your feedback on our articles, if you have a well-researched paper you would like to share with us please contact us.

    Check your testosterone

    Sex:
    Age:
    Tick all that apply:
    I have the following symptoms:
    Testosterone conversion tool
    Order testosterone blood tests

    Quick Low Testosterone Test

    If you know your total testosterone reading from a previous blood test input the results to the left above to see if your testosterone levels are normal.

    Low Testosterone Levels

    You may have low testosterone depending on the symptoms you have, please contact us to find out how we can help.

    Take our ADAMS low testosterone questionnaire.

    Please Retry

    The Total Testosterone Level You Entered Is Incorrect. Figure Must be in nmol/L you can use our converter here.

    Take our ADAMS low testosterone questionnaire.

    Normal Testosterone Levels

    Your testosterone levels appear to be in the normal range.

    Take our ADAMS low testosterone questionnaire.

    Further testosterone tests not necessary

    You must be over 38, have had your ovaries removed or have suffered with premature menopause to warrant further hormone tests.

    Take our ADAMS low testosterone questionnaire.

    Further investigation needed

    Please contact us to discuss your hormones, we need your total testosterone levels to validate your hormone deficiency. You can order a blood test here.

    Take our ADAMS low testosterone questionnaire.

    Low Testosterone Levels

    You may have low testosterone depending on the symptoms you have, please contact us to find out how we can help.

    Take our ADAMS low testosterone questionnaire.

    High Testosterone Levels

    You appear to have higher than normal testosterone levels, please contact us for further investigation.

    Take our ADAMS low testosterone questionnaire.

    Normal Testosterone Levels

    You appear to have normal testosterone levels. Contact us if you have any concerns.

    Take our ADAMS low testosterone questionnaire.

    Leave a Reply

    Your email address will not be published.

    About the Author: Mike Kocsis

    Mike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones Ltd which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy (TRT) and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.

    Learn More About Us

    Last update: February 24th, 2022

    Related Articles

    Talking to Your Doctor about Low Testosterone

    Testosterone is an essential hormone required to live a normal, healthy life. Testosterone deficiency can negatively affect your mental, physical, and emotional health. Different factors such as age, weight, diet, and health conditions can contribute to low testosterone. According to a survey, 40% of men who are 40 or above suffer from low testosterone. Another study shows that 30% of obese men develop low testosterone. If you, too, are suffering from this health issue, you might be planning to visit […]

    Read More
    Debunking Myths about Testosterone Replacement Therapy (TRT)

    Testosterone Replacement Therapy is a popular treatment option used to increase testosterone levels. When doing online research on this treatment, you may find many myths and misconceptions about it, which may confuse you about whether to have it or not. That is why it is important to correct your knowledge by getting information only from authentic sources. In this article, we have debunked popular Testosterone Replacement Therapy-related myths to help you better understand its effects. Myth: Testosterone is only produced […]

    Read More
    Testosterone Creams and Gels

    Testosterone creams and gels are popular forms of testosterone medication prescribed to men who have low testosterone levels. There are other forms of testosterone medication, such as injections, but many people prefer testosterone gels and creams because they are easier to use and apply than injections. If you are considering these forms of testosterone medication but are still not sure whether to use them or not, read the article to learn more about them and make a knowledgeable decision. How to […]

    Read More

    Get In Touch



    File(s) size limit is 20MB.

    Contact Us

    Our Service is available from Monday to Thursday 9:30am to 6pm

    Friday 9:30am to 5pm

    Address

    24 Holborn Viaduct
    City of London
    London
    EC1A 2BN

    Email

    support@balancemyhormones.co.uk