Talking to Your Doctor about Low Testosterone

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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 your doctor in the near future. Here is a simple guide that’ll help you make the most of your doctor visit.

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What exactly is testosterone?

Testosterone is an important hormone produced by the testes in men and the ovaries in women.

Your brain controls its production. The hypothalamus (a part of brain) sends signals to the pituitary gland, located underneath the brain. The pituitary reads the message and sends chemical messengers (in the form of luteinizing hormone and follicle stimulating hormone) to testes to begin testosterone production.

This creates a “feedback loop” which controls testosterone levels in the blood. Any disturbance in this loop can either increase or decrease blood testosterone levels.

What roles does testosterone play?

Testosterone plays a variety of roles in both men and women. It works with estrogen (primary female sex hormone) to regulate different functions in women.

Here are testosterone’s common functions:

• Development of male sex characteristics (facial hair growth, deepening of voice, etc.)
• Sperm formation
• Support bone density
• Maintain muscle mass and muscle strength
• Regulate sex drive, erectile function and sexual function
• Maintain red blood cell formation
• Regulate body fat distribution

What is low T & Why do I have it?

Low T (also called male hypogonadism and testosterone deficiency syndrome) is exactly what its name says. It is a condition in which your body does not produce enough testosterone.

Low T occurs when testicles don’t do their job well or don’t receive proper signals from the brain. It can happen because of age, a medical problem or certain lifestyle factors. Doctors conduct blood tests to diagnose it.

Low testosterone symptoms

• Decreased muscle mass
• Weight gain or increased body fat
• Poor concentration
• Erectile dysfunction and low sexual desire
• Low energy levels or fatigue
• Body hair loss (particularly armpit and pubic hair)
• Delayed puberty (in teenagers)

Why do I have low sex drive and lack energy?

Low libido and fatigue are common symptoms of low testosterone in men. But they can happen because of many other reasons. If you are experiencing these issues, discuss them with your doctor to identify their cause.

How can I find out if I have low T or not?

You should visit your doctor and share your concerns with professional help. Your doctor will ask you about your medical history, and he may have a physical examination. If their analysis indicates that you may have low T, then he will recommend you have a testosterone test.

A testosterone test is like a simple blood test. You will have to give your blood sample, and then your total testosterone level will be detected in the blood. A blood sample for this test is usually taken in the morning because it is when you have the highest testosterone levels.

Your doctor may ask you to have two testosterone tests because the concentration of this hormone changes throughout the day. It would be better to have it checked twice before drawing any conclusion.

If both of your testosterone tests show that your testosterone level is below 300 nanograms per deciliter (ng/dL), it means you have low testosterone levels.

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What are the treatment options for low T?

In most cases, doctors suggest testosterone replacement therapy (TRT) to men with several low T symptoms. This is where your doctor prescribes testosterone-boosting products that restore your T-levels to normal range.

These products can be in different forms, such as gels, patches, injections, pellets, pills, etc. This treatment has gained acceptance and popularity over the last few years. Millions of men around the world have turned to this hormone replacement therapy and have seen it reduce their low T symptoms.

Your doctor may suggest an alternative solution based on what’s really causing low T in your body. For instance, if it is due to obesity, they may first address this issue.

What are the different types of TRT? Which one is right for me?

Testosterone replacement is given in different forms. Some of these forms are:

• Gels: It is applied to the skin once a day. Testosterone gets absorbed into the body through the skin. Some forms of gels are applied inside the nose.
• Skin patches: They are applied to the upper body parts.
• Injections: Testosterone is injected into muscles, from where it enters your bloodstream.

You can choose any form of low testosterone treatment based on what you find more convenient. Almost all forms of testosterone therapy provide similar results, but they may have different side effects.

A study found that testosterone injections cause fewer side effects (particularly cardiovascular issues) than testosterone patches or gel.

Ask your doctor for the pros and cons of each TRT form. Choose the one that you find the most suitable.

Does testosterone replacement therapy affect fertility?

TRT can reduce fertility by suppressing natural testosterone formation which is required for sperm production.

If you are planning to have children while having TRT, discuss this matter with your healthcare provider. It will allow them to add treatments like HCG injections to your TRT plan to help you preserve fertility while you are on testosterone.

Am I a good candidate for TRT?

TRT is not prescribed to all low T men because it can carry certain risks and side effects.

Doctors usually conduct different tests before initiating TRT. These tests are performed to make sure you are in good health and don’t have a condition that can worsen over time due to TRT. They do not advise TRT to patients who have the following health conditions.

• Untreated sleep apnea
• Prostate cancer
• Breast cancer
• Uncontrolled health failure
• Heart disease
• Severe urinary tract infection

Tell your doctor your medical history without any hesitation. Talk about side effects and risks in detail to make sure you choose the right treatment option for you.

How will you determine the optimal testosterone dose for me?

Your doctor will determine the initial dose based on how low your testosterone level is and what your current health condition is. They will then analyse the effects of the prescribed dose and may adjust/alter it based on how your body responds.

How long after starting TRT will I feel the difference?

Before starting testosterone replacement, you need to understand that the therapy does not show results overnight. Its benefits start appearing after 4 to 6 weeks of starting the treatment.

One of the first differences that men notice is the improvement in their sex life.

Once I start testosterone treatment, can I stop?

TRT is not a cure for low T. It increases your blood testosterone levels as long as you take the prescribed testosterone dose.

Once you stop taking testosterone, your blood testosterone level will decline to what it used to be before treatment. Your low T signs and symptoms (muscle mass reduction, low sex drive, fatigue, mood changes) will also return.

Will I be monitored while on TRT?

Most doctors monitor the effects of TRT on a patient’s body for as long as they have the treatment. Your testosterone levels are checked after 3 and 6 months of starting treatment via blood testing.

If your testosterone levels are normal, your current dose will stay the same. But if they are low, your dose will be adjusted accordingly.

Your doctor will test your prostate cancer and blood clot risk at the start of the treatment, after 6 months of starting the treatment, and then once a year. They will evaluate your testosterone and red blood cell levels annually throughout treatment.

This process can vary from clinic to clinic. You should talk in detail to your doctor to learn how they will monitor your health while you are on TRT.

Make the most of your visit to the doctor

Here is the step-by-step guide to help you make the most of your visit to a doctor.

1.     Keep a journal

To make sure you do not miss anything, it is best to make a journal and write about everything that concerns you.

Do you think your sex life is suffering and your partner is not satisfied anymore? Write about it in the journal.

Do you think you have a hard time concentrating and recalling good old times? Mention this issue in your journal.

Or you may be concerned about your body weight and increase in breast tissue mass? Write about it, too.

Sharing your mind and thoughts with your doctor will help you feel better, and your doctor will also find it easier to diagnose the issue.

2.     Be honest and open

Do not get shy when talking to your doctor about this health issue. If you want to be treated as early as possible and get rightly diagnosed, you will have to be open and honest.

Share your medical history with the doctor. Tell him if more people in your family are having the same issue. If you had surgery in the past, inform your doctor about it because brain and prostate surgeries can lead to conditions like low T.

If you are taking certain medications and narcotics, you should tell your doctor the name of each medicine because medications can also contribute to low blood testosterone. Discuss your daily routine and eating habits as well because it will also help diagnose the problem.

3.     Talk about testosterone replacement therapy

If your test shows that your testosterone level is low, then your doctor may recommend testosterone replacement therapy (TRT). Discuss its procedure, cost, administration method, effects and duration in detail.

4.     Discuss the risks and benefits

Testosterone replacement therapy has both pros and cons that you must discuss with your doctor to find whether it is safe for you or not.

TRT benefits include:

• Increase in overall energy
• Improved symptoms of erectile dysfunction
• Improved sexual function
• Improved level of concentration
• Improvement in bone health
• Increase in lean muscle mass and muscle strength

General side effects of testosterone replacement therapy may be:

• Acne
• Baldness
• Enlarged breasts
• Infertility
• Testicle shrinkage
• Increased risk of blood clots
• Increased heart stroke risk
• Oily skin
• Skin reactions

5.     Ask for alternative treatment options as well

People diagnosed with low T are often first asked to bring healthy changes to their lifestyles, such as reducing alcohol intake, doing exercise regularly, getting enough sleep, eating a balanced diet, and increasing testosterone through natural food sources.

If these solutions do not work for you, your doctor will prescribe testosterone to restore your hormonal balance.

6.     Choose the suitable treatment option

If your doctor has decided that testosterone replacement therapy is the right solution for you, you will have to decide which method of testosterone administration to choose.

There are different ways of taking testosterone, including:

• Injections
• Testosterone pills
• Gels and creams
• Skin patches
• Testosterone pellets

If you choose injections, you will have to get your dose once or twice every fortnight. If you choose gels or skin patches, you will be asked to apply them once a day.

Once you start this treatment, you will have to visit your doctor often to ensure you have normal testosterone levels and no serious side effects. Your doctor can ask you to have blood tests, rectal exams and more tests during these visits.

Restoring testosterone levels through treatments like TRT can help you improve your mental and physical health. Reach out to a professional TRT specialist today to get the best solution and live a healthy life like before.

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Summary/Scientific Studies/Further Reading/References

Traish, A.M., 2018. Benefits and health implications of testosterone therapy in men with testosterone deficiency. Sexual medicine reviews, 6(1), pp.86-105.

Tyagi, V., Scordo, M., Yoon, R.S., Liporace, F.A. and Greene, L.W., 2017. Revisiting the role of testosterone: Are we missing something?. Reviews in urology, 19(1), p.16.

Köhn, F.M., 2006. Testosterone and body functions. The aging male, 9(4), pp.183-188.

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