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Testosterone is a hormone that is made by a man's testicles. Many men discover that by the time they are in their late 30's or early 40's that they have less energy, are often tired, are slower physically and mentally, are often grumpy, and have lost a lot of the sex drive that they had when they were younger. A normal part of the aging process? - maybe. Or maybe it is caused by a low testosterone level.  Testosterone is responsible for the proper development of a man's secondary sexual characteristics like the growth of his penis, muscle mass, facial and body hair and a deeper voice. Most men have a normal amount of testosterone as a teenager and they develop normally because of this.  Testosterone is also responsible for the maintenance of a man's muscles, his libido or sexual desire, keeping red blood cells and bones healthy and in general plays a large part in a man's sense of well-being.  SIGNS AND SYMPTOMS OF TESTOSTERONE DEFICIENCY Decreased libido or sex drive Erectile Dysfunction Decrease in muscle mass Increase in body fat Increased cholesterol Decrease in body hair Decreased energy level Less effective at work Decreased semen volume Decreased orgasm intensity Anemia Depression Grumpiness Irritability Problems sleeping Decreased immunity Decreased sense of well-being Difficulty concentrating Fragile bones  As a man ages his testosterone level gradually decreases. This usually begins at around age 30. Other causes of testosterone deficiency include: POSSIBLE CAUSES OF TESTOSTERONE DEFICIENCY Testicular injury or infection Many medications Chronic illness Chemotherapy for cancer Radiation for cancer Pituitary dysfunction Alcoholism Liver cirrhosis Kidney failure Vasectomy Stress AIDS Genetic & congenital conditions  A simple blood test will determine if a man has a normal level of testosterone. This test is more accurate if the blood is drawn in the early morning hours.  OPTIONS FOR TESTOSTERONE REPLACEMENT THERAPY Intramuscular injections Patches Gels Pellets Pills  BENEFITS OF TESTOSTERONE REPLACEMENT THERAPY Increased sense of well-being Increased muscle mass Decreased body fat Increased sex drive Improved erections Higher energy level More productive at work Happier in general Increased immunity Improved mood Improved concentration Increased semen volume Increased orgasm intensity Stronger bones  Testosterone replacement therapy has been and remains controversial because of the possible side effects of its use and because the long-term effects of testosterone replacement are largely unknown. Testosterone supplementation or therapy should not be confused with the super-physiologic and large doses of testosterone and other anabolic steroids that have been abused by some bodybuilders and athletes. These large doses of steroids are almost always not needed or indicated in the first place, often unmonitored by a physician and are dangerous and unwise. The goal of physician directed testosterone replacement therapy is to bring a man who has a low or borderline testosterone level into the middle of the normal therapeutic range. Before we start a man on testosterone replacement therapy we check the baseline status of dozens of laboratory tests, perform a thorough physical exam and examine his prostate. Men are then monitored at regular intervals by both blood tests and physical exams to make sure that there are no adverse effects of the testosterone therapy. Notwithstanding our best efforts to prevent side effects of testosterone replacement therapy, there are occasionally side effects, including: POSSIBLE SIDE EFFECTS OF TESTOSTERONE REPLACEMENT Acne or oily skin Increased red blood cell count Increase in size of prostate Increase in PSA Decreased sperm count Infertility Fluid retention High blood pressure Breast enlargement Sleep apnea Testicular atrophy Increased lipid levels Some men should not use testosterone therapy. They include men who have or who have ever had prostate or breast cancer, men who have an enlarged prostate or a high PSA.  All men get tired occasionally, but prolonged fatigue is not normal at any age. Your doctor will determine if you are a candidate for testosterone replacement therapy. |
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