Low Testosterone (Hypogonadism)

Symptoms of low testosterone in men may include a combination of the following:

• Diminished volume of semen
• Erectile dysfunction
• Fatigue or decreased energy
• Inability to reach orgasm
• Increased body fat or inability to lose weight
• Low libido (sex drive)
• Low sperm count
• Low bone density
• Mood changes
• Reduced muscle mass
• Smaller or softer testicles

The causes of low testosterone in men can vary greatly and may include the following:

• Andropause (male menopause) due to natural aging
• Chronic (ongoing) diseases, such as diabetes
• Hormonal disorders
• Injury or infection of the testicles
• Nutritional deficiencies
• Obesity
• Treatment for testicular cancers
• Use of illegal drugs (including marijuana)

To diagnose low testosterone, we perform a physical examination and review all of your symptoms. We may order tests to check hormone levels, including testosterone and estrogen.

Our team may recommend other tests, including:

• Urinalysis (urine test)
• Sperm count
• Prostate-specific antigen (PSA) test to check for prostate cancer (blood test)
• Hematocrit test (measures red blood cells, which are fewer when testosterone is low)

In addition to affecting quality of life, mental health and intimacy, low testosterone can also impact chronic (ongoing) health conditions. Recent research suggests that men with low testosterone are at a higher risk of developing diabetes, osteoporosis (bone condition) and heart disease.

Treatments for low testosterone involve replacing the hormone in the body. Testosterone replacement therapy is considered a life-long treatment option. We carefully monitor men taking testosterone to make sure hormone levels are stable and check for side effects.

Testosterone may be replaced in the body using:

• Gel, cream or patches applied to the skin
• Injections
• Long-acting supplements
• Medications to stimulate natural testosterone production
• Nasal spray
• Oral tablets and capsules

Men treated with testosterone have a higher risk of developing enlarged prostate symptoms or urinary tract infection symptoms. Increasing testosterone levels can also affect mood.

Those who have kidney, liver or heart problems may increase their risk of edema (fluid retention) by taking testosterone. Testosterone can also make sleep apnea (breathing problems during sleep) worse. Testosterone may also decrease fertility (the ability to have children). Testosterone treatments are not usually recommended for men who have been treated for prostate or breast cancer. It can also increase the risk of blood clots, heart attack and stroke.