Low Testosterone: It’s More Common Than You Think

Contributed By Dr. T. Sivaraj, Holly Springs Medical Center

As men age, their testosterone levels slowly decline. This is a normal part of life. Significant drops in testosterone levels, however, are not normal and can cause troublesome symptoms. The good news is treatments are available.

Testosterone is an important hormone, particularly for men. Produced primarily in the testes, testosterone is present even before birth in the male fetus. It is what causes the male genitals to develop. Testosterone is responsible for the muscular and vocal changes in pubescent boys as well as facial and body hair growth, sperm production and sex drive.

The level of testosterone in the male body is typically highest in the morning and fluctuates throughout the day. The amount of testosterone the body produces is controlled by the brain, which sends messages to the testes essentially telling them how much to produce and release into the bloodstream. As men age, their testosterone levels decline. This is sometimes referred to as andropause, similar to menopause, which is the decline in hormones that aging women experience.

An abnormally low testosterone level can occur in men of all ages, and it is much more common than we realize. The U.S. Food & Drug Administration estimates that up to 5 million American men have low testosterone but only 5 percent receive treatment.

A simple blood test is all a physician needs to determine a man’s testosterone level. In my practice, I include testosterone testing as part of the physical exam for men age 40 and older. It is surprising how many men have low testosterone and do not realize it. With all the advertisements for erectile dysfunction medications that are out there, people tend to think that’s the No. 1 symptom of low testosterone. It isn’t. In fact, low testosterone is usually asymptomatic. Fatigue is probably the most common symptom, followed by a very low or no interest in sexual intercourse. Impotence or erectile dysfunction is probably the third most common symptom. Others include mood changes, depression, changes in facial and body hair, increased breast size and drops in muscle mass.

We really do not know what causes the brain to change the message it sends to the testes that results in a significant drop in testosterone production. Injuries, testicular infections, testicular cancer or cancer treatments may be to blame. Mail-order products used to increase muscle mass (anabolic steroids) may, in the long run, also interfere with the body’s natural testosterone production.

Several treatment options for low testosterone are available. They include:
• Supplemental injections of synthetic testosterone
• Transdermal replacement therapy (patch or gel)
• Implantable testosterone pellets

Testosterone treatment may not be recommended for men who have prostate cancer or other male cancers or men who wish to have children. These treatments are generally easily tolerated by patients. Men should talk to their doctors about the treatment that is best for them. General practitioners also refer patients to urologists for treatment.

The next time you visit your doctor, ask about testosterone testing, particularly if your energy level is not what it once was. Low testosterone may be to blame, and it can be corrected.

Dr. T. Sivaraj has been practicing internal medicine for more than 16 years. For more information, visit www.hollyspringsmedicalcenter.com.

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