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Overview

Testosterone is the male sex hormone, made in the testes, that is responsible for distinct male characteristics. Sexual development, functions, body and facial hair, voice, and muscle strength are all controlled by the production of testosterone. It is also necessary for the production of sperm. Levels of testosterone in men normally decrease as they age, but testosterone deficiency can cause many symptoms.

Symptoms

Men with testosterone deficiency may experience a group of symptoms:

  • Low sex drive
  • Erectile dysfunction
  • Reduced muscle mass
  • Loss of body hair
  • Fatigue
  • Irritability
  • Depression

Diagnosis

To rule out other possibilities, your doctor will ask you a variety of questions to obtain a thorough medical history. During a physical exam, they will check for any abnormalities. In order to test for testosterone deficiency, your doctor will take a blood test to measure your levels of testosterone and other hormones. 

Treatment

Your doctor will create a treatment plan based on your health history and symptoms. This may include lifestyle changes and/or medication therapy.

Lifestyle Changes

Your doctor may recommend lifestyle changes to help treat other conditions such as diabetes, anemia, or bone loss density. This may include quitting smoking, reducing alcohol consumption, losing weight, getting physical activity, and eating a healthier diet – these lifestyle changes will likely raise your testosterone levels naturally. 

Testosterone Therapy (TT)

If your symptoms are due solely to testosterone deficiency, your doctor may recommend TT. 

There are 5 different ways to administer this hormone:

  • Transdermal – topical gels, creams, liquids, patches; last 4 days
  • Injection – short or long-acting; can be received weekly, biweekly, or monthly
  • Oral – sublingual dissolving patch; lasts 12 hours
  • Intranasal – nose spray taken 3 times daily
  • Pellets – placed under the skin of the upper hip or buttocks; lasts 3-6 months

Since there are several ways to administer testosterone therapy, side effects may vary. For gels and liquids, there may be redness on the skin. With patches, you may experience itching and/or a rash around the area. Some people experience allergic reactions to the long-acting injection, so your doctor will monitor you closely for your first few injections. Lab tests to check for testosterone levels are done every 6-12 months to make sure levels are normal.

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