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Low testosterone occurs in men when the testicles don’t produce the levels of the male sex hormone that they’re designed to produce. This can cause many problems for men because testosterone plays an important role in the male body. It helps develop sexual characteristics, maintain muscle and bone mass, keep your red blood cell levels up, and give you an overall sense of well-being. During puberty, those levels are important for developing features in men like a deeper voice, facial hair, and muscle strength. But too much loss leads to hypogonadism, which is defined as testosterone levels below 300 nanograms per deciliter. A variety of factors – from injury to obesity – can lead to low testosterone. A testosterone deficiency can affect many aspects of well-being – from muscle strength and energy to libido and mood.
Cheng grew up in New Jersey and went to Rice University to study psychology. He received his medical degree from Baylor College of Medicine in Houston, graduating with honors. He completed his general surgery internship and urology residency at Harvard Medical School/Brigham & Women’s Hospital. After residency, he went to the University of Utah, where he completed his Genitourinary Reconstruction and Men’s Health fellowship under the direction of Dr. James Hotaling. If you have a condition such as diabetes and you find your nerve pain and numbness getting worse, talk with your doctor about the possibility that you may also have low testosterone.
Testosterone stimulates osteoblasts to deposit bone, so if your T levels are low, you may make less bone. "Fortunately an increased boost in energy is one of the first things I hear from my guys I put on TRT," says Calvert. While you can blame forgetfulness or not feeling as sharp as you once were on getting older, these could also be signs that your testosterone is low. The relationship isn’t completely understood, but researchers suspect that testosterone acts as a vasodilator, allowing more blood flow into the penis, says Calvert. Without enough testosterone, blood may not be able to enter the penis and allow it to get rigid enough for sex.
Some men go to their doctor’s office to receive testosterone injections. Frequency can vary from one injection every week to one injection every 10 weeks. (Most men have an injection every 2 weeks.) Shots may be placed just under the skin or directly into a muscle. The average life expectancy is more than 76 years, and if you reach age 65, you can likely count on an additional 18 years. That’s great news until you realize that you could be living more than two-thirds of your life with significantly less testosterone than you started with.
People with high testosterone levels can find it difficult to achieve erections, and people with low levels the opposite. A noticeable drop in libido is one of the most common signs of low T. If your interest in sex has faded significantly, it could be linked to declining testosterone levels. The bottom of a man's normal total testosterone range is about 300 ng/dL, and the upper limit is about 800ng/dL, depending on the lab. In general, levels below 300 ng/dL combined with symptoms are indicators of testosterone deficiency. Our physicians are experienced in treating the complete range of urologic conditions and diseases, from kidney stones and sexual dysfunction to prostate cancer, incontinence and infertility.
Men can sometimes present with very severe mood or anxiety changes that are caused by hormonal imbalance. If appropriate, we may prescribe a low dose of progesterone in the testosterone cream to help alleviate these symptoms. This gives us a good idea of what’s going on, and if we do suspect low testosterone, we will request blood tests to confirm our suspicions. We can also use a DUTCH test to look at the cortisol levels and balance of sex hormones. Studies have shown that men are less likely to visit their doctor, for both physical and mental health concerns than women. This may be more worrying for single men, as Harvard University found that married men are more likely to have better health. Men can also have difficulty achieving and maintaining erections if their testosterone levels are too low.
If you are experiencing diminished interest in sex, ED or multiple symptoms together such as lack of desire to have sex and lack of energy, you should talk to your doctor. Low testosterone is a common condition that often goes undiagnosed because its symptoms are similar to other conditions. The body relies on a balance of hormones to carry out everyday functions. This means when one hormone, such as testosterone runs low, it can tip the balance on other chemical messengers, unsettling everything from the thyroid and prolactin, to insulin sensitivity. If you’re experiencing a complete loss or a major reduction in your interest for sex, this can be a major indicator of low testosterone. Low testosterone often results in low semen volume, which may affect fertility because your sperm rely on this milky substance for maximum motility.
Among men who experienced sexual dysfunction, TRT increased sexual activity by 49% within six months, improving moods and sex drive but not necessarily erectile dysfunction. The depression directly caused by low T can be amplified when low libido and erectile dysfunction start to affect a person’s sex life. There is a cause-and-effect relationship, wherein 35% to 50% of men with hypogonadism experience clinical depression, while 63% of men with clinical depression experience sexual dysfunction. Patients must understand the diagnostic criteria required to warrant testosterone therapy. This includes at least 2 separate low testosterone levels and a specific hormone-related symptom that could be reasonably expected to improve with 400 mg testosterone cypionate per week supplementation.