Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Dec 23, 2018
Last Modified Date: Dec 23, 2018
Published Date: Dec 23, 2018
TABLE OF CONTENTS
Chapter 1: Low Testosterone: The Basics Chapter 2: Low Testosterone Levels Explained Chapter 3: Causes of Low Testosterone Chapter 4: Common Symptoms of Low Testosterone Chapter 5: How to Diagnose Low Testosterone Chapter 6: How to Treat Low Testosterone Chapter 7: Commonly Asked Questions about Testosterone
Low Testosterone: The Basics
While it is most commonly thought of as a sex hormone, testosterone plays a number of other roles in the body, supporting many of the body's essential systems and functions. When levels of testosterone drop lower than normal, that imbalance of male hormones has wide-ranging affects throughout the body, producing symptoms that can range from physical changes to emotional and cognitive ones. Since low testosterone symptoms vary so widely and can mimic symptoms of a number of other health conditions, hormone level testing is essential in definitively diagnosing this common hormonal imbalance.
In men, testosterone is manufactured primarily by the testes and regulated by the pituitary gland. The primary male sex hormone, testosterone is essential to the process of sperm production, affects sex drive and aids in the development and maintenance of adult male characteristics and physical features. Testosterone also affects body composition, metabolism, cardiovascular health, bone mass and bone strength, as well as a number of key cognitive functions, such as attention, memory and spatial ability.
Low Testosterone Levels Explained
A relatively common condition, low testosterone can cause a range of physical issues and health conditions, especially among men. Fortunately, the signs of low testosterone, or "low-T," are easy to identify and typically respond to a number of treatment options. Learn how to recognize the symptoms of low testosterone, discover some common causes of this condition, and find out how to diagnose and treat low-T.
Testosterone is a hormone that your body's adrenal glands produce naturally throughout your life. While both men and women produce this hormone, men's testicles make significantly more testosterone than women's ovaries do.
Although testosterone level influences sperm production and sex drive, this hormone also affects a range of physical and mental issues. Testosterone levels impact the way your body stores fat, how it retains muscle and bone mass, and how it produces red blood cells. This hormone can also affect your mood and energy level.
Throughout most men's lives, testosterone levels typically follow a standard pattern, increasing substantially during puberty and decreasing gradually after the age of 30. Although low testosterone levels are most common in older men, low-T can affect people of all ages. You have low-T if your testosterone levels fall below the average range, which is from 300 to 1,000 nanograms per deciliter (ng/dL).
Also known as Testosterone Deficiency Syndrome (TD), low-T isn't uncommon. An estimated 2 percent of men have low testosterone. Age, health conditions, and other factors may increase the frequency of this condition.
Causes of Low Testosterone
A wide range of primary and secondary issues can lead to low testosterone levels. Primary issues typically include problems with the testicles, while secondary issues generally relate to the pituitary gland, which produces testosterone. Get to know some of the most common primary and secondary causes of low-T.
Male hypogonadism is a common cause of low T; a condition in which the body fails to produce enough testosterone. Primary hypogonadism, also known as primary testicular failure, is caused by dysfunctional testes, which can occur due to infection, injury, radiation exposure or certain genetic, developmental and autoimmune disorders.
Central hypogonadism occurs when the hypothalamus and pituitary, which regulate the production and secretion of male hormones, do not function properly, leading to low testosterone. Common causes of central hypogonadism include genetic problems, certain medications, radiation, surgery, trauma, infections, rapid weight loss, tumors and nutritional deficiencies.
Andropause is another very common condition associated with low T. As men age, testosterone production declines, a natural transition that is comparable to menopause in women, commonly referred to as male menopause. On average, this change begins around the age of 40, with testosterone levels dropping approximately 1 percent per year, generally leveling off around the age of 55. In some men, levels drop more drastically than others, leading to testosterone deficiency.
Other common causes of low T include inflammatory diseases, diabetes, metabolic syndrome, cardiovascular disease and medications, especially drugs used in the treatment of prostate cancer and corticosteroid drugs. Kidney or liver disease can lead to low testosterone, as can stress, alcoholism and obesity.
The most common cause of declining testosterone levels is advanced age: all men produce decreased levels of this hormone as their age increases. While the American Urological Association estimates that only about 1 percent of younger men have low-T, the condition is much more common in older men. In fact, studies have shown that approximately 20 percent of men over 60 have TD, while half of men over 80 may experience abnormally low testosterone levels.
For men, obesity can also contribute to low testosterone levels. In fact, according to the American Urological Association, up to 30 percent of overweight men may experience low-T. Carrying excess fat cells can cause testosterone to convert to estrogen, leading to rising estrogen levels and decreased testosterone levels.
While minor infections don't typically cause TD, some viral infections can cause decreased testosterone levels later in life. If you develop mumps as a teenager or as an adult, the virus may affect your testicles, eventually causing testicular damage and low testosterone levels. In some cases, getting the mumps virus may cause you to become sterile.
Only a select few acute infections can lead to low-T, but several chronic illnesses can contribute to declining testosterone levels. If you have chronic kidney or liver disease, HIV or AIDS, or type 2 diabetes, your risk factor for developing TD could be higher. For example, the American Urological Association reports that having diabetes could double your chances of developing abnormally low testosterone levels.
Testicular injuries and impacts to the scrotum can also lead to damage and low-T later in life. While serious injuries to one testicle don't always have a substantial impact on your overall hormone production, a series of injuries to both testicles can cause your testosterone levels to decline over time.
Congenital conditions, such as Klinefelter syndrome, can contribute to low-T. This syndrome causes a man to have two X chromosomes and one Y chromosome rather than one of each. The additional X chromosome can lead to abnormal testicle development and testosterone levels far below average.
Irregularities in the hypothalamus, which oversees the pituitary gland, can also impact testosterone levels. Malformations, tumors, inflammation, and blood flow issues related to these glands can cause low-T, as can chemotherapy treatments that affect these glands and neighboring areas.
Along with chemotherapy and radiation treatments, some other medications can cause testosterone levels to decline. Steroids, narcotics, and opioid medications can all affect the normal functions of your pituitary gland, ultimately leading to low-T. Abusing medications and drinking excessively can also decrease your testosterone levels over time.
Common Symptoms of Low Testosterone
If your testosterone production is below normal, you could experience a wide range of symptoms. In many cases, you'll have more than one symptom at a time. Take a look at some of the most common signs that you may have low-T.
Decreased Sex Drive
In adult men, one of the most common signs of low testosterone levels is a decreased sex drive. Since this hormone is one of the main drivers of your libido, lower-than-normal levels may contribute to a similarly low level of interest in sex.
Although many men experience a gradual decrease in sex drive as they age, low-T tends to cause a sudden and substantial disinterest in sex. Since this drastic change can quickly cause relationship issues and personal frustrations, low sex drive tends to be one of the easiest TD symptoms to identify. Fortunately, this common symptom is also one of the first to resolve itself once you begin low-T treatment.
Reduced Semen Volume
Your testosterone level is closely linked with your sperm and semen production. If you notice a drop in semen volume during ejaculation or if you find that your sperm count has decreased, you may have low-T. Since reduced semen volume and sperm count can lead to reproductive issues, you may want to identify the cause of these symptoms right away.
While testosterone isn't the only element that enables men to get and maintain an erection, this hormone plays an important role. After all, it causes the brain to generate nitric oxide, which prompts the chemical reactions necessary for an erection. If your testosterone levels drop below normal, you could have trouble achieving an erection during sex, and you may also notice that you don't have as many spontaneous erections while sleeping. Eventually, difficulties achieving and maintaining erections could lead to developing erectile dysfunction.
Because several factors affect erections, difficulties in this area don't automatically mean you have low testosterone levels. If you experience erection problems combined with other common symptoms of low-T, however, there's a chance you have TD.
Diminished Muscle Mass
Although erectile dysfunction and drastic changes to your sex drive are some of the clearest indicators of low testosterone levels, physical issues can also signal low-T in men. Since testosterone helps boost your muscles, low levels of this hormone can contribute to decreased muscle mass.
If you have this symptom, you probably won't notice a loss of strength or diminished muscle function. Instead, you may notice that your muscles simply don't appear as prominent as they once did, even though you maintain a consistent level of activity and you still strive to build muscle. You might also notice that the sleeves of your shirts fit more loosely than they once did, a sure sign that you've lost muscle mass.
Declining Bone Mass
Muscles aren't the only bodily components that tend to shrink when your testosterone levels decrease. Because testosterone plays an important role in keeping your bones strong, low levels of this hormone cause many men to experience a decrease in bone mass, eventually making your bones weaker and more prone to breakage.
Although it isn't easy to detect decreased bone mass visually, repeated fractures or constant feelings of weakness can signal bone mass problems. If you suspect that thinning bone mass is affecting your health, consider getting a testosterone test and a bone density scan to get to the bottom of the issue.
Increased Body Fat
Testosterone affects nearly every part of your bodily structure, and your body fat is no exception. In general, men with high or average levels of testosterone tend to be leaner and carry less body fat. In contrast, men with low levels of testosterone typically appear heavier and carry higher percentages of body fat.
While some low-T men develop enlarged breast tissue, especially if they have a natural imbalance of testosterone and estrogen, most others simply carry extra body fat around the middle. Since extra weight around your midsection can cause complications like heart disease and other serious conditions, identifying and addressing the cause of your excess weight is important. A simple testosterone test can tell you whether your hormone levels are lower than normal, and your doctor can advise about appropriate steps to take next.
Along with affecting muscle, bone, and fat production, testosterone also impacts your hair growth. In fact, low testosterone levels can contribute to hair loss and may even lead to balding. While many men are genetically predisposed to going bald and many others gradually lose hair as they age, decreased testosterone levels can accelerate hair loss. In fact, below-average testosterone levels may even lead to all-over body and facial hair loss.
If you've developed a pattern of early hair loss that doesn't appear inherited or if you've begun to lose body and facial hair, you may be dealing with low testosterone levels. Consider completing a testosterone test, especially if you've also experienced other common low-T symptoms like mood swings and low muscle mass.
Testosterone has the potential to affect your energy levels, and TD can cause you to feel tired constantly, even if you get adequate sleep. If you have low testosterone levels, you might feel fatigued or lethargic, even if you haven't engaged in strenuous activities or suffered from sleep loss. Many men with low-T also struggle to stay active or maintain motivation to complete basic daily tasks.
In some cases, low testosterone levels can also cause frequent sleep disturbances, which can eventually cause fatigue and related issues. Many men with TD experience sleep apnea, insomnia, and interruptions in their regular sleep patterns.
Although many conditions can contribute to sleep issues and feelings of fatigue, low-T could be the cause of yours if you constantly feel tired even though you regularly consume caffeine and fuel your body with energy. A testosterone test can reveal whether low hormone levels are contributing to your sense of lethargy.
It's no secret that the hormones your body produces naturally are designed to regulate your emotions and your moods. That's why low testosterone levels often lead to difficulties maintaining a stable mood or keeping your emotions under control. In many cases, low-T can make you feel sad for seemingly no reason or deplete your sense of well-being. Since testosterone also affects your sense of confidence, TD can cause you to lose your sense of self-assurance and lower your quality of life. In some cases, low testosterone levels can even lead to mental health issues like anxiety.
Like many conditions, anxiety, irritability, and other mood issues can result from many causes. If you notice frequent mood swings, a drastic change in emotions, or unusual feelings of nervousness combined with other low-T symptoms, consider getting your testosterone levels analyzed.
You might consider memory issues to be a normal part of aging, but low testosterone levels can contribute to cognitive decline or amplify the side effects of this condition. Many men experience a gradual loss of focus, reduced memory capabilities, and a general feeling of mental fogginess when their testosterone levels drop.
A 2015 study of the links between testosterone levels and cognitive decline indicates a close correlation between the two in men over 70 years old. As the study shows, continual decreases in testosterone level tend to contribute to compromised memory skills.
On their own, memory issues and frequent forgetfulness don't necessarily indicate a serious drop in testosterone levels. However, if you notice memory loss in conjunction with other symptoms, such as low sex drive or reduced muscle mass, you may want to pursue a testosterone test and talk with your doctor about a low-T diagnosis.
Complications of Low Testosterone Levels
Over time, low testosterone levels can impact much more than your sex drive. In fact, TD can cause numerous complications that could affect several areas of your life.
Since low testosterone levels impact bone mass, TD can eventually cause osteoporosis and other serious bone health issues. Because low-T can affect semen volume and cause erectile dysfunction, low testosterone levels can also lead to infertility and reproductive issues.
While physical complications aren't unusual, some men also experience mental health issues as a result of low testosterone levels. In fact, one of the most common side effects of low-T is depression, which can result from the stress that low hormone levels tend to cause.
How to Diagnose Low Testosterone
If you have any of the common symptoms of low testosterone levels; and, suspect that you have low-T, taking a blood test is the easiest way to gain insight into your condition. A testosterone blood test measures the total amount of the hormone in your body and reflects both bound and unbound versions of testosterone. To assess its levels, you will simply need to order a test and provide a blood sample.
Note that you may have to stop taking medications, like steroids and barbiturates, prior to taking a testosterone blood test, as these and other alike medications can contribute to inaccurate results. Pay close attention to the time of day when you take the testosterone blood test. Since most people's hormone levels are highest shortly after waking up, your doctor may recommend that you provide a blood sample in the morning.
After receiving your blood sample, the lab will analyze the total amount of testosterone. If your testosterone level is below the average range for men, or under 300 ng/dL, consider talking with your doctor for a definitive diagnosis and a consultation. Your health care provider can advise about at what is the normal range for your testosterone levels, given your age and any health issues you have.
If your doctor determines that your testosterone results are abnormal, your health care provider may perform a physical exam, order additional testing, or suggest treatment options to address low-T. In many cases, you'll find that you need periodic testosterone blood tests to track your hormone levels over time and assess the effects of any treatments you pursue.
Measuring Your Testosterone
There are a few methods used to determine if a man has indeed low amounts of testosterone in his body. The first method is for the physician to take a complete medical history of the patient. The doctor will be looking for signs and symptoms of androgen deficiency. The patient will be asked questions about their sex life, poor erections, less volume of semen, orgasmic quality, decreased energy, loss of muscle strength, self-esteem problems, depression, tiredness, irritability, insomnia, sweating, hair loss and abdominal weight gain. Other important symptoms include high LDL cholesterol, osteoporosis, an increase in total body fat and a reduction of red blood cells in the plasma. For many men, premature aging is a form of hypogonadism. Although there are more symptoms than listed here, the line of questioning will be the same in the doctor's office. From the information provided here, it shows how important it is to verify the diagnosis since so many of these symptoms can relate to other diseases.
After determining whether the symptoms seem to suggest Low T, you will need to have your testosterone measured using a Testosterone blood test The two most relevant blood tests are the Total Testosterone and the Free Testosterone tests. Most anti-aging doctors recommend to take the blood draw in the morning, usually before 10:00 a.m. This is when the male's testosterone level is at its highest point. Several blood tests should be performed, over a period of a week, to determine the actual number when trying to diagnose andropause. The levels of testosterone tend to fluctuate throughout the day. Once a final diagnosis is confirmed, there are several options to be considered and discussed with the doctor regarding the testosterone delivery system and what will work best for them.
How to Treat Low Testosterone
Testosterone replacement therapy, or male menopause, is also known as Low T or Andropause. It is gaining more and more attention as the medical community and researchers learn about this condition that affects all men, as they age. In some instances, younger men may be affected by Low T due to other medical conditions. Because of the stigma attached to low testosterone, men are not inclined to talk about it that much and in the open, but the tide is turning with commercials about Low T. It is now known that men start losing 1% of their testosterone every year starting around the age of 30.
We now have continuous research and clinical trials going on that helps us to better understand male menopause in order to serve the male population more effectively. Another benefit of the research and clinical trials will also help men who, because of a disease or illness, suffer from Low T. These are treatable conditions with very good results. Previously, the medical profession was unaware of androgen deficiency because it came on gradually; and, carried a variety of vague symptoms.
Testosterone Replacement Therapies
The availability of testosterone comes in many forms: injectable, cream, gel, transdermal patch, mucoadhesive material applied to the teeth twice a day, testosterone stick (used like deodorant stick) and a long-acting subcutaneous implant of pellets. Depending on the doctor and the range within which your testosterone levels fall, the doctor will pick the right treatment. But, most will offer the cream as the first line of defense. Apply it in the morning as during the normal cycle of testosterone levels, these latter will be at their highest point. The doctor will want the patient to stay on the testosterone plan for a period of 8 - 10 weeks. This way, the patient will be able to show normal levels of the hormone. Blood work should be checked every 3 - 6 months to determine levels of the hormone in the system.
Receiving a TD diagnosis can be daunting. However, most patients have access to several treatment options that can improve symptoms and increase testosterone levels. Learn about some of the most common types of testosterone replacement therapy (TRT).
In many cases, your doctor can prescribe a testosterone patch that you apply directly to your skin. You'll typically apply a transdermal patch each night, routinely changing the location to ensure that your body continues to absorb the hormone effectively without generating uncomfortable skin reactions.
Prescription gel applications could also be an option for TRT. Most testosterone gels require you to apply the medication on your arm, your armpit, or your thigh. You'll then need to wait for the gel to dry completely, taking care not to shower, sweat, or otherwise remove the gel before your body absorbs the hormone. You'll also need to take precautions to prevent touching others with the liquid medication.
While most gels require you to apply the medication directly to your skin, some require you to pump the gel into your nostrils. Although many nasal gels are easy to apply, they typically involve multiple daily applications to ensure that you absorb enough of the hormone.
In other cases, an internal application may work better for you. Your doctor may prescribe a testosterone injection that you'll need to apply to a muscle. Depending on the medication, you may be able to inject yourself at home each day or you may need to visit your doctor for regular injections. Most injections require multiple applications at specific intervals.
One of the newest types of TRT treatment, pellets can also increase abnormally low testosterone levels. If you opt for this treatment, your doctor will implant several small pellets under your skin, typically in your buttocks. These pellets are designed to release testosterone over several months, gradually helping your hormones return to normal levels and alleviate your symptoms.
In some cases, you can consider making strategic lifestyle changes in addition to or instead of taking advantage of medical treatments. Adopting a healthier diet, avoiding alcohol, incorporating more exercise and movement into your day, and getting adequate sleep may help you maintain a lower weight, which can decrease the risk of low-T.
Potential Side Effects of Testosterone Replacement Therapy
All drugs carry side effects and testosterone cream is no different. If it is overused, side effects would include dizziness, headaches, fluid retention and high blood pressure. There is evidence that the cream can cause prostate problems: this would preclude men that are already having problems with their prostate.
While TRT treatments are relatively common and typically produce positive results, some therapies can generate negative side effects. In some cases, TRT treatments cause testicle shrinkage and decreased sperm production. In other cases, these therapies can cause physical side effects like weight gain and increased oil production in the skin. Treatments for low testosterone may also increase your risk of developing blood clots or having a stroke.
Although some TRT treatments can lead to an enlarged prostate or breast growth, studies have not linked low testosterone therapy to prostate cancer. If you have concerns about the side effects of any treatment you're considering; then, you need to have a frank discussion with your doctor to ensure that you understand the risks and benefits. Naturally, you'll want to feel confident that you're making the right decision for your health and well-being.
Whether you've experienced common symptoms of low-T or you have one of the risk factors for developing TD, it's important to know where your testosterone levels stand. Since low testosterone levels can impact your mental and physical health throughout your life and may even shorten your life expectancy, maintaining normal hormone levels is essential for your well-being. Order a total testosterone test from Health Testing Centers and get essential insight about your health today.
Commonly Asked Questions about Testosterone
Why does testosterone decline with age?
Testosterone is at its peak in puberty, when male muscles are developed, voice deepens and the size of the penis and testicles increases. By the age of 30, however, the hormone begins to gradually decline. While a decline is a natural part of the aging process, some people experience abnormally low testosterone levels.
How testosterone affects men and women?
If you consider the importance of sexual health in both males and females, having normal levels of testosterone can help:
- Fight depression.
- Decrease body fat through the regulation of insulin, fat metabolism and glucose.
- Increase muscle strength and mass.
- Help protect against cardiovascular disease.
- Strengthen bones and ward off osteoporosis.
- Regulates cognitive and physical energy.
- Maintain sex drive.
What is “Low-T” and what are the symptoms?
As men age, their bodies often slow the process of making testosterone. The hormone’s decline is often referred to as “male menopause” or “Low-T” by the media and advertising campaigns. It’s estimated that up to five million American men experience low testosterone, but that less than 10 percent are actually treated.
When testosterone levels fall below the normal range, symptoms can include:
- Erectile dysfunction (ED)
- Low sex drive
- Increased irritability; depression
- A reduction in strength and muscle mass
- A decrease in bone density that can result in osteoporosis
Besides aging, some medical conditions can cause testosterone levels to drop – pituitary gland disorders, for example, or genetic disorders. Among the FDA-approved testosterone replacement therapies are: injections, patches and a clear gel rubbed into the skin. Regular checkups, age appropriate screening and a blood test can all help determine if your testosterone levels are normal.
What are some medical uses for testosterone?
Its primary medical use is for the treatment of too little testosterone production – or hypogonadism. Hormone replacement therapy helps to maintain serum testosterone levels within the normal range. Other medical uses include: help in reducing infertility, increasing libido, osteoporosis treatment, bone marrow stimulation and anemia treatment. Because it is such a powerful hormone, testosterone treatment should only be administered with proper medical management.
How do you sum everything about Testosterone?
What You Should Know is that this steroid hormone is found in mammals and other vertebrates. estosterone is the main male sex hormone. It is secreted primarily in the testicles of males and the ovaries of females. Small amounts are also secreted by the adrenal glands.
Its job is to play a key role in male reproduction, but it has other purposes too: it increases muscle mass, bone strength and body hair, and is considered essential to good health for both males and females. Testosterone levels tend to decrease in later adult life, which can lead to problems with energy levels, sexual performance and “low-T” symptoms.
On average, the body of an adult man produces about ten times more testosterone than that of a woman; but these latter are more sensitive to this powerful steroid. Abuse of testosterone can cause mood swings, acne, aggressive behavior and other problems. A physician who specializes in hormone disorders is called an endocrinologist.
So how do I know if I need testosterone therapy?
Today, this question has been on every man’s mind with testosterone being under the microscope as a way to boost and maintain youthful masculine vigor.
Some studies, though small in number, suggest that testosterone therapy can help improve energy levels, cognitive abilities and sex drive. But, not everyone will benefit from hormone replacement therapy. A blood test to measure testosterone levels can help determine if you are within the normal range. Never embark on steroid replacement therapy without medical support and supervision.
What do females need to know about testosterone?
For both sexes, hormones provide the foundation for a biological makeup. Though more attention is directed towards men when it comes to low testosterone levels; women can also have a deficiency. Causes of low-T among women include genetics, environmental exposures, drug and alcohol abuse among other factors. In addition, antidepressants, high blood pressure and cholesterol medications can reduce testosterone levels.
Among the symptoms of low-T in women:
- Weight gain
- Low libido
The bottom line is that for both men and women, blood levels need to be checked first. Any existing hormone deficiency should then be diagnosed and treated by a licensed medical provider.
Testosterone Injections: Do They Mean that Virility is Safely Restored?
Anecdotal evidence suggests that testosterone when given to older men can provide greater energy levels, the libido of far younger men, a general improvement in mood and a feeling of overall well-being. Virility is expected to be magically restored! If this is the case why don’t all older men, with lowered testosterone levels, rush out to get injections to reclaim their lost youth? If testosterone levels in an individual are low, it would surely make sense then to simply replace that underproduced hormone. Unfortunately, as simple as such a reasoning might seem simple; it is not.
As with any medication, testosterone can have unwanted side effects. For example, an increased incidence of cardiovascular problems in men receiving testosterone replacement therapy have been reported. There is also a school of thought that a decline in testosterone levels is an inevitable part of old age that is best tackled by living a healthy lifestyle accompanied by regular exercise. Hormone therapy is not necessarily something to rush into.
Any man that believes his testosterone levels are low to the point that his life is being adversely affected should confirm this by having it tested. That possibility needs to be addressed before any possible treatment options are considered.
What are the Available Treatments for Testosterone Problems?
Understanding testosterone – what it is and what it does – is relatively straightforward. Deciding whether to take medical action to boost testosterone levels is the question. This is why a medical opinion should be sought before embarking on a course of treatment.
If your doctor recommends it, hormone replacement therapy is available to bring levels back to normal. With treatment, sexual problems and low energy associated with a lack of the hormone should be alleviated. The treatment can be administered in different ways. A doctor will decide which method is the most suitable for a patient. Once treatment has started, another test will be needed to measure the effect and to adjust the dosage of the medication.
Methods used in hormone replacement are:
Testosterone injections: These are given into a muscle (intramuscular) and are administered over different periods depending on the medication used. An injection may be required every 14 or 21 days, however, the gap between treatments can be as long as three months. The doctor or a practice nurse normally gives the injection. Injections of this nature are not particularly painful although there will obviously be some discomfort.
Implants: The patient is given a local anesthetic to allow a doctor to insert a cylindrical pellet into the thigh, abdomen or buttocks. This small operation needs to be performed every three to six months.
Gum (buccal): The gum is placed in the mouth by the patient and is held in place above the front teeth.
Gel: This is rubbed into the skin of the abdomen, arm or shoulder. Used after showering the treatment should be active over 24 hours. Care must be taken to ensure that a patient’s partner, other family members or pets, are not exposed to the gel. It can be transferred by physical contact and the unintended recipient might experience adverse effects
Healthy older men who have only slightly decreased testosterone levels are unlikely to benefit dramatically from testosterone injections, according to the Journal of the American Geriatrics Society, Improvements in erectile function and libido due to testosterone replacement therapy in men with markedly low testosterone levels has had more success.
Why you Should Maintain Normal Testosterone Levels?
Testosterone, the primary male sex hormone, is not only a magic bullet for reproductive health. This powerful hormone influences a wide range of other essential bodily functions. That means that not having enough of it in your system can cause an array of problems, affecting physical, emotional and cognitive health. So how much testosterone is enough and what can be done to help maintain normal testosterone levels?
Testosterone Level Testing
The first step in maintaining normal testosterone levels is keeping tabs on where you stand. That means getting your testosterone levels checked regularly. Once a year is wise to ensure you're maintaining healthy levels, especially in men over age 35. Since levels fluctuate from one day to another, a series of several tests are recommended for the most accurate assessment of testosterone levels, and it is important to have both total testosterone and free testosterone levels checked.
What are Normal Testosterone Levels?
According to the National Institute of Health, total testosterone levels from 300 to 1,000 ng/dL, are normal for adult men. Normal levels of free testosterone are about 2 percent of total testosterone, or, according to Mayo Medical Laboratories, between 9 and 30 ng/dL.
Maintaining Testosterone Levels Safely
If your levels are very low – below 200ng/dL – you'll need to see a doctor to discuss treatment options. If you have levels falling on the low end of the normal range or simply want to prevent low T, there are things you can do on your own to help maintain or boost testosterone levels, such as
Weight loss – Being overweight or obese can contribute to decreased testosterone levels. Body fat contains aromatase, an enzyme that converts testosterone into estrogen, so the more body fat you have, the lower your testosterone levels are likely to be. According to Harvard Medical School, clinical evidence shows that for each one point increase in body mass index (BMI), testosterone can fall by as much as 2 percent. So, losing those extra pounds can help maintain healthy testosterone levels.
Reduce alcohol consumption – Regular use of alcohol - particularly when it is heavy - has been shown to reduce testosterone levels. Cutting out alcohol completely is your best bet, but short of that, reducing your consumption to one or two drinks at a time and not drinking daily can help reduce the effects of alcohol on your testosterone levels.
Avoid becoming stressed – A study at the University of Texas at Austin showed that participants with high levels of the stress hormone cortisol had a significant drop in testosterone levels after being defeated in a competition.
Exercise Regularly – Thirty minutes of vigorous exercise per day helps maintain testosterone levels. A balanced mix of resistance training and aerobic exercise is best for both testosterone levels and general health.
Change Your Diet – Diet may have an effect on how testosterone is metabolized. To maintain a healthy balanced diet, avoid highly processed, fatty and sugary foods in favor of lean proteins, low-fat dairy and plenty of fresh fruits and vegetables. Nutrients to pay special attention to in terms of testosterone level maintenance include magnesium, found in dark leafy greens, nuts, and beans and vitamin D, found in dairy products and eggs.
Why Normal Testosterone Levels Matter
Maintaining normal testosterone levels will not only lower your risk of low-T symptoms and health issues, but can help you maintain the feeling of well-being and vitality that you need to get the most out of life. So, eat right, get fit, eliminate unhealthy habits and keep tabs on your testosterone levels. These are lifestyle changes that are well worth your time and effort to maintain both normal testosterone levels and optimal health.
Corona, G., et al. (2013, May 2). Body weight loss reverts obesity-associated hypogonadotropic hypogonadism: a systematic review and meta-analysis. European Journal of Endocrinology, 168(6), 829-843.
Grossmann, M. (2014, January 27). Testosterone and glucose metabolism in men: current concepts and controversies. Journal of Endocrinology, 220(3), R37-55
The National Sleep Foundation. How much sleep do we really need? (2015). Retrieved from: www.sleepfoundation.org/how-sleep-works/how-much-sleep-do-we-really-need
Leproult, R., & Van Cauter, E. (2011, June 1). Effect of 1 week of sleep restriction on testosterone levels in young healthy men. Journal of the American Medical Association, 305(21), 2173-2174
The American Diabetes Association. Low testosterone. (2015). Retrieved from: www.diabetes.org/living-with-diabetes/treatment-and-care/men/low-testosterone.html
Mayo Clinic. (2014, February 5). Exercise: 7 benefits of regular physical activity. Retrieved from: www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise/art-20048389
Mayo Clinic. (2014). Testosterone therapy: Potential risks and benefits as you age. Retrieved from: www.mayoclinic.org/healthy-lifestyle/sexual-health/in-depth/testosterone-therapy/art-20045728?pg=1
Sato, K., Lemitsu, M., Matsutani, K., Kurihara, T., Hamaoka, T., & Fujita, S. Resistance training restores muscle sex steroid hormone steroidogenesis in older men. (2014, April). The FASEB Journal, 28(4), 1891-1897
Stokes, V. J., Anderson, R. A., & George, J. T. (2014, August 19). How does obesity affect fertility in men – and what are the treatment options? Clinical Endocrinology, 82(5), 633-638