What is it?
Low Testosterone, or hypogonadism, refers to a decrease in testosterone levels either due to a problem with testicular production or problems in the pituitary gland. Levels of testosterone are typically measured under 300ng/dl and lead to unwanted symptoms.
Some men, even with testosterone levels over 300 will be labeled “low-normal”. For example, a 35-year-old man with a testosterone level of 340 falls in the normal range according to lab reports (250-1000 ng/dl), but for his age he is hypogonadal if having Low T symptoms.
Men experiencing symptoms and “low-normal” testosterone levels often benefit greatly from getting to a more optimized range over 800ng/dl.
What are the symptoms?
- Erectile Dysfunction
- Low Libido
- Difficulty Concentrating (“brain fog”)
- Weight Gain
- Decreased Muscle Mass
What causes it?
There are multiple possible causes of Low T, such as aging, diabetes, testicular injury, infection, or radiation to the pelvis. Oftentimes it is “idiopathic”, which means the cause is unknown.
What are treatment options?
This is the most natural treatment method, using bio-identical hormonal pellets leading to long-lasting improvements in mental acuity, strength, erection quality, and sexual performance. Pellets last 6-9 months and offer sustained release based on cardiac output. This means that there are no “highs and lows” such as when patient’s self-inject synthetic testosterone.
These are synthetic forms of testosterone replacement therapy (TRT). Injections do not offer sustained release like bio-identical pellets and need to be dosed frequently for proper efficacy. Testosterone injections have a short half-life, meaning in the days before the next injection patients may experience a “crash” as their testosterone falls to low baseline levels.
With Injection therapy, patients administer the medication intramuscularly at home on a weekly basis. Self-injections are easily done in the comfort of your own home after being taught in office.
Human Chorionic Gonadotropin (HCG) and Selective Estrogen Receptor Modulators (SERM) are alternatives to TRT that can be prescribed in specific situations. An example of SERM is the medication Clomid (Clomiphene Citrate). Both HCG and SERMs preserve fertility, which is suppressed with use of exogenous testosterone.
Men of child-bearing age with low testosterone may be better suited to these types of supplementation. Please arrange for an in-office consultation to discuss these alternatives to TRT if you have low testosterone levels but still want to have children in the near future.
Frequently asked questions
Will I still have ED after testosterone replacement?
Treating low T can improve erection quality, however not always. Some patients will need their testosterone corrected and will need treatment specific to ED, such as Wave Therapy, to truly achieve their goals.
Do I need monitoring while on Bio-Identical Hormonal Pellets?
Typically annual labs will be required to make sure hormones are at the proper level, and to avoid any possible adverse effects.
Does testosterone replacement therapy cause prostate cancer?
No. There is no evidence TRT causes prostate cancer. In fact, clinical studies now show that men with treated prostate cancer may safely use TRT to improve their lives! That being said, PSA (prostate specific antigen) is still actively monitored to rule out any prostate issue