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Low Testosterone

There are plenty of factors that play a role in lowering hormone levels in men. Aging, lack of physical activity, stress, and nutrition can affect testosterone levels. Learn more about this condition and find out how it can be easily treated.

What is Low Testosterone?

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 in your brain. 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 suffers from low T if he is experiencing low T symptoms.

Men experiencing symptoms with “low-normal” testosterone levels often benefit greatly from getting to a more optimized range over 800ng/dl.

What are the symptoms of Low Testosterone?

  • Erectile Dysfunction
  • Low Libido
  • Fatigue
  • Difficulty Concentrating (“brain fog”)
  • Weight Gain
  • Decreased Muscle Mass


What causes Low Testosterone?

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.

Who is an Ideal Candidate for Testosterone Treatment?

You are an ideal candidate for treatment if you want to optimize your hormones and improve your vitality. If you are feeling the symptoms of low testosterone and suffer from a poor quality of life, start with a consultation and get your labs checked. Low or low-normal levels justify a treatment trial with aim to relieve your symptoms.

What should I Expect at Consultation?

During your consultation with Dr. Dhir at HTX Urology, your medical history will be discussed in detail, especially your height, weight, blood pressure, underlying medical conditions, and medications.

A physical examination of your prostate and testicles may be performed to check for size, injuries, and other abnormalities. Blood tests are ordered for confirmation of low T and for proper dosing of medication.

What are treatment options for Low Testosterone?

Testosterone Pellets

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 patients self-inject synthetic testosterone.

Testosterone Injections

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 the office.

Testosterone Alternatives

Human Chorionic Gonadotropin (HCG) and Selective Estrogen Receptor Modulators (SERM) are alternatives to TRT that can be prescribed in specific situations. Both HCG and SERMs preserve fertility, which is suppressed with the use of pure testosterone. Please note, HCG can be expensive and is usually administered two to three times weekly.

Men of child-bearing age with hypogonadism may be better suited to the above-mentioned testosterone alternatives. 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.

What should I Expect after Testosterone Pellet Insertion?

Men who opt for testosterone pelleting will require some downtime after the procedure. Use ice packs and limit strenuous activity the day of your procedure. Avoid excessive bending and squatting at the hips for the first week.

There will be a dressing over your small incision that should not be removed for 7 days. Daily showers are encouraged but avoid pools or hot tubs for that first week while healing occurs.

Blood tests are checked 4 weeks after pellet insertion to determine your hormone levels and if a dosage adjustment will be needed in future procedures.

How much do Testosterone treatments cost?

With the patient-centered approach at HTX Urology, the cost of low testosterone treatments can vary. Pricing depends on the type of treatment chosen and duration of treatment.

Please note that self-injecting testosterone is a cheaper method but tends to carry higher levels of side effects versus Testosterone pelleting. Pellets are not covered by insurance but are the best method at sustained results with low side-effect profile.

Ask Dr. Dhir: Talking Testosterone Replacement Therapy

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 Focused Wave Therapy, to truly achieve their goals.

Do I need lab monitoring while on testosterone pellets?

Blood tests are required to make sure hormones are at the proper level, and to avoid any possible adverse effects. Labs are usually drawn 4 weeks after pelleting and one week prior to the next pellet appointment – usually 6 months later.

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 previously treated prostate cancer may safely use TRT to improve their symptoms! That being said, PSA (prostate-specific antigen) is still closely monitored to rule out any prostate issues.

Arrange a Consultation

Take control of your life and get your vitality back by addressing your symptoms of low testosterone in Houston. Contact Dr. Dhir at HTX Urology to schedule your consultation today.