You have probably seen any number of ads on the television and online about low T. They seem to indicate that this is a growing national problem and all men should begin taking medication to correct their testosterone deficiency and become more “manly men.” It might be time to slow down this growing snowball down the mountain, and look carefully to evaluate when do men need testosterone treatment?
Some Facts First
Because requests for testosterone treatment have tripled in the last decade, the AUA, or American Urological Association, has issued guidelines for the diagnosis and management of testosterone deficiency.
Testosterone is a hormone produced in the testicles of men and is necessary for physical, sexual, cognitive, and many metabolic functions. The hormone testosterone gives men their deep voice, body hair and muscular body. The sexual component peaks in adolescence and young adulthood.
A man’s ability to produce testosterone starts to decline at about 40 years of age, and levels continue to drop 1 – 3% a year thereafter. It is important to note that just because the levels are dropping after 40 doesn’t necessarily mean that all men are candidates for therapy. There must be certain symptoms present.
In order to be clinically diagnosed as having low T, a man must have low testosterone levels and exhibit the following signs or symptoms: low sex drive, low sperm count, trouble getting an erection, hair loss, hot flashes and low bone density.
In addition, men must also exhibit the following signs or conditions:
- Diminished muscle mass
- Increased body fat
- Elevated hemoglobin A1C
- Changes in testes
- Lack of motivation and concentration
- Low trauma bone fractures
Confirmation of low T requires two separate blood tests on non-consecutive days taken early in the morning. Testosterone is highest in the early part of the day.
The blood must be tested by labs certified by the CDC.
Monitoring Low Testosterone Treatment
The guidelines emphasize the importance of checking T levels during the treatment process to make sure the hormone eventually falls within the desired range. It is also important to monitor sexual issues, plus heart and bone health.
Treatments can be a gel, an adhesive pellet, or injections.
Risks Of Testosterone Replacement Therapy
It is important to talk to Louisiana Healthcare Associates Urology Division about your specific risks, but common risk factors include the following:
- Worsening sleep apnea
- Stimulates noncancerous growths in the prostate gland (BPH)
- Enlarged breasts
- Limits sperm production and shrinking testicles
- Too much red blood cell production can lead to a clot