What are the symptoms of very low testosterone. How is low testosterone diagnosed. What treatment options are available for men with low testosterone levels. Are there any risks associated with testosterone replacement therapy. How does low testosterone affect men’s health and well-being.

Understanding Low Testosterone: A Comprehensive Overview

Low testosterone, also known as male hypogonadism, is a condition where the male reproductive glands (testes) fail to produce adequate levels of testosterone, a crucial male sex hormone. This hormone plays a vital role in maintaining and developing various aspects of male health, including sexual features, muscle mass, red blood cell levels, bone density, overall well-being, and sexual and reproductive function.

The prevalence of low testosterone is significant, affecting nearly 40% of men aged 45 and older. However, defining normal testosterone levels can be challenging due to various factors that influence hormone levels, such as body mass index (BMI), nutrition, alcohol consumption, certain medications, age, and illness.

Causes of Low Testosterone

While the natural aging process is a primary factor in declining testosterone levels, with levels dropping by approximately 1% per year after age 30, several other potential causes exist:

• Injury or infection of the testes
• Chemotherapy or radiation treatment for cancer
• Genetic abnormalities
• Dysfunction of the hypothalamus and pituitary gland
• Inflammatory diseases
• Obesity
• Medications, particularly hormones used to treat prostate cancer
• Chronic illness
• Stress
• Alcoholism
• Steroid use

Recognizing the Symptoms of Very Low Testosterone

The symptoms of low testosterone can vary depending on the individual’s age and the severity of the hormone deficiency. Recognizing these symptoms is crucial for early diagnosis and treatment.

Common Symptoms in Adult Men

• Reduced libido (sex drive)
• Erectile dysfunction
• Decreased sense of well-being
• Depressed mood
• Difficulties with concentration and memory
• Fatigue
• Irritability and mood swings
• Loss of muscular strength

Physical Changes Associated with Low Testosterone

In addition to the aforementioned symptoms, men with low testosterone may experience:

• Decreased hemoglobin levels and mild anemia
• Reduction in body hair
• Thinning of bones (osteoporosis)
• Increased body fat
• Breast development (gynecomastia)
• Infertility

Do these symptoms always indicate low testosterone? Not necessarily. Many of these symptoms can be caused by other factors or medical conditions. Therefore, it’s essential to consult with a healthcare professional for proper diagnosis.

Diagnosing Low Testosterone: The Importance of Accurate Testing

Diagnosing low testosterone requires more than just recognizing symptoms. A definitive diagnosis is made through blood tests that measure the amount of testosterone in the body.

The Blood Test Process

How is a testosterone blood test conducted? Typically, a healthcare provider will order a blood test to measure total testosterone levels. However, a single test may not be sufficient due to the natural fluctuations in testosterone levels throughout the day.

When is the best time to test for testosterone levels? Testosterone levels are generally highest in the morning, around 8 a.m. For this reason, doctors often prefer to measure testosterone levels early in the morning to get the most accurate results.

Interpreting Test Results

What constitutes a “normal” testosterone level? The normal range for testosterone can vary depending on the laboratory and the individual’s age. Generally, a total testosterone level below 300 nanograms per deciliter (ng/dL) is considered low for adult men.

Are there other tests that might be conducted? In some cases, additional tests may be necessary, such as:

• Free testosterone test
• Luteinizing hormone (LH) test
• Follicle-stimulating hormone (FSH) test
• Prolactin test

These tests can help determine the underlying cause of low testosterone and guide treatment decisions.

Treatment Options for Low Testosterone: Exploring Testosterone Replacement Therapy

Once a diagnosis of low testosterone is confirmed, the primary treatment option is testosterone replacement therapy (TRT). This therapy aims to restore testosterone levels to a normal range, alleviating symptoms and improving overall quality of life.

Forms of Testosterone Replacement Therapy

Testosterone replacement therapy can be administered in several ways:

1. Intramuscular injections: Usually given every 10 to 14 days
2. Testosterone patches: Applied daily to different parts of the body
3. Testosterone gels: Applied daily to clean, dry skin of the upper back and arms
4. Pellets: Implanted under the skin every two months

Is oral testosterone an option? Oral testosterone is not approved for use in the United States due to potential liver toxicity concerns.

Benefits of Testosterone Replacement Therapy

What improvements can men expect from testosterone replacement therapy? Potential benefits include:

• Increased muscle mass and strength
• Improved bone density
• Enhanced mood and sense of well-being
• Better sexual function
• Improved cognitive function
• Increased energy levels
• Reduction in body fat

Can testosterone replacement therapy help with delayed puberty in boys? Yes, in boys with delayed puberty, TRT can help initiate and progress through normal pubertal development.

Potential Risks and Side Effects of Testosterone Replacement Therapy

While testosterone replacement therapy can offer significant benefits, it’s important to be aware of potential risks and side effects.

Common Side Effects

What side effects might occur with testosterone replacement therapy?

• Acne or oily skin
• Mild fluid retention
• Stimulation of the prostate, potentially causing urination difficulties
• Breast enlargement or tenderness
• Worsening of sleep apnea
• Testicular shrinkage
• Skin irritation (with topical treatments)

Laboratory Abnormalities

Are there any changes in laboratory tests that might occur with TRT? Some potential changes include:

• Increase in prostate-specific antigen (PSA) levels
• Increase in red blood cell count
• Decrease in sperm count, potentially affecting fertility

How often should men on TRT have follow-up appointments? Regular follow-up appointments with a healthcare provider are crucial for monitoring treatment efficacy and potential side effects.

Monitoring and Long-term Management of Testosterone Replacement Therapy

Effective management of testosterone replacement therapy requires ongoing monitoring and adjustments as needed.

Prostate Health Monitoring

How is prostate health monitored during TRT? Guidelines suggest:

• Assessing prostate cancer risk before starting treatment
• Checking PSA levels at 3, 6, and 12 months within the first year, then annually
• Performing a digital rectal examination at 3-6 months and 1 year after beginning therapy, then annually

Is prostate monitoring necessary for all men? While recommended for men on TRT, regular prostate health checks are advised for all men as they age, regardless of testosterone treatment.

Adjusting Treatment

How often should testosterone levels be checked during treatment? Testosterone levels should be monitored regularly, typically every 3-6 months during the first year of treatment, and then annually thereafter.

Can the dosage or form of TRT be changed? Yes, the dosage or form of testosterone replacement may be adjusted based on the patient’s response to treatment and any side effects experienced.

Lifestyle Factors and Natural Ways to Support Testosterone Levels

While testosterone replacement therapy is the primary treatment for clinically low testosterone, certain lifestyle factors can also influence testosterone levels.

Diet and Exercise

Can diet and exercise affect testosterone levels? Yes, maintaining a healthy diet and regular exercise routine can positively impact testosterone production. Some dietary and lifestyle recommendations include:

• Consuming adequate protein
• Including healthy fats in the diet
• Maintaining a healthy weight
• Engaging in regular strength training exercises
• Getting sufficient sleep
• Managing stress levels

Natural Supplements

Are there any natural supplements that can boost testosterone? While some supplements claim to increase testosterone levels, their effectiveness is often not scientifically proven. Always consult with a healthcare provider before starting any supplement regimen.

Some supplements that have shown potential in supporting testosterone levels include:

• Vitamin D
• Zinc
• Magnesium
• D-Aspartic acid

However, these should not be considered as replacements for medical treatment in cases of clinically low testosterone.

The Impact of Low Testosterone on Overall Health and Well-being

Low testosterone can have far-reaching effects on a man’s physical and mental health, extending beyond sexual function and body composition.

Cardiovascular Health

Is there a link between low testosterone and cardiovascular health? Some studies suggest that low testosterone may be associated with an increased risk of cardiovascular disease. However, the relationship is complex and not fully understood.

How might testosterone affect heart health? Testosterone may influence several cardiovascular risk factors, including:

• Body fat distribution
• Insulin sensitivity
• Lipid profiles
• Blood pressure

More research is needed to fully elucidate the relationship between testosterone and cardiovascular health.

Cognitive Function and Mental Health

Can low testosterone affect brain function? Yes, testosterone plays a role in cognitive function. Some studies have found associations between low testosterone and:

• Decreased cognitive performance
• Increased risk of depression
• Mood disturbances

However, the exact nature of these relationships and the potential benefits of testosterone therapy on cognitive function remain areas of ongoing research.

How does testosterone influence mood? Testosterone can affect neurotransmitter systems in the brain, potentially influencing mood and emotional well-being. Men with low testosterone often report improvements in mood and overall sense of well-being after starting testosterone replacement therapy.

Bone Health

What role does testosterone play in bone health? Testosterone is crucial for maintaining bone density. Low testosterone levels can lead to decreased bone mass and an increased risk of osteoporosis.

Can testosterone replacement therapy improve bone health? Yes, studies have shown that testosterone replacement therapy can increase bone density in men with low testosterone, potentially reducing the risk of fractures.

Future Directions in Low Testosterone Research and Treatment

As our understanding of testosterone’s role in male health continues to evolve, new areas of research and potential treatment approaches are emerging.

Personalized Medicine Approaches

How might personalized medicine impact testosterone treatment? Future approaches may involve more tailored treatment plans based on individual genetic profiles, lifestyle factors, and specific symptoms. This could lead to more effective and targeted therapies with fewer side effects.

Novel Delivery Methods

Are there new ways to administer testosterone being developed? Researchers are exploring innovative delivery methods for testosterone replacement therapy, including:

• Nasal gels
• Longer-acting injections
• Improved transdermal delivery systems

These new methods aim to provide more consistent hormone levels and improve treatment convenience.

Understanding Long-term Effects

What are the long-term effects of testosterone replacement therapy? While short-term benefits and risks are well-documented, more research is needed to fully understand the long-term effects of testosterone replacement therapy, particularly on cardiovascular health and prostate cancer risk.

Are there ongoing clinical trials related to low testosterone? Numerous clinical trials are underway to investigate various aspects of low testosterone and its treatment. These studies aim to:

• Refine diagnostic criteria
• Explore new treatment options
• Investigate potential benefits in specific populations
• Assess long-term safety and efficacy of testosterone replacement therapy

In conclusion, very low testosterone is a complex condition that can significantly impact a man’s health and quality of life. While testosterone replacement therapy offers an effective treatment option for many men, it’s crucial to approach diagnosis and treatment under the guidance of a healthcare professional. As research continues to advance our understanding of testosterone’s role in male health, we can expect to see more refined and personalized approaches to managing low testosterone in the future.

Causes, Symptoms, Diagnosis & Treatment

Overview

What is low testosterone (male hypogonadism)?

Low testosterone (male hypogonadism) is a condition in which the testes (testicles, the male reproductive glands) do not produce enough testosterone (a male sex hormone).

In men, testosterone helps maintain and develop:

• Sexual features
• Muscle mass
• Adequate levels of red blood cells
• Bone density
• Sense of well-being
• Sexual and reproductive function

How common is low testosterone?

Low testosterone affects almost 40% of men aged 45 and older. It is difficult to define normal testosterone levels, because levels vary throughout the day and are affected by body mass index (BMI), nutrition, alcohol consumption, certain medications, age and illness.

Symptoms and Causes

What causes low testosterone?

As a man ages, the amount of testosterone in his body gradually drops. This natural decline starts after age 30 and continues (about 1% per year) throughout his life.

There are many other potential causes of low testosterone, including the following:

What are the symptoms of low testosterone?

Symptoms of low testosterone depend on the age of person, and include the following:

• Low sex drive
• Erectile dysfunction
• Decreased sense of well-being
• Depressed mood
• Difficulties with concentration and memory
• Fatigue
• Moodiness and irritability
• Loss of muscular strength

Other changes that occur with low testosterone include:

• A decrease in hemoglobin and mild anemia
• A decrease in body hair
• Thinning of the bones (osteoporosis)
• Increased body fat
• Breast development (gynecomastia)
• Infertility

Diagnosis and Tests

How is low testosterone diagnosed?

Low testosterone is diagnosed by measuring the amount of testosterone in the blood with a blood test. It may take several measurements to determine if a patient has low testosterone, since levels tend to change throughout the day. The highest levels of testosterone are generally in the morning, near 8 a.m. This is why doctors prefer to measure testosterone levels in the early morning.

Management and Treatment

How is low testosterone treated?

Low testosterone is treated with testosterone replacement therapy, which can be given in several different ways:

• Intramuscular injections (into a muscle), usually every 10 to 14 days;
• Testosterone patches, which are used every day and are applied to different parts of the body, including the buttocks, arms, back, and abdomen
• Testosterone gels that are applied every day to the clean dry skin of the upper back and arms (the gels require care in making sure that the hormone is not accidentally transferred to another person or partner)
• Pellets that are implanted under the skin every two months

(Oral testosterone is not approved for use in the United States. )

What are the benefits of testosterone replacement therapy?

Potential benefits of testosterone replacement therapy may include:

• In boys, avoiding problems related to delayed puberty
• Loss of fat
• Increased bone density and protection against osteoporosis
• Improved mood and sense of well-being
• Improved sexual function
• Improved mental sharpness
• Greater muscle strength and physical performance

What are the side effects of testosterone replacement therapy?

The side effects of testosterone replacement therapy include:

• Acne or oily skin
• Swelling in the ankles caused by mild fluid retention
• Stimulation of the prostate, which can cause urination symptoms such as difficulty urinating
• Breast enlargement or tenderness
• Worsening of sleep apnea (a sleep disorder that results in frequent nighttime awakenings and daytime sleepiness)
• Smaller testicles
• Skin irritation (in patients receiving topical testosterone replacement)

Laboratory abnormalities that can occur with testosterone replacement include:

• Increase in prostate-specific antigen (PSA)
• Increase in red blood cell count
• Decrease in sperm count, producing infertility (inability to have children), which is especially important in younger men who desire fertility

If you are taking hormone replacement therapy, regular follow-up appointments with your physician are important.

Guidelines suggest discussing the potential risk vs. benefit of evaluating prostate cancer risk and prostate monitoring. The doctor and patient will decide together regarding prostate cancer monitoring. For patients who choose monitoring, clinicians should assess prostate cancer risk before starting testosterone treatment, and 3 to 12 months after starting testosterone:

• PSA levels should be checked at 3, 6, and 12 months within the first year, and then every year after that.
• A digital rectal examination of the prostate should be done at 3-6 months and 1 year after beginning therapy, and then every year after that. This is recommended even for men who are not on testosterone replacement therapy, as an age-related prostate cancer screening. This usually begins at age 50.
• Hematocrit levels will be checked before testosterone therapy starts, and then on a regular basis to make sure red blood cell levels remain normal.

Who shouldn’t take testosterone replacement therapy?

Testosterone replacement therapy may cause the prostate to grow. If a man has early prostate cancer, there is concern that testosterone may stimulate the cancer’s growth. Therefore, men who have prostate cancer should not take testosterone replacement therapy. It is important for all men considering testosterone replacement therapy to undergo prostate screening before starting this therapy.

Other men who should not take testosterone replacement therapy include those who have:

• An enlarged prostate resulting in urinary symptoms (difficulty starting a urinary stream)
• A lump on their prostate that has not been evaluated
• A PSA measurement above 4
• Breast cancer
• An elevated hematocrit level (higher-than-normal number of red blood cells)
• Severe congestive heart failure
• Obstructive sleep apnea that has not been treated

Prevention

Can low testosterone be prevented?

There are no known ways to prevent low testosterone that is caused by genetic conditions or damage to the testes or pituitary gland.

A healthy lifestyle that includes good nutrition, exercise, weight management, and that avoids excessive use of alcohol and drugs can help keep testosterone levels normal.

Causes, Symptoms, Diagnosis & Treatment

Overview

What is low testosterone (male hypogonadism)?

Low testosterone (male hypogonadism) is a condition in which the testes (testicles, the male reproductive glands) do not produce enough testosterone (a male sex hormone).

In men, testosterone helps maintain and develop:

• Sexual features
• Muscle mass
• Adequate levels of red blood cells
• Bone density
• Sense of well-being
• Sexual and reproductive function

How common is low testosterone?

Low testosterone affects almost 40% of men aged 45 and older. It is difficult to define normal testosterone levels, because levels vary throughout the day and are affected by body mass index (BMI), nutrition, alcohol consumption, certain medications, age and illness.

Symptoms and Causes

What causes low testosterone?

As a man ages, the amount of testosterone in his body gradually drops. This natural decline starts after age 30 and continues (about 1% per year) throughout his life.

There are many other potential causes of low testosterone, including the following:

What are the symptoms of low testosterone?

Symptoms of low testosterone depend on the age of person, and include the following:

• Low sex drive
• Erectile dysfunction
• Decreased sense of well-being
• Depressed mood
• Difficulties with concentration and memory
• Fatigue
• Moodiness and irritability
• Loss of muscular strength

Other changes that occur with low testosterone include:

• A decrease in hemoglobin and mild anemia
• A decrease in body hair
• Thinning of the bones (osteoporosis)
• Increased body fat
• Breast development (gynecomastia)
• Infertility

Diagnosis and Tests

How is low testosterone diagnosed?

Low testosterone is diagnosed by measuring the amount of testosterone in the blood with a blood test. It may take several measurements to determine if a patient has low testosterone, since levels tend to change throughout the day. The highest levels of testosterone are generally in the morning, near 8 a.m. This is why doctors prefer to measure testosterone levels in the early morning.

Management and Treatment

How is low testosterone treated?

Low testosterone is treated with testosterone replacement therapy, which can be given in several different ways:

• Intramuscular injections (into a muscle), usually every 10 to 14 days;
• Testosterone patches, which are used every day and are applied to different parts of the body, including the buttocks, arms, back, and abdomen
• Testosterone gels that are applied every day to the clean dry skin of the upper back and arms (the gels require care in making sure that the hormone is not accidentally transferred to another person or partner)
• Pellets that are implanted under the skin every two months

(Oral testosterone is not approved for use in the United States. )

What are the benefits of testosterone replacement therapy?

Potential benefits of testosterone replacement therapy may include:

• In boys, avoiding problems related to delayed puberty
• Loss of fat
• Increased bone density and protection against osteoporosis
• Improved mood and sense of well-being
• Improved sexual function
• Improved mental sharpness
• Greater muscle strength and physical performance

What are the side effects of testosterone replacement therapy?

The side effects of testosterone replacement therapy include:

• Acne or oily skin
• Swelling in the ankles caused by mild fluid retention
• Stimulation of the prostate, which can cause urination symptoms such as difficulty urinating
• Breast enlargement or tenderness
• Worsening of sleep apnea (a sleep disorder that results in frequent nighttime awakenings and daytime sleepiness)
• Smaller testicles
• Skin irritation (in patients receiving topical testosterone replacement)

Laboratory abnormalities that can occur with testosterone replacement include:

• Increase in prostate-specific antigen (PSA)
• Increase in red blood cell count
• Decrease in sperm count, producing infertility (inability to have children), which is especially important in younger men who desire fertility

If you are taking hormone replacement therapy, regular follow-up appointments with your physician are important.

Guidelines suggest discussing the potential risk vs. benefit of evaluating prostate cancer risk and prostate monitoring. The doctor and patient will decide together regarding prostate cancer monitoring. For patients who choose monitoring, clinicians should assess prostate cancer risk before starting testosterone treatment, and 3 to 12 months after starting testosterone:

• PSA levels should be checked at 3, 6, and 12 months within the first year, and then every year after that.
• A digital rectal examination of the prostate should be done at 3-6 months and 1 year after beginning therapy, and then every year after that. This is recommended even for men who are not on testosterone replacement therapy, as an age-related prostate cancer screening. This usually begins at age 50.
• Hematocrit levels will be checked before testosterone therapy starts, and then on a regular basis to make sure red blood cell levels remain normal.

Who shouldn’t take testosterone replacement therapy?

Testosterone replacement therapy may cause the prostate to grow. If a man has early prostate cancer, there is concern that testosterone may stimulate the cancer’s growth. Therefore, men who have prostate cancer should not take testosterone replacement therapy. It is important for all men considering testosterone replacement therapy to undergo prostate screening before starting this therapy.

Other men who should not take testosterone replacement therapy include those who have:

• An enlarged prostate resulting in urinary symptoms (difficulty starting a urinary stream)
• A lump on their prostate that has not been evaluated
• A PSA measurement above 4
• Breast cancer
• An elevated hematocrit level (higher-than-normal number of red blood cells)
• Severe congestive heart failure
• Obstructive sleep apnea that has not been treated

Prevention

Can low testosterone be prevented?

There are no known ways to prevent low testosterone that is caused by genetic conditions or damage to the testes or pituitary gland.

A healthy lifestyle that includes good nutrition, exercise, weight management, and that avoids excessive use of alcohol and drugs can help keep testosterone levels normal.

Causes, Symptoms, Diagnosis & Treatment

Overview

What is low testosterone (male hypogonadism)?

Low testosterone (male hypogonadism) is a condition in which the testes (testicles, the male reproductive glands) do not produce enough testosterone (a male sex hormone).

In men, testosterone helps maintain and develop:

• Sexual features
• Muscle mass
• Adequate levels of red blood cells
• Bone density
• Sense of well-being
• Sexual and reproductive function

How common is low testosterone?

Low testosterone affects almost 40% of men aged 45 and older. It is difficult to define normal testosterone levels, because levels vary throughout the day and are affected by body mass index (BMI), nutrition, alcohol consumption, certain medications, age and illness.

Symptoms and Causes

What causes low testosterone?

As a man ages, the amount of testosterone in his body gradually drops. This natural decline starts after age 30 and continues (about 1% per year) throughout his life.

There are many other potential causes of low testosterone, including the following:

What are the symptoms of low testosterone?

Symptoms of low testosterone depend on the age of person, and include the following:

• Low sex drive
• Erectile dysfunction
• Decreased sense of well-being
• Depressed mood
• Difficulties with concentration and memory
• Fatigue
• Moodiness and irritability
• Loss of muscular strength

Other changes that occur with low testosterone include:

• A decrease in hemoglobin and mild anemia
• A decrease in body hair
• Thinning of the bones (osteoporosis)
• Increased body fat
• Breast development (gynecomastia)
• Infertility

Diagnosis and Tests

How is low testosterone diagnosed?

Low testosterone is diagnosed by measuring the amount of testosterone in the blood with a blood test. It may take several measurements to determine if a patient has low testosterone, since levels tend to change throughout the day. The highest levels of testosterone are generally in the morning, near 8 a.m. This is why doctors prefer to measure testosterone levels in the early morning.

Management and Treatment

How is low testosterone treated?

Low testosterone is treated with testosterone replacement therapy, which can be given in several different ways:

• Intramuscular injections (into a muscle), usually every 10 to 14 days;
• Testosterone patches, which are used every day and are applied to different parts of the body, including the buttocks, arms, back, and abdomen
• Testosterone gels that are applied every day to the clean dry skin of the upper back and arms (the gels require care in making sure that the hormone is not accidentally transferred to another person or partner)
• Pellets that are implanted under the skin every two months

(Oral testosterone is not approved for use in the United States. )

What are the benefits of testosterone replacement therapy?

Potential benefits of testosterone replacement therapy may include:

• In boys, avoiding problems related to delayed puberty
• Loss of fat
• Increased bone density and protection against osteoporosis
• Improved mood and sense of well-being
• Improved sexual function
• Improved mental sharpness
• Greater muscle strength and physical performance

What are the side effects of testosterone replacement therapy?

The side effects of testosterone replacement therapy include:

• Acne or oily skin
• Swelling in the ankles caused by mild fluid retention
• Stimulation of the prostate, which can cause urination symptoms such as difficulty urinating
• Breast enlargement or tenderness
• Worsening of sleep apnea (a sleep disorder that results in frequent nighttime awakenings and daytime sleepiness)
• Smaller testicles
• Skin irritation (in patients receiving topical testosterone replacement)

Laboratory abnormalities that can occur with testosterone replacement include:

• Increase in prostate-specific antigen (PSA)
• Increase in red blood cell count
• Decrease in sperm count, producing infertility (inability to have children), which is especially important in younger men who desire fertility

If you are taking hormone replacement therapy, regular follow-up appointments with your physician are important.

Guidelines suggest discussing the potential risk vs. benefit of evaluating prostate cancer risk and prostate monitoring. The doctor and patient will decide together regarding prostate cancer monitoring. For patients who choose monitoring, clinicians should assess prostate cancer risk before starting testosterone treatment, and 3 to 12 months after starting testosterone:

• PSA levels should be checked at 3, 6, and 12 months within the first year, and then every year after that.
• A digital rectal examination of the prostate should be done at 3-6 months and 1 year after beginning therapy, and then every year after that. This is recommended even for men who are not on testosterone replacement therapy, as an age-related prostate cancer screening. This usually begins at age 50.
• Hematocrit levels will be checked before testosterone therapy starts, and then on a regular basis to make sure red blood cell levels remain normal.

Who shouldn’t take testosterone replacement therapy?

Testosterone replacement therapy may cause the prostate to grow. If a man has early prostate cancer, there is concern that testosterone may stimulate the cancer’s growth. Therefore, men who have prostate cancer should not take testosterone replacement therapy. It is important for all men considering testosterone replacement therapy to undergo prostate screening before starting this therapy.

Other men who should not take testosterone replacement therapy include those who have:

• An enlarged prostate resulting in urinary symptoms (difficulty starting a urinary stream)
• A lump on their prostate that has not been evaluated
• A PSA measurement above 4
• Breast cancer
• An elevated hematocrit level (higher-than-normal number of red blood cells)
• Severe congestive heart failure
• Obstructive sleep apnea that has not been treated

Prevention

Can low testosterone be prevented?

There are no known ways to prevent low testosterone that is caused by genetic conditions or damage to the testes or pituitary gland.

A healthy lifestyle that includes good nutrition, exercise, weight management, and that avoids excessive use of alcohol and drugs can help keep testosterone levels normal.

Low Testosterone – WebMD: Symptoms, Health Effects, and Testosterone Replacement

In recent years, Spyros Mezitis, MD, PhD, has found himself talking to a lot more male patients about low testosterone, a diagnosis he says is becoming increasingly common.

“More men are getting older, and men are more open about talking about erectile dysfunction,” Mezitis, an endocrinologist at Lenox Hill Hospital in New York City, tells WebMD.

On the one hand, increased diagnosis of low testosterone is driven by an aging population, less stigma, and more precise tests. But there’s another big reason why men come to Mezitis’ office for a testosterone test.

“Men are bombarded by media, by advertising campaigns — ‘Don’t feel well? Ask your doctor about low testosterone,'” he says.

They come in saying they feel excessively fatigued, weaker, depressed, and that they have lost their sex drive — all common symptoms of a drop in testosterone.

“As an endocrinologist, I’m thinking hormones,” says Mezitis, who estimates that about a quarter to a third of the men he tests for low testosterone have levels below normal. “Sometimes it is testosterone, sometimes it is the thyroid, and sometimes it’s something unrelated to hormones.”

What Is Testosterone and Why Does It Decline?

Testosterone is a hormone. It’s what puts hair on a man’s chest. It’s the force behind their sex drive.

During puberty, testosterone helps build men’s muscles, deepens their voice, and boosts the size of their penis and testes. In adulthood, it keeps men’s muscles and bones strong and maintains their interest in sex. In short, it’s what makes a man a man (at least physically).

After age 30, most men begin to experience a gradual decline in testosterone. A decrease in sex drive sometimes accompanies the drop in testosterone, leading many men to mistakenly believe that their loss of interest in sex is simply due to getting older.

“Some say it’s just a part of aging, but that’s a misconception,” says Jason Hedges, MD, PhD, a urologist at Oregon Health and Science University in Portland. A gradual decline in testosterone can’t explain a near-total lack of interest in sex, for example. And for Hedges’ patients who are in their 20s, 30s, and early 40s and having erectile problems, other health problems may be a bigger issue than aging.

“A lot of the symptoms are mirrored by other medical problems,” Hedges says. “And for a long time, we were not attributing them to low testosterone, but to diabetes, depression, high blood pressure, and coronary artery disease. But awareness and appreciation of low testosterone has risen. We recognize now that low testosterone may be at the root of problems.”

Doctors will want to rule out any such possible explanations for symptoms before blaming them on low testosterone. They will also want to order a specific blood test to determine a man’s testosterone level.

“The blood test is really the thing,” Mezitis says.

Low Testosterone: How Low Is Too Low?

The bottom of a man’s normal total testosterone range is about 300 nanograms per deciliter (ng/dL). The upper limit is about 800ng/dL depending on the lab. A lower-than-normal score on a blood test can be caused by a number of conditions, including:

Some medicines and genetic conditions can also lower a man’s testosterone score. Aging does contribute to low scores. In some cases, the cause is unknown.

A low score does not always translate to symptoms, Mezitis says, “but we often find something that’s off when we see scores of 200 or 100 ng/dL.”

Hedges agrees and warns that even if a man does not have symptoms, he may be well advised to seek treatment. Low testosterone scores often lead to drops in bone density, meaning that bones become more fragile and increasingly prone to breaks.

“That’s something I would want to have a conversation about,” Hedges says. “Bone density issues are not always apparent.”

Low Testosterone Treatment

Having a gradual decline in your testosterone level as you age is to be expected. Treatment is sometimes considered if you’re experiencing symptoms related to low testosterone.

If a young man’s low testosterone is a problem for a couple trying to get pregnant, gonadotropin injections may be an option in some cases. These are hormones that signal the body to produce more testosterone. This may increase the sperm count. Hedges also describes implantable testosterone pellets, a relatively new form of treatment in which several pellets are placed under the skin of the buttocks, where they release testosterone over the course of about three to four months. Injections and nasal gels may be other options for some men.

What Are the Risks and Benefits of Testosterone Treatment?

“If their symptoms are truly due to low testosterone, patients tell me that within a few weeks they notice a significant difference, though sometimes it is not too dramatic,” Hedges says. “Sex is better, depression is better — you can see it directly and quickly.”

There are also risks. Testosterone treatment can raise men’s red blood cell count as well as enlarge their breasts. It can also accelerate prostate growth. Men with breast cancer should not receive testosterone treatment.

Testosterone treatment usually is not advised for men with prostate cancer. Hedges says some of the associations between testosterone replacement therapy and prostate health are currently being challenged. In his practice, he does offer testosterone treatment to men who have been treated for prostate cancer.

“The take-home [message] is treatment is safe as long as you get careful monitoring,” Hedges says. “If there are known issues, patients should be treated by a specialist.”

Low Testosterone: How Low Can It Go?

As if erectile dysfunction weren’t enough to worry about, low testosterone weighs on the minds of many men. Throughout your life, testosterone plays an important role in regulating sexual, mental, and physical health. That’s why low testosterone, or low T as it’s called, can cause common symptoms like erectile dysfunction (ED), low libido, depression, and low energy. The good news in all of this is that very low testosterone is very unlikely, and certain signs will let you know when testing and possible treatment are needed.

How Low Can Testosterone Go?

Unlike women, who have a rapid decline in estrogen at menopause, men may experience a gradual decline in testosterone. Studies show that about 20 percent of men have low T in their sixties and about 50 percent have low T in their eighties. In younger men, low T may be caused by common problems like obesity, diabetes, and stress. Altogether, low T may affect up to 5 million American men.

“The lower your testosterone goes, the more likely you are to have the common symptoms like low energy and low libido,” says Daniel Shoskes, MD, a urologist at the Glickman Urological & Kidney Institute at the Cleveland Clinic in Ohio. “A deep reduction can cause less common symptoms like anemia, osteoporosis, depression, and confusion. But the idea that healthy men’s testosterone levels need to be monitored to prevent these symptoms is probably nonsense. ”

When symptoms indicate that you may have a low T problem, a simple test can help make the diagnosis. A morning blood test is the best way to measure testosterone. “There is a very wide range of normal, and testosterone levels change during the day,” says Dr. Shoskes. The normal range is anywhere from 300 to 800 nanograms per deciliter (ng/dL). You would not be considered to have low T unless you had a number below 300.

Dangerously low testosterone levels may occur under certain conditions. One example is treatment for prostate cancer. Because prostate cancer can be fueled by testosterone, doctors may use treatments to block testosterone in advanced cases. This is called androgen deprivation therapy (ADT).

One example of ADT is surgical removal of the testicles. This will drop testosterone levels by more than 90 percent in 24 hours. Another way to block testosterone is with drugs. In a study published in the journal Clinical Genitourinary Cancer, researchers looked at the testosterone levels of men being treated for prostate cancer with an ADT drug after six months. Of 153 men, 25 were found to have a testosterone level less than 20 ng/dL.

At these lowest levels of testosterone, low T symptoms may include:

• Complete loss of libido
• Impotence
• Severe ED
• Tender and enlarged breasts
• Osteoporosis
• Depression
• Hot flashes
• Weight gain
• Severe fatigue
• Anemia
• High cholesterol

When to Talk With Your Doctor About Low T

If you’re an otherwise healthy adult man, you’re not likely to experience dangerously low testosterone. But you should talk with your doctor if you have ongoing symptoms of low T.

A review article in the BC Medical Journal suggests that your doctor might consider a blood test to diagnose low T if you have persistent symptoms that include:

• Mood changes such as irritability or sadness
• Loss of interest in sex
• Loss of morning erections or other erection problems
• Low energy and easy fatigue
• Loss of muscle strength or bulk

Very low testosterone is very unlikely and you probably do not need to worry about it. But if you have persistent symptoms of falling testosterone levels, talk with your doctor about low T. Diagnosing low T early may help prevent more serious low T symptoms later on.

Family Practice and Urgent Care

Much of what you associate with men, in terms of general appearance, is because of testosterone. During puberty, this hormone helps build muscle, deepens a man’s voice, and boosts the size of his sex organs. Throughout life, testosterone is the hormone that drives libido and keeps muscles and bones healthy. Testosterone levels are highest at the tail end of puberty (around 17), but typically remain at high levels until around age 30.

After 30, most men experience a gradual decline in testosterone. Many men notice that this correlates with a loss of sexual desire, which is totally normal. Sometimes, however, testosterone levels drop too low. This can reduce your bones’ strength and muscle mass, exacerbate sexual issues, and lead to a host of health issues. Low testosterone can be dangerous if not treated.

Do you think you have low testosterone? Put your health first with Woodstock Family Practice & Urgent Care and James Y. Lee, DO. Dr. Lee is a men’s health expert; he’ll work with the rest of our team to make sure you get the care you deserve to be the best man you can be.

Low testosterone basics

As stated above, the vast majority of men experience a slow decline in testosterone somewhere around 30. This is totally normal and is just a part of getting older. According to the Urology Care Foundation, about 2.1% of all men suffer from low testosterone levels. Though only 1% of men below 30 suffer from the condition, over 50% of men over 80 experience symptoms. With the Baby Boomer generation inching further into old age, odds are that more men than ever are dealing with low testosterone.

Low testosterone symptoms

Low testosterone can present with a variety of symptoms. Since testosterone is a key part of sex drive and energy, most men will experience sexual difficulty and fatigue. Overall symptoms include:

• Reduced sex drive
• Reduced erectile function
• Loss of body hair
• Less beard growth
• Loss of lean muscle mass
• Feeling extremely tired all the time (fatigue)
• Obesity (being overweight)
• Affected memory
• Symptoms of depression
• Fractures caused by decreased bone mass

If you’re experiencing any of the above, come see Dr. Lee. Even if you don’t have low testosterone, these symptoms could be caused by a different medical issue that needs attention.  

Low testosterone treatment

The most common treatment for low testosterone is testosterone replacement therapy (TRT). TRT is typically only prescribed if you present with two or more symptoms of low testosterone or have blood test results that indicate low levels. TRT therapy looks to replace the testosterone your body isn’t producing. There are multiple delivery options, including:

• Skin patches
• Gels
• Tablets that dissolve in the mouth
• Injections
• Surgically implanted pellets that release the hormone

 Most patients report positive results within four to six weeks. TRT is the most effective treatment method for low testosterone. However, you can help the medication by making lifestyle changes that can potentially increase testosterone levels. Diet and exercise have both been shown to boost testosterone levels, especially in younger men suffering from the condition. The impact made by diet and exercise becomes smaller as you age. Elderly patients typically see little to no improvement from lifestyle changes.

If you think you’re suffering from low testosterone, come see Dr. Lee and the rest of our team at Woodstock Family Practice & Urgent Care. We’ll make sure you get back to feeling your best. Call or book an appointment at our Woodstock office. 

14 signs and symptoms of low testosterone

With John P. Mulhall, MD, and Shalendar Bhasin, MD

While the number of men seeking testosterone treatment has tripled over the past decade, many patients who need hormone replacement for a testosterone deficiency are not receiving it. 1 When low T occurs because of poor functioning testes or a tumor on the pituitary gland, for example, the result may be hypogonadism.

Recognizing this trend has led to the publication of guidelines for the diagnosis and management of testosterone deficiency in men by the American Urological Association1  (AUA) and an updated best practice recommendation from the Endocrine Society.2

“The use of testosterone therapy has increased dramatically in relatively healthy men without a clear indication of testosterone deficiency (low T), while other men in need of testosterone therapy fail to receive it due to clinician concerns regarding cardiovascular events or the development of prostate cancer,” says John P. Mulhall, MD, director of the Male Sexual and Reproductive Medicine Program at Memorial Sloan Kettering Cancer Center in New York City, and lead author of the AUA guideline.

“One goal of the AUA guideline is to outline criteria to determine who has a bona fide testosterone deficiency, how to evaluate and determine who should be treated,” he tells EndocrineWeb.

Similarly, the Endocrine Society updated their best practices guidance for testosterone therapy in men with hypogonadism, a form of testosterone deficiency.

These clinical recommendations were prepared in response to a “much higher quality of evidence published in recent years about testosterone deficiency and a wider availability of high quality assays for measuring testosterone levels, which had been a problematic issue,” said Shalendar Bhasin, MD, professor of Medicine at Harvard Medical School, and director of Men’s Health, Research Program at Brigham and Women’s Hospital, in Boston Massachusetts, who led the work on the Endocrine Society project.

How Does Low Testosterone Differ from a Hormonal Deficiency?

Testosterone—a hormone produced primarily in testicles but also to a lesser extent by the ovaries and adrenal cortex—is essential for a variety of physical, cognitive, sexual, and metabolic functions in men. This sex hormone usually peaks in adolescence and early adulthood. As men age, the ability to produce testosterone begins to decline such that testosterone levels begin to drop about 1 to 3 percent a year beginning around age 40 years.

This natural decline, however, does not imply that a man is testosterone deficient or a candidate for testosterone therapy.^1,2 A deficiency in this hormone only occurs in cases where there is a low level of testosterone along with specific symptoms or signs.

“Testosterone deficiency is a very specific clinical condition that is defined by the presence of a set of specific signs and symptoms that occur as a result of decreased production of testosterone by the testes in men,” says Dr. Bhasin. “It’s extremely important that testosterone is used only as Food and Drug Administration-approved treatment for this condition.

“What’s been happening over the past couple of years is that there has been a rise in off-label use of testosterone to treat a variety of age-related conditions and symptoms that don’t qualify as a testosterone deficiency,” he says.

Diagnosing and Testing for Hypogonadism

Outside of age, there are “myriad causes for testosterone deficiency,” Dr. Mulhall adds. “They include testicular dysfunction, chemotherapy or radiation to testes, or loss of the testes,” he said. Then there are secondary testosterone deficiencies, genetic disorders, Kleinfelter syndrome, pituitary disorders, steroid use, opioid use, diabetes, and obesity.

While testosterone supplementation is being used to treat low hypoactive sexual desire, a type of sexual dysfunction, in women, “we don’t know if it’s a bona fide condition,” says Dr. Bhasin. It’s been plausible but remains only a hypothesis that hasn’t been proven definitively.

According to the recommendations issued by both the Endocrine Society and AUA,^1,2 before a diagnosis of testosterone deficiency can be made, patients must demonstrate both a low testosterone levels and show signs and/or symptoms of the condition.

Signs and Symptoms Signaling a Problem:^2,3

Red flag symptoms:

• Low sex drive
• Difficulty with erection
• Low sperm count
• Unexplained loss of hair
• Hot flashes
• Low bone density

Additional signs:

• Testicular atrophy (changes in testes)
• Diminished lean muscle mass
• Increased body fat
• Elevated hemoglobin A1c
• Osteopenia or low trauma bone fracture
• Problems sleeping (insomnia)
• Fatigue
• Difficulty concentrating, lack of motivation, depression

When and How Should a Low Testosterone be Treated?

“Testosterone replacement shouldn’t be used to treat a naturally occurring, age-related decline in this hormone or simply for a low T number,” says Dr. Bhasin, “but if a man has a testosterone deficiency or classical hypogonadism, the benefits of treating the condition with testosterone is favorable and outweighs any risks.”

According to Dr. Bhasin, over the last two to three years there has been greater availability of high quality lab providing good results for testosterone levels, which until recently has been a problematic when trying to make a firm diagnosis.

To confirm the existence of low testosterone requiring treatment, the patient should have two separate blood tests on nonconsecutive days in the early morning (testosterone levels fluctuate during the day and are highest in the early hours) that are analyzed by reliable laboratories certified by the Centers for Disease Control and Prevention, Dr. Bhasin told EndocrineWeb.

A normal range for testosterone levels is 300 ng/dL to 1,000 ng/dL, with the Endocrine Society considering low testosterone below 263 ng/dL, says Dr. Bhasin.

Your doctors should also determine if you (your spouse) shows signs or symptoms of a testosterone deficiency. One problem with the symptoms for testosterone deficiency is many are “incredibly nonspecific” Dr. Mulhall cautions, which is why getting accurate testosterone levels is vital.

 “If a man had a testosterone level less than 220 and shows signs of osteopenia, the testosterone is low because the patients has bone density loss,” says Dr. Mulhall, “but you can’t just go on the number alone.”

Monitoring, Managing, and Follow-Up Care

Both sets of guidelines stress the importance of monitoring T levels during treatment to make sure the hormone falls within a desired range and to check the status of other health conditions such as sex, heart and bone health.  

“While the number of men using testosterone has increased, it’s concerning that about 20 to 25 percent of men who go on testosterone never get their levels double checked before treatment, and a percentage of men who go on testosterone who don’t get their levels checked at all while they’re on the treatment,” says Dr. Mulhall.

There are a number of health reasons to monitor testosterone treatments. For example, low testosterone is a risk factor for cardiovascular events, but “giving a patient [supplemental] testosterone cannot be said to definitively raise or lower the risk for cardiovascular issues,” Dr. Mulhall says.

While testosterone replacement therapy does not cause prostate cancer, Dr. Bhasin notes that increasing testosterone could raise PSA levels, which may lead to an increased risk for prostate cancer, particularly in the 30% of men over 70 years of age who may have with an early stage prostate that has not yet become detectable.⁴  

“One important goal of monitoring testosterone levels is to minimize the risk of unnecessary biopsies,” he adds.

Know the Health Warnings of T Supplementation 

When it comes to treatment, there are a variety of forms of testosterone—from gels to adhesive pellets to injections—that can be administered to men.

However, you should be aware that patients who use transdermal gels to restore normal T levels should be careful to avoid any risk of transferring testosterone gels to women and children.⁴ Covering the shoulders or upper arms where the gel has been applied is sufficient to protect against accidental exposure of this hormone to others.

From a reproductive standpoint, both professional organization guidelines note that men who are trying to conceive should not receive testosterone treatments because it impairs sperm production.

“Even when testosterone replacement is stopped, there will be a period of time during which it will take sperm production a while to recover,” says Dr. Mulhall.

“There’s no magic to diagnosing or treating testosterone deficiency,” says Bhasin. “Like any other condition it’s really important to have accurate measurements and be rigorous in the diagnosis and a major concern has been starting treatments without an appropriate diagnosis.

“The result has been that half the people never refill their prescriptions and about three quarters of men given a testosterone prescription will not be using testosterone after the first year,” he said.  “It’s a bona fide condition that is under diagnosed and over treated.”

Last updated on 05/07/2018

Low Testosterone Treatments

90,000 Low testosterone levels in men – symptoms and consequences.

Testosterone is the most well-known sex hormone in society. It is present in both the male and female body. However, in men, its level is higher. It is testosterone that determines sexual development and male body constitution.

The functions of testosterone in the male body:

• Sexual attraction.
• Erectile function.
• Production of semen.
• Growth and maintenance of muscle mass.
• Maintaining the balance of muscle and fat mass.
• Maintaining normal bone density.
• Production of erythrocytes.
• Hair growth in “male” places.

The norm of testosterone in a man’s blood is 300–1000 ng / dl. With a hormone deficiency, all of the above functions are not performed in full, which leads to the onset of characteristic symptoms.

Sexual issues

One of the main signs of a drop in testosterone levels is a decrease in libido. It is characterized by:

• Erectile dysfunction. Testosterone activates special receptors in the brain, thanks to which nitric oxide is produced, which is involved in the reactions necessary for the flow of blood to the penis for subsequent erection. In addition to the lack of an erection before intercourse, unreasonable spontaneous erections are possible, for example, during sleep.
• Decrease in the amount of semen. The hormone affects its production.
• Decreased sex drive. With age, testosterone production in the body slows down, which leads to a natural decrease in sexual interest in the opposite sex. However, with a pathological hormone deficiency, attraction disappears at an atypical age for this phenomenon.

Attention! Erectile dysfunction is not usually associated with testosterone deficiency.If it is detected, you should undergo a full-fledged medical diagnosis in order to identify the true cause of the phenomenon. It could be a wide variety of diseases – depression, diabetes mellitus, alcoholism, hypertension, thyroid pathology, stress.

Fatigue

Another common symptom of low testosterone is extreme fatigue. Do you have the same rest as before, but feel weak and lack of motivation? Check your testosterone levels.

External changes

Low testosterone in a man is fraught with physical body transformations:

• Hair loss on the head, face and body.
• Decrease in muscle mass. Perhaps without losing muscle strength, since the hormone is not responsible for it.
• Increase in fat mass. An increase in the abdomen and breasts is often observed – the figure takes on feminine features due to an imbalance between testosterone and estrogen, which is responsible for female sexual characteristics.
• Thinning of bone mass – osteoporosis, thinning of bones, increased risk of fractures.

Sleep quality disorder

Low testosterone is often accompanied by insomnia. Poor quality sleep, in turn, further impairs the synthesis of the male hormone.

Mood swings

Testosterone affects the psychological, intellectual and emotional state of a person. With its deficiency, a man is more susceptible to depression, concentrates more heavily, is easily irritated.

Character changes

All of the above consequences of low testosterone cannot but affect the character and behavior of a man. An experiment conducted by the staff of the California Institute of Technology showed that hormone deficiency makes a man timid, shy, insecure, shy, lack of initiative and sluggishness. At the same time, he becomes irritable, aggressive, depressive, touchy. Those with chronic testosterone deficiency rarely become leaders in the team.

“Testosterone is a very insidious hormone”: an interview with an endocrinologist

We continue our series of meetings with prominent Russian doctors. Today – a detailed conversation about our endocrine system in general and the “beloved” male hormone testosterone in particular with the director of the Clinic of Endocrinology of the First Moscow State Medical University named after M.V. Sechenov Valery Fadeev.

We know that endocrinology is about hormones, we often hear “check the thyroid gland”.On the other hand, many people have a rather poor idea of ​​how the activity of the thyroid gland is connected with the daily functioning of the body, in particular the male.

The difference between the functioning of the female and male endocrine systems is very large, despite the fact that the set of hormones in men and women is the same. The difference is in the amount and in the nature of the secretion. A significant part of hormones in the female body is produced cyclically, and in the male – tonically, that is, continuously, without monthly cyclicality.The hypothalamic-pituitary system of a person adjusts the appearance of a certain amount of testosterone during fetal development, from the moment of fertilization to the birth of a child, for such a “male” production of hormones.

About testosterone, which is of great interest to our readers, I will ask you in particular detail. But let’s start, if possible, with the basics – with the functions of the thyroid gland.

Thyroid hormones are the oldest in origin, regulating the most basic functions of the cell.Moreover, each cell. More precisely, they regulate the processes of oxidation and oxygen consumption by the cell. Our body can be compared to a stove in which a fire burns. We put firewood there – what we eat. Oxygen is needed to keep the fire from going out. There is a damper in the stove, and with its help we can make the flame stronger – by opening it wider, or we can extinguish it – we will leave a small crack, and the light will smolder. The function of thyroid hormones is to control the damper, more precisely – the intensity of oxidation, combustion, as a result of which heat is generated – the energy that every cell needs.

How did we know that hormones exist in our bodies?

Before the concept of “hormone” appeared, it was about the so-called humoral factors. Back in the XIV century, the Chinese associated secondary sexual characteristics with them: doctors of that time say that “the external manifestation of the power of the male seed is the beard,” “the beard has to do with the kidneys and testicles.” In the middle of the 19th century, the German professor Berthold conducted experiments: the rooster was castrated, as a result of which a regression of the secondary sex characteristic – the comb – took place. After that, the cockerels were injected with the extract of the removed testes, and the comb was restored. These were the first experiments related to testosterone. The very concept of “hormone” appeared later, at the beginning of the 20th century, and since then its interpretation has undergone numerous transformations.

Endocrinology emerged as a hormone-only medical field?

Yes, classical endocrinology concerns seven anatomically distinguished endocrine glands: thyroid, parathyroid, pituitary gland, pancreas, adrenal cortex, testes and ovaries, pineal gland.These are endocrine glands that secrete hormones. Actually, the name “endocrinology” is translated as “the science of what is secreted inside” – it studies the chemicals released by these glands into the blood and regulating the functions of many cells.

Tell us about the interaction of the nervous and endocrine systems.

Comparing the nervous system to the endocrine system is like comparing a telephone and a radio. The nervous system is a telephone: nerve wires that run from the brain and transmit information to a specific point.The hormonal gland produces information that is carried through the blood to very many – like a radio that broadcasts from one point, but everyone can hear it. That is, the impulse of the endocrine system is a speakerphone. In the event of a malfunction in the nervous system, only that which is activated by this nerve – one muscle – stops working: as if you interrupt the telephone wire, only the telephone will not work. And if the radio station breaks down, no one will hear the message. That is, the pathology of the endocrine system is polysystemic – it is the pathology of many structures at once.An example is hormones of the same thyroid gland, which act on almost all cells in our body. Everything in our cell is energy-dependent – all enzyme systems, all their functioning, since every cell has ATP, adenosine triphosphate is our battery. And the intensity of energy production in it is regulated by thyroid hormones.

Should a young man, who is not worried about anything, once prophylactically visit an endocrinologist?

In general, preventive medicine is a rather controversial thing.The concept “the more you examine, the better” that exists in the middle class is fundamentally wrong. In the modern world, unnecessary examinations can do no less harm than their absence, also because their interpretation is very difficult. On ultrasound in the thyroid gland, structures of one millimeter are visible. And they can make more noise without leading to any consequences. Preventive endocrinology can be talked about primarily in connection with blood sugar levels. If we are talking about an overweight man, it is advisable to control sugar from the age of 20-25 – at least once every few years.This should also be done if the parents were sick with diabetes or had cardiovascular pathology.

Are endocrine system diseases inherited?

Inclination is inherited. These are the so-called multifactorial diseases – there is some predisposition that may or may not be realized. If a person has a tendency to diabetes, but does not gain excess weight, he may not get sick. That is, environmental factors, in particular food, can contribute to the implementation of a genetic factor.Thirty years ago, we called type 2 diabetes age-related, and today it even occurs in children. Unfortunately, we see diabetes in 25-year-old obese patients all the time. By the way, it’s important to say that there is an obvious link between obesity and decreased testicular function. With severe obesity, testosterone levels decrease. The fact is that adipose tissue is a place of exchange of sex hormones, with obesity in a man, the balance of estrogen and testosterone changes. This leads to suppression of the pituitary regulation of the testes and a decrease in testosterone production.

What do young men usually go to see an endocrinologist with?

In men aged 20-30 years, endocrine pathology occurs relatively infrequently – almost ten times less often than in women. But if a man at a young age develops, for example, Basedow’s disease, then it proceeds much more severely and with a worse prognosis. Why? It’s hard to say, there are no clearly proven explanations. But I repeat once again – at a young age, the pathology of the thyroid gland in men is rare.The greatest problem is the decrease in its functions, which occurs in men after 40 years. The symptoms of this disorder are very nonspecific: we can talk about, let’s say, incomprehensibly poor health – a general breakdown, lethargy, fatigue, decreased muscle tone, potency, libido, erectile dysfunction, that is, some kind of nonspecificity that could potentially be a background or a plume of any disease. In a hospital sample, as we call it, if a patient comes to the doctor and there is a set of these factors without an obvious concomitant disease, and even more so if it is present, it is better to check the function of the thyroid gland.

What methods are used for this today?

Blood is taken from a vein and one indicator is determined – TSH, thyroid-stimulating hormone of the pituitary gland. Its level allows you to more than accurately assess the functioning of the thyroid gland. Problems with this hormone are more common in women, but they are not uncommon for men either.

It turns out that from the point of view of the hormonal system, men are more protected by nature?

Yes, only they live on average twenty years less.In fact, a woman is protected by nature – and from the standpoint of the endocrine system too. It still bears the task of reproduction, while the biological significance of a man who has performed a copulative function is practically over.

If you remember the copulatory function, let’s talk about testosterone, which worries everyone so much.

Testosterone is a very interesting hormone, one might say insidious. The 21st century is in the yard, and there is still no understanding of how to accurately determine it – all methods have flaws.Measurement of hormone levels is carried out by immunometric methods, that is, using antibodies. Testosterone is a steroid hormone that is very small in structure; the size of the antibody is a certain number of times larger. That is, the testosterone figure is a very delicate matter. It must be able to interpret it depending on the situation, in combination with other hormones, with gonadotropins – hormones of the anterior pituitary gland. Therefore, the prevailing opinion that if you were given a huge amount of testosterone in the laboratory, then you are a superman, is wrong.In general, this is part of the myth that endocrinology is some kind of attachment to the hormonal laboratory: we sit here, send everyone to hormonal research, get numbers – and make a diagnosis. Absolute nonsense.

What is the main task of endocrinology?

It is a clinical discipline, just like, say, cardiology. And the interpretation of laboratory tests is often at the last stage of our reasoning. The cardiologist also has an echocardiogram: it can be in perfect order, but the person has a whole bunch of problems.The same can be said about hormones: if the diagnosis could be made numerically, I would not be needed here. You can put a laboratory assistant in order to diagnose and write out appointments right on the form of hormonal research results.

Let’s trace the life of testosterone in the context of the maturation of the male body.

Let’s. Let’s omit puberty and early development – there are very complex, I would even say, ornate processes of the relationship between the hormones of the adrenal cortex and the testicles, which is hardly interesting to your readers.By the age of 20, the indicators of testosterone production reach peak values, and from the age of 30, slowly, slowly, in different ways for everyone, but in general it is quite natural, they begin to decline. Testosterone is produced in the testes, but it is a deep misconception to consider it a hormone created by nature only for an erection. Erectile function can be perfectly normal even with low testosterone, but libido, desire, libido – call it what you will – is likely to be reduced. Testosterone is an anabolic of the male body, it does almost everything that distinguishes a man from a woman, it contributes to the development of not only the reproductive system, but also the muscular system, the brain, and even the production of red blood cells.Without him, a man turns into a eunuch – a thin voice, lack of body hair, flabby muscular system, obesity, tummy. But at the age of your readers, testosterone deficiency is rare. If we take one hundred percent of men aged 20-30 years with erectile dysfunction, then, probably, 90-95 percent – this is a psychogenic problem. After all, erectile function has a lot of components, first of all, the brain, the system is very complex. And most often it fails with all sorts of violations: children’s fears, complexes, neuroses, personality disorders, relationships between partners, that’s all.And the real deficiency of testosterone, rather, looks towards the age of “50 plus”. And that’s where there is a lot of speculation on this topic.

Pharma intrigues?

Partly yes. In part – the lobby of those involved in erectile dysfunction is inflating this topic. Both abroad and we have “specialists” who are ready to sew a testosterone deficiency on literally everyone, blaming practically all male diseases for this deficiency, including obesity. Almost diabetes is treated with testosterone.After all, what is a deficit? The figure is below normal. And this concept is very relative, especially for hormones. The case when the word “norm” must be put in large quotation marks. There is no norm, there is a reference, but this concept is statistical: they took, relatively speaking, one hundred healthy men aged 20-30, looked at testosterone, deduced the average, removed the Gauss dome and got two numbers.

At the same time, there are characteristics of the population, racial, regional, age …

Just about, age-related.And here you can speculate indefinitely. Shifted the reading frame and said: “You have a deficit …”

“… take a pill.”

Yes, take the pill. There are not many studies that have examined testosterone prescription to older men, firstly, and secondly, they are not as long. Some of them had positive results, some – negative in terms of cardiovascular risk.

So artificially raising testosterone levels carries a risk of heart problems?

I cannot answer unequivocally.But research results in this sense are contradictory. There is a figure that clearly shows a testosterone deficiency, then its appointment has positive consequences. But if we take, as we call it, the “gray” zone, when someone considers this value to be a deficit, and someone does not, here this appointment most often does not lead to any results. After all, hormones are part of a large integral system inside a person. Man, unfortunately, is mortal, and so far no one can do anything about it. A person is aging, and all his systems, including the endocrine system, are aging, integrally adjusting to a particular age.And if you start at the age of 60 artificially with the help of pills to arrange yourself 18, you cause a conflict of systems. It is not for nothing that the Old Testament says: “No one puts new wine into old wineskins; otherwise the new wine will burst the wineskins, and it will run out of its own accord, and the wineskins will be lost. ” You see, a hormone is a systemically acting active element. If you injected testosterone into the systemic circulation, it had an effect not only on your penis: it had an effect on the brain, heart, blood vessels, liver – everything! This means that the consequences can also be systemic.

And unpredictable?

Well, if someone wants to experiment and is ready, as in “Egyptian Nights”, to get some kind of stroke for one sexual intercourse – this is his choice. But in any case, you should not do this at the age of 20-30. If at this age there are sexual problems – do not immediately sin on low testosterone. Yes, this happens, but extremely rarely, and then it is a serious violation. But often in such a situation, they grab onto marginal results, when the appointment of testosterone is just a convenient way out for the doctor.

Why is such an appointment dangerous?

There is an aspect in which the male body is more gentle than the female – I’m talking about the production of sperm. External administration of testosterone suppresses it. In general, if a person gets at least a severe runny nose with a fever, spermatogenesis will be suppressed for some time. Nature arranged it this way: a sick male should not fertilize females. You don’t even need a runny nose: let’s say a man is wrapped up at work, gets nervous, doesn’t get enough sleep at night – in this situation he will have low testosterone simply due to a general breakdown.Even at a young age. We experimented in our clinic: testosterone was monitored in patients with diabetes mellitus during hospitalization, and then – two weeks after it lay with us. First, the man slept well. Secondly, we have put in order some general indicators. And after two weeks his testosterone is already normal! A single definition of testosterone cannot be trusted at all. And when they begin to assess the spermogram in a man who is sick with some kind of chronic disease, uncompensated, this is also absurd.The first step is to cure him. Bring it to a normal state, and then evaluate the work of the reproductive system. Either he’s on a binge …

Here’s another interesting topic – alcohol and male hormonal levels. Does whiskey actually lower blood sugar?

Any ethanol, any ethyl alcohol potentially blocks the production of glucose by the liver, and can actually lower the sugar level for a while. But I don’t recommend treating diabetes with alcohol – it doesn’t matter if it’s whiskey, vodka or tequila.

But what about the cherished 40 milligrams a day, which are allowed even by cardiologists?

40 milligrams is possible – of course, provided that the person is ready to stop there. Alcohol is a universal tranquilizer, and in the modern world it also plays a positive role, helping a person in a state of chronic stress to relieve this stress. Chronic stress, by the way, also affects sexual function badly. So no one is against small amounts of alcohol to relieve stress.But in large ones – it only does harm, disrupts erection and ejaculation. You are asking about the connection with thyroid function – alcohol does not directly affect it. And on sexual function – only negatively.

Are you talking about fertility?

Exactly. In chronic alcoholics, the work of the testicle is fundamentally disrupted. Against the background of intoxication, testosterone production decreases and spermatogenesis is impaired, this has been proven. And if we are talking about fertility, today there are practically no drugs that affect spermatogenesis.This is such a delicate and complex process that we have not yet learned how to intervene in it. A woman can be stimulated to ovulate in order to get an egg, but if a man’s spermatogenic epithelium is affected, there is no treatment.

What exactly negatively affects the function of this epithelium?

The epithelium produces sperm. And many factors influence this process, including your own testosterone. The cells that produce it in the testicle are close to each other and influence each other: Sertoli cells, Leydig cells, which form the spermatogenic epithelium, are linked in local regulation.Plus, the production of testosterone and the production of sperm in the testicle is influenced by pituitary hormones. So this epithelium is quite sensitive to toxic influences.

Anyone, not just alcohol?

Of course. Here’s a simple example: let’s say, God forbid, if we are talking about malignant tumors for which chemotherapy is prescribed, practically the first thing that suffers is the spermatogenic epithelium. Because dividing cells are killed.So, sperm cryopreservation is recommended for young patients before prescribing anticancer chemotherapy.

Let’s continue our endocrinological educational program. What is important to know about the work of the pituitary gland and hypothalamus?

We are talking, rather, about the work of the hypothalamic-pituitary system. The nuclei of the hypothalamus are the nuclei of the nervous system that produce humoral factors. These are, as a rule, very small molecules consisting of several amino acids, which enter the pituitary gland through very short vessels and stimulate the production of pituitary hormones there.The pituitary gland is such a conductor, a key regulatory structure of many elements of the endocrine system. This means that sexual function, the work of the thyroid gland, adrenal glands, the production of prolactin, the production of growth hormone and a number of other factors depend on it.

Including metabolism?

You know, endocrinologists fall into a stupor a little when they hear the expression “metabolic disorder” or, say, “hormonal background”. Human life is metabolism, and everything is involved in it, including eyes, teeth, hair, ears and nails.

Let’s not fall into a stupor, let’s return to the hypothalamus.

The hypothalamus carries out the relationship between the nervous and endocrine systems. These systems are interconnected, they function together. But, returning to the beginning of a conversation, the nervous systems are fast regulation, like a phone call: an impulse came, and the muscles instantly contracted. The humoral system, which includes the production of hormones, is a slower basal regulation that carries out fundamental life processes.Here we must remember the evolution, the development of the animal world: it all started not with nerves, but with the fact that there was some kind of plasma in which certain substances circulated.

I feel here echoes of an old interdisciplinary controversy …

No no. The nervous system is, of course, also important. We just talked a lot today, for example, about fertility, about sexual function. This is not a simple muscle contraction, this is a complex process extended over time, which is regulated precisely by the relationship of hormones.The nerve cannot extend from the brain to the testicle and contribute to the production of sperm, you know? That would be too cool. And the hypothalamus is just responsible for the integrative interaction of neural influences.

How does the male endocrine system respond to physical activity and the fuel that artificially feeds these loads? I’m talking about sports nutrition.

If you are already over 30, then, probably, you go to the gym for health, and not in order to turn yourself into a closet of muscles and seduce girls.At the age of 18, you can, of course, think that a woman needs your muscle mass, but in principle this is absolute stupidity and in 99% of cases it will not work. If you set yourself the task of seducing as many women as possible, you need to spend more effort on developing your brain. And in the gym – think about blood vessels, muscles and some kind of harmony. Now to the question of sports nutrition and energy. I have a very negative attitude towards them. I don’t want to scare anyone, but I had to witness lethal myocardial dystrophy while taking a large number of energy drinks.As for hormones and, in particular, the same testosterone, unfortunately, I am afraid that you and I will not be able to break the stereotypes that have developed in these gyms. We cannot explain that self-indulgence with testosterone will lead to the fact that by the time such a guy meets his only one, he will have nothing left of the spermatogenic epithelium. I myself visit a fitness club and often witness young people’s conversations on, let’s say, medical topics. What I hear is not just wild – I don’t even have enough words to describe it: “Now I am on androgens, then I dry myself, then I add triiodothyronine …” very high intellectual bar.

What – what does he add?

Triiodothyronine is a thyroid hormone. And then, with the air of an absolute expert, but with mistakes in basic concepts, such a person begins to give recommendations to another person. In this case, we are talking about very serious hormonal drugs … A real freak show, and with a risk to health. As for the consumption of a large amount of proteins, this is primarily non-physiological, it is a large burden on the kidneys.I have a lot of patients from former serious athletes and those who served in the special forces. With their physical exertion, taking some drugs and special food is not fun, not a way to seduce a girl, but part of the hardest work with hyperloads. So, as a rule, these people have a whole bunch of endocrine and cardiovascular diseases. With age, many of them acquire obesity, hypertension, and diabetes mellitus.

Please tell us about anti-aging endocrinology, about age-related hormone therapy that is fashionable nowadays.

Due to the development of the anti-aging industry in recent years, most professional endocrinological associations were forced to publish regulatory documents on hormone therapy: clinical guidelines for the treatment of hypothyroidism, hypogonadism, growth hormone deficiency. Our professional position is unambiguous: hormone therapy is indicated only and exclusively in a situation of hormone deficiency. But there is a powerful anti-aging lobby, non-professional paramedical and other marginal associations.I attended their conferences: from the point of view of professional clinical endocrinologists, what happens there sometimes looks wild. Pampering in our sphere, as, indeed, in any, ends badly. Growth hormone, for example, which people indulge in for rejuvenation, is a growth factor, cells multiply from it, which means that we can easily grow a tumor for ourselves. The danger is that the anti-aging industry is in an uncontrolled field: they don’t need statistics, they don’t need prospective research, they live outside of medical ideology.

That is, starting to rejuvenate with hormone therapy is, in general, a serious risk.

You need to rejuvenate when you are young. Our regulatory system is structured too complexly so that by introducing one or another element into it, it would be possible to start some processes in the opposite direction. Today we have listed the classic hormones, and in addition to them there are two hundred more, and all of them are involved in the work of the body. “Hormone”, by the way, does not come from the word “harmony”, as many think, but from the word hormao – “put into action.”And all these actions should be, let’s say, proportional to each other. I repeat: the hormone acts on a lot of structures at once, it enters the systemic circulation and reaches all cells. We have identified one of its functions, but there are a dozen more that we do not know about. For example, a nerve has one function – the innervation of muscles, and a hormone is something more complex. From time to time, one of its effects pops up, and it begins: “This is the hormone of this and that.” Almost every hormone at one time was called the hormone of youth.There are episodes of their popularity: either testosterone is popular here, or prolactin, or thyroxine. Then suddenly dehydroepiandrosterone is declared the hormone of youth – it is an adrenal androgen: at one time in the USA it could be bought at any pharmacy without any prescription.

What should a young man do in general to preserve his endocrine system?

To begin with, surprisingly enough, remember a simple thing: salt must be with iodine.When your wife or girlfriend goes to the store, ask her not to spend money on various Japanese and Himalayan frills, but to buy our domestic salt, where “iodized” is written on the pack. Its effectiveness is absolutely proven – it solves the problem of iodine deficiency, prevents the development of goiter and brings many more benefits. This is even more important for women, but men also need to make sure that enough iodine is supplied to the body. This is about the thyroid gland. As for diabetes mellitus, it is clear that the disease is associated with a hereditary predisposition, but we must remember about its direct connection with excess weight: the stomach not only interferes with tying shoelaces, but also affects our general condition and cardiovascular system.Next is the sexual function. A man is given a spermatogenic epithelium, one for life, and must be protected. The quality of sperm at 20 and at 60 is very different: it reflects everything that befalls us – from the head and nerves to the environment, not to mention any intoxications, especially chronic ones. So, as you can see, I cannot recommend anything that goes beyond the concept of a healthy lifestyle, although this term smacks of something archaic. You need physical activity, and it is highly desirable – without the use of various stimulants.When you are twenty, it seems that you can cram any nasty stuff into yourself. But a dozen or two years pass, and we understand that life is not endless. And just then the results of all our youthful experiments fall on us … Do you humble servant, do you know how much he studied until he began to inject something into the patient’s body? To prescribe the hormone, I graduated from six years of university, two years of residency, graduate school, defended several dissertations, and believe me, I still check, double-check and weigh everything. I never prescribe hormones during the first visit of a patient, I suggest that they be examined in dynamics and only then do I make a decision.And when boys start to play with hormones in fitness clubs, it’s wildness. In my opinion, a certain deficiency is manifested here, male complexes that are trying to compensate by pumping muscles. So in that sense, I would recommend starting to think about what’s going on with your head, and not with testosterone.

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MensHealth

Testosterone deficiency – diagnosis and treatment

Testosterone is the main male hormone (androgen), which, from a young age, affects the appearance, sexual activity and well-being of the stronger sex.The substance is produced by the testes, or rather Leydig cells. Deficiency of testosterone in a man’s body can lead to serious complications, so the problem must be addressed in a timely manner.

MedEx Personal Medicine Clinic invites you to undergo examination and determine hormonal status. We will identify the causes of testosterone deficiency, prescribe treatment, and tell you about relapse prevention. Reception is carried out by experienced therapists and urologists.

Functions of testosterone in the body

The word “testosterone” refers to a whole group of steroid hormones of various forms, which are powerful anabolic steroids.Substances stimulate the synthesis of a huge amount of proteins in the cells of the human body. Testosterone activates the processes of regeneration, tissue growth, penetrates the nuclei and triggers more than 146 genes. It is safe to say that the group of steroid hormones affects not only men’s health, but also the state of the whole organism as a whole.

Causes of testosterone deficiency

The overwhelming majority of clinical cases are age-related changes. Androgen deficiency is observed in men after 30 years, when the production of active substances slows down by about 1% annually.At the age of over 40, the level of hormone synthesis falls by 1.5% per year, which is associated with a decrease in reproductive function.

Other possible causes of testosterone deficiency:

• surgical removal of testicles for medical reasons;
• bad habits: smoking, alcohol, psychotropic substances;
• sedentary lifestyle, sedentary work;
• unfavorable ecological situation in the area of ​​residence;
• work with hazardous and harmful production factors, toxic substances;
• hypertension, cardiovascular diseases;
• taking medications (opioids, corticosteroids, ketoconazole, hormones) without medical prescription;
• high levels of bilirubin, which destroys testosterone;
• renal failure;
• endocrine diseases, pathologies associated with a shift in hormonal levels;
• obesity, diabetes mellitus;
• postponed inflammatory diseases, infections;
• increased blood lipoprotein levels;
• genetic pathologies, for example, Down syndrome, Kalman, Klinefelter.

In addition to physical factors, psychological reasons can also provoke a lack of testosterone. If a man is constantly experiencing stress, depression, adrenaline is actively entering his bloodstream. This hormone is capable of blocking testosterone even when the androgen is produced in sufficient quantities.

Symptoms of a lack of testosterone in men

Signs of hormone deficiency depend on the cause. If the synthesis of testosterone slows down due to genetic abnormalities, then the man shows pronounced external symptoms of deficiency:

• formation of female genitals, accumulation of adipose tissue in the waist area;
• underdevelopment of the penis and testicles;
• true or false hermaphroditism (the patient has both female and male external genitals).

The characteristic signs of hormone deficiency in adolescence are a slowdown in the growth of the genitals, a slender physique. The boy’s figure develops according to the female type. His hips become wide, his legs are full, there are no secondary male sexual characteristics. One of the symptoms of testosterone deficiency is the absence of voice withdrawal.

Violation of the hormonal background is reflected in the character of an adult man. Behavioral traits become a symptom of testosterone deficiency:

• increased emotionality, sentimentality, mood swings;
• sleep disorders;
• depression, tearfulness, moodiness, suicidal mood;
• scattered attention, inability to concentrate on one thing.

To the symptoms of a lack of testosterone in a man in adulthood, there is a lack of muscle growth, hair loss on the chest, head, arms and legs, enlargement of the mammary glands (gynecomastia), increased sweating, metabolic disorders. On the part of the heart, a low level of hormones is manifested by arrhythmia, tachycardia, hot flushes, cardialgia.

As the deficiency progresses, the patient begins to experience difficulties in intimate life.A symptom of a lack of testosterone in a man may be a decrease in potency, impotence, premature ejaculation, infertility.

Diagnosis of pathologies

As soon as the first signs of testosterone deficiency appear, a man needs to undergo a comprehensive examination. Deficiency diagnosis begins with laboratory blood tests to determine the concentration of hormone forms in nmol / ml.

The biomaterial is examined by the enzyme immunoassay. A substance based on an enzyme is added to the blood, which stains testosterone in a bright color.According to the intensity of the shade, the level of various forms of androgen in the blood is calculated. The method of enzyme immunoassay is accurate, fast, and false results are excluded.

Three types of testosterone are determined in the blood:

1. Free – the active form of the hormone responsible for the manifestation of male sexual characteristics. In the total volume of androgens, the share of such testosterone is no more than 2%.

2. Bound – a form combined with globulin (SHBG) and albumin.

3. Total – the total value of free and bound hormone.

If, in the presence of obvious signs of testosterone deficiency, the analysis shows the norm, the man is prescribed additional blood tests:

1. Determination of the level of globulin. This protein binds, blocks androgens. The higher the amount of globulin, the lower the testosterone concentration in a man. Androgen deficiency in the analysis develops in endocrine diseases, diabetes mellitus, severe liver dysfunction.

2. Determination of LH and FSH – gonadotropic hormones. Substances are synthesized by the pituitary gland and affect the production of androgens in the male body.When the level of testosterone decreases and at the same time there is a decrease in the concentration of LH and FSH according to the results of the analysis, the cause of the deficiency must be sought in the work of the pituitary gland or hypothalamus. Proper treatment will help restore the balance of male hormones.

3. Determination of the content of dihydrotestosterone. The active substance is one of the forms of free testosterone. A decrease in the concentration of dihydrotestosterone indicates a deficiency of 5-alpha reductase. The cause of the disease should be sought in metabolic processes.If the normal level of 5-alpha reductase is restored, then androgens will begin to be produced in sufficient quantities.

4. Determination of the amount of estradiol. This hormone is a male testosterone antagonist. The more estradiol in the blood, the more pronounced the androgen deficiency will be.

Hypogonadism is diagnosed in men if hormonal imbalance is accompanied by characteristic signs of testosterone deficiency. The doctor’s task is to determine the cause of this condition.This can be a violation of the functionality of the nervous system or diseases of the reproductive organs. To select an effective treatment for testosterone deficiency, an ultrasound of the pelvic organs, prostate gland, CT or X-ray if indicated, other laboratory and instrumental methods for diagnosing the causes of hypogonadism may be required.

Testosterone deficiency treatment

Low androgen levels affect a man’s quality of life. Therefore, treatment of testosterone deficiency should be started as early as possible.Hormonal imbalance can lead to complications such as diabetes mellitus, heart and vascular disease. In the absence of treatment, testosterone deficiency leads to a whole chain of metabolic disorders. Over time, surges in blood pressure increase, up to a stroke. Without treatment, pathologies of the musculoskeletal system develop: a man’s muscles weaken, bone density decreases. Patients complain of pain in the joints and limbs. Lack of hormones disrupts the trophism of tissues and cells.The patient’s skin dries up, the hair becomes brittle, and early wrinkles appear on the face.

Interesting fact: low testosterone levels are usually treated with non-hormonal agents. For many men, it is enough to follow a sleep regimen, walk more, lead a healthy lifestyle, and adhere to proper nutrition. Gradually, the level of hormones returns to normal without medication, sexual activity is restored. Regular sexual activity helps to increase testosterone levels.Intimacy must be with a regular partner.

Drug treatment for testosterone deficiency includes the following drugs:

1. Hormonal agents. To increase the level of androgen, a man is treated with pills or injections in a strictly calculated dose. The drugs have many side effects, so their use requires regular medical supervision.

2. Transdermal patches. The drugs also contain hormones, but at a lower dose. The patch is applied to the inner thigh or scrotum and worn for several hours a day.Transdermal drugs have fewer side effects than pills, but local irritation is noted in some cases.

For the prevention of testosterone decline, men are advised to lead a healthy lifestyle. Refusal from bad habits and promiscuous sex will help maintain strength and attractiveness for the opposite sex for a long time.

Diagnostics and treatment of testosterone deficiency in Moscow

MedEx Personal Medicine Clinic invites you to an appointment at a convenient time.If you want to establish and eliminate the causes of testosterone deficiency, sign up for a consultation with our doctors. The phone number is listed on the website.

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What are the symptoms of low testosterone in men in their 30s?

The peak of testosterone production in a man’s body occurs between the ages of 25 and 30.Then the amount of the hormone begins to gradually decrease – by 1-2% every year. But testosterone levels can decrease for more than natural reasons. Its content is influenced by stress, lack of calories and overeating, medication, overtraining, as well as illness, lack of sleep and alcohol. To maintain your testosterone levels even after 30, 40, 50, you can always sign up for Testosterone Max and improve your quality of life.

The effect of the use of symptoms of low testosterone in men in 30

Testosterone is the main hormone of the male body.It is responsible for physical strength, sexual health, musculoskeletal health and emotions. How to increase testosterone in men is of interest to every second representative of the stronger sex. This is not surprising – after 35-40 years (and sometimes even earlier), the androgen level begins to decline, which primarily affects health and sexual function (libido, erection, fertility). There are simple and safe methods for raising the hormone that every man can use. It’s easy to find them out – sign up for the Testosterone Max course and learn how to manage your male health.

Expert opinion

The power of testosterone is almost legendary, and this is not surprising: it promotes muscle growth and fat burning, as well as a whole host of other benefits, including improving mood, sleep, libido, energy and overall health. Unfortunately, after age 30, most men begin to experience a gradual decrease in testosterone levels in the body, which puts them at greater risk of heart disease, type 2 diabetes, obesity, low bone mineral density, impaired sexual function, decreased muscle mass and physical performance.It is possible to change life and increase testosterone levels at any age – Testosterone Max will help you with this.

How to order

In order to place an order for symptoms of low testosterone in men over 30, you must leave your contact information on the site. The operator will contact you within 15 minutes. Will clarify all the details with you and we will send your order. In 3-10 days you will receive the parcel and pay for it upon receipt.

Customer Reviews:

Nika

A decrease in testosterone concentration is fraught with a deterioration in sexual function, mental activity, metabolism, loss of muscle mass, strength, as well as a depressed emotional state.You can increase testosterone levels with a balanced diet, taking vitamin-mineral complexes and other methods. Vitamins for increasing testosterone are found in foods, both plant and animal origin. It’s not for nothing that many men love meat and other protein foods, along with which vitamins that increase testosterone enter the body. Interesting? After completing the Testosterone Max course, you can not only take control of your testosterone, but also learn to be the master of your life.

Fyokla Pavlovna

For the last couple of months I felt constant fatigue, came home from work and immediately fell on the sofa. There was no strength left for anything, sex began once every 2 weeks, if not less often. Passed tests, it turned out that my testosterone dropped. Androgen injections did not want to do, they are still harmful. I started looking on the Internet how to increase the male hormone in a natural way and came across a Testosterone Max subscription, went through a little training. Libido returned, potency is all right.I don’t know what the hormone level is, but I feel good

What does testosterone affect in our body? Improving the ability to build muscle mass. Better burning of subcutaneous fat. Stronger erection, libido and sexual activity. Increased desire for success, domination and power. Boosts mood and motivation. Stronger bones and a healthier heart. Do you want to be healthy and happy? Come to the Testosterone Max course. Where to Buy Low Testosterone Symptoms in Men in 30s? The power of testosterone is almost legendary, and this is not surprising: it promotes muscle growth and fat burning, as well as a whole bunch of other benefits, including improving mood, sleep, libido, energy and overall health.Unfortunately, after age 30, most men begin to experience a gradual decrease in testosterone levels in the body, which puts them at greater risk of heart disease, type 2 diabetes, obesity, low bone mineral density, impaired sexual function, decreased muscle mass and physical performance. It is possible to change life and increase testosterone levels at any age – Testosterone Max will help you with this.

Diagnosis and Treatment of Testosterone Deficiency (Hypogonadism) in Men, Public Organization…. Hypogonadism in men, defined as a decrease in serum testosterone levels in combination with characteristic symptoms and / or signs (described in detail below), can be observed with pathological changes in the testes and / or pituitary gland, such as Klinefelter’s syndrome, Kalman’s syndrome, as well as in men with idiopathic, metabolic or iatrogenic disorders leading to androgen deficiency. Low testosterone levels in men. Testosterone is popularly known as the main superior of male qualities.Physical strength, muscle strength, degree of hair growth, voice data will depend on how high its level in the blood is. The work of many organs is also associated with the content of this hormone and its activity. … Testosterone is one of the most important hormones for men. It is he who determines such masculine traits as voice, appearance and even some behavioral features. However, there is no need to wonder how to increase testosterone in men if the goal is to become more masculine and attractive to women, or to improve personal life.The steroid hormone testosterone in men is produced in the testes. It is he who makes men out of men. Has a biological effect on almost all organs and tissues. At 10-12 years of age (puberty), increased testosterone production begins, which leads to: rapid muscle and bone growth (anabolic effect). … From the age of 30, testosterone levels decrease by about 1-2% per year. The prevalence of hypogonadism (decrease in testosterone) in men is 6%, and in obesity and diabetes mellitus – more than 50%…. In this case, the reason for the low level of testosterone in its low production in the testicles. Lifetime hormone replacement therapy with testosterone is prescribed. The questionnaire of symptoms and cumulative assessment of age-related androgen deficiency (low testosterone levels in the blood) in men (AMS). Fill out the questionnaire. Test for the diagnosis of testosterone deficiency ADAM (Androgen Deficiency in Aging Males questionnaire). … Please remember that normal testosterone levels for men over the age of 50 should ideally be above 12 nmol / L.In laboratories for this age, a minimum rate of 6.7 nmol / l is indicated, since everyone is accustomed to believing that men over 50 should not have a lot of testosterone. Low testosterone levels in men. Testosterone deficiency in men is the cause of sexual dysfunction, decreased libido and difficulty in sperm production. Low testosterone levels also increase your risk of experiencing symptoms similar to women’s menopause. Men experience hot flashes, fatigue, irritability. The risk of developing osteoporosis increases.Treatment for low testosterone levels consists of administering this hormone in the form of patches or gel. What is the role of testosterone in men? The content of the article. What is the role of testosterone in men? Low testosterone levels are symptoms. How is low testosterone levels diagnosed? Low testosterone is a cure. Symptoms of hormonal imbalance. A decrease in testosterone production in men is accompanied by a number of unpleasant symptoms. The main ones are. Cardiovascular pathology. It occurs in men on average 3-5 times more often than in women.The relationship between arterial hypertension and low testosterone levels has been proven. Atherosclerosis. Is a provocateur of strokes and heart attacks. Metabolic syndrome. Decreased testosterone levels contribute to weight gain and obesity. Erectile disfunction. The combined effect is exerted by a violation of the hormonal background, and extra pounds. Osteoporosis. Testosterone and age. Top 8 symptoms of a dangerous drop in testosterone: changes in libido, erection, sperm quality, fat, etc. … For a man in his prime (40 years old), the difference between morning and evening indicators can reach 200 units.Normally, testosterone levels range from 300 to 1000 ng / dL. If this indicator is less, they speak of a low testosterone level. … Low testosterone levels lead to decreased bone density. As in women, sex hormones in men play an important role in the balance of bone formation and destruction. Testosterone deficiency, especially in older men, makes their bones fragile and increases the likelihood of fractures. Decrease in the size of the testicles. Broad shoulders and a deep voice, a beard and well-developed muscles … These, as well as a number of other masculine traits, are provided by the substance we know as testosterone.We are talking about him with the endocrinologist Clinic Expert Tula Makarova Oksana Viktorovna. Why androgen deficiency occurs in men: in adolescence and adulthood. How to know if you have a testosterone deficiency. Methods for the treatment of androgen deficiency. … If its amount is below 8 nmol / L and the man does not have thyroid disease or hyperprolactinemia, androgen deficiency is diagnosed. When diagnosing age-related androgenic deficiency, there are borderline values ​​of 8-12 nmol / l. in this case, it is additionally necessary to determine the amount of free testosterone…. If you have any symptoms of a lack of testosterone, you need to see a urologist or andrologist.

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Testosterone is the main hormone in the male body. It is responsible for physical strength, sexual health, musculoskeletal health and emotions. How to increase testosterone in men is of interest to every second representative of the stronger sex. This is not surprising – after 35-40 years (and sometimes even earlier), the androgen level begins to decline, which primarily affects health and sexual function (libido, erection, fertility).There are simple and safe methods for raising the hormone that every man can use. It’s easy to find them out – sign up for the Testosterone Max course and learn how to manage your male health.

symptoms of low testosterone in men in their 30s

The peak of testosterone production in a man’s body occurs between the ages of 25 and 30. Then the amount of the hormone begins to gradually decrease – by 1-2% every year. But testosterone levels can decrease for more than natural reasons.Its content is influenced by stress, lack of calories and overeating, medication, overtraining, as well as illness, lack of sleep and alcohol. To maintain your testosterone levels even after 30, 40, 50, you can always sign up for Testosterone Max and improve your quality of life.

How to increase testosterone in the body: natural ways and drugs. July 9, 2021. The peak of testosterone production in a man’s body occurs between the ages of 25 and 30. Then the amount of the hormone begins to gradually decrease – by 1-2% every year.But testosterone levels can decrease for more than natural reasons. … One of the first and most effective ways to increase testosterone levels is through strength training to increase muscle mass. The main condition for such activities is the presence of a burden. Trainings are carried out with weights: barbells, dumbbells, kettlebells, on simulators. Exercises such as squats, bench presses, and deadlifts are helpful. Testosterone – a guide to medicines. Method of administration and dosage. Characteristics, pharmacology, indications and contraindications.The largest information portal about medicine in Russia ZdorovyeInfo. … Trade names. Andriol TC, Androgel, Nebido, Testosterone propionate injection in oil. Composition and form of release. Synthetic drug. The active ingredient is testosterone. They release 1) capsules (in 1 capsule – 40 mg of active ingredient) – in vials of 60 pcs .; 2) 1% gel in laminated sachets of 2.5 g and 5 g; 3) solution for intramuscular administration (oil) 10 mg / ml – in ampoules of 1 ml; 4) solution for intramuscular administration of 250 mg / ml – in ampoules of 4 ml.Drugs for increasing testosterone: TOP-10 of the best. For many, the male hormone testosterone is associated primarily with sexual activity. … Be aware that all testosterone-increasing drugs are divided into two types: some of them stimulate the production of their own hormone, others replace it with a synthetic analogue. In any case, the complex must be selected together with the doctor, after passing the appropriate blood test. … An overview of the 10 best testosterone boosting drugs. Let’s take a look at ten good drugs for increasing testosterone in men, namely: Testoboom; ZM8 + Types of hormonal preparations for men.Tablets and capsules are very easily absorbed by the body, but quickly excreted from it. … Patches are a wonderful and convenient way to boost your male hormone levels. One patch has a therapeutic effect for one day. With prolonged use, irritation may appear, it is necessary to change the place of use. Implants under the skin are inserted in the form of a cylinder into the abdominal region. This procedure is performed under local anesthesia. The drug gradually enters the body in the right amount and complements the lack of testosterone.The implant lasts approximately 4 to 6 months. The best effect was observed when testosterone was prescribed to men with type 2 diabetes mellitus in the absence of an effect from PDE-5. … Elevated gonadotropin levels indicate primary hypogonadism; low LH levels combined with decreased testosterone levels indicate secondary hypogonadism. … Replacement therapy with testosterone drugs can effectively eliminate the symptoms of age-related androgen deficiency, which, combined with the introduction of convenient forms of drug administration and a good safety profile, contributes to its increasingly widespread introduction into clinical practice.A selection of the best testosterone medications, testosterone boosters, based on review sites. Content. TOP 2 testosterone stimulants. 1 – Tribestan. 2 – Tribulus. TOP 3 best testosterone supplements from iHerb. 1 – Six Star, Elite Series. 2 – RSP Nutrition, Prime-T. 3 – Olympian Labs, DIM-100. TOP-7 artificial testosterone preparations. 1 – Androderm. 2 – Testosterone propionate. 3 – Sustanon-250. … Gels, patches can increase testosterone levels in a fairly short period of time.Most often, these types of substitution therapy are prescribed to older men at the initial stage of the disease. Injection solutions are a popular form of testosterone. About testosterone, which is of great interest to our readers, I will ask you in particular detail. But let’s start, if possible, with the basics – with the functions of the thyroid gland. Thyroid hormones are the oldest in origin, regulating the most basic functions of the cell. … In the middle of the 19th century, the German professor Berthold conducted experiments: the rooster was castrated, as a result of which a regression of the secondary sex characteristic – the comb – took place.After that, the cockerels were injected with the extract of the removed testes, and the comb was restored. These were the first experiments related to testosterone. Testosterone – what is it? Testosterone tests. How to increase testosterone. Diabetes. The causes of diabetes mellitus. … Doubtful! Quite the opposite: a good level of the male hormone in the blood maintains a high libido and stimulates sexual activity. A nature-programmed decrease in the level of androgens in the blood by 1-2% per year in all men, without exception, inevitably leads to a decrease in sexual desire and sexual activity.The drugs of the PDE-5 type inhibitor group (Viagra, Levitra, Zidena, Cialis) increase the level of the hormone. Doubtful! … Testosterone drugs cause prostate cancer. The most enduring myth that has migrated from the 20th century to the 21st century! These drugs are metabolized more slowly in the liver than natural testosterone, but their androgenic properties are low, they are prone to hepatotoxicity, can increase the level of low density lipoproteins and reduce the level of high density lipoproteins [10]. In addition, these tablets are taken 3-4 times a day, which is not always convenient to perform and does not allow predicting serum testosterone levels.The situation is similar with the drug TU (testosterone undecanoate), which, among other things, is absorbed through the lymphatic system, and therefore it is taken with fatty foods. Testosterone is a male sex hormone that plays an important role in fertility, sexual function, bone and muscle health. Testosterone levels decrease with age – from 1 to 2 percent per year, but diseases, lifestyle and other factors can affect the amount of this hormone in the body. … Ginger Ginger can increase testosterone levels and enhance male fertility.People have long used ginger for medicinal and culinary purposes. … While sun exposure is one of the best ways to get vitamin D, not everyone can spend enough time outdoors in sunny weather.

The male sex hormone testosterone is not as bad as its reputation | Culture and Lifestyle in Germany and Europe | DW

The hormone testosterone is the main male sex hormone. In the body of men, its concentration is about ten times higher than that of women.It promotes, for example, the building of muscle mass, and also plays an important role in the production of sperm. In addition, the effect of testosterone on a person is manifested not only at a purely biological level, but also affects his social behavior.

An excess of testosterone, as it was believed until now, makes men aggressive, selfish and reckless, ready for rash acts. But new research is proving that conventional wisdom about this hormone isn’t entirely true.

More generous

“We have found that many stereotypes are not true,” Markus Heinrichs, a researcher at the University of Freiburg, said in an interview with the Süddeutsche Zeitung. “People with high testosterone levels are often more generous, fair and warning “. Together with his colleagues from the universities of Zurich and London, Markus Heinrich proved for the first time that the hormone testosterone promotes the manifestation of these positive qualities.

120 people took part in the experiment, the results of which were published in the famous scientific journal Nature. Scientists gave half of them 0.5 milligrams of testosterone, the other half received a placebo. The participants played a game in pairs, during which one of them received ten one-dollar bills and had to offer the second player a part of this money. The task was to make as fair an offer to the opponent as possible, and so that both were happy with it. If the offer was not accepted by the partner, both lost.

“If the conventional wisdom about testosterone were true, then the participants in the experiment who took the hormone would choose an aggressive, selfish and risky strategy of playing, regardless of the possible negative consequences,” says Markus Heinrichs. However, the result was completely different. Participants with higher testosterone levels offered their playmates, on average, about four dollars, while participants in the group that received a placebo instead of the hormone were willing to pay only 3.40 dollars.Such a result disproves the conventional wisdom that testosterone makes people selfish.

Aggressiveness is not the only path to leadership

Psychologists’ experiment showed another interesting thing. As it turned out, the most unfair proposals were made by those participants who were convinced that they were given an additional “shot” of testosterone – when in fact they were given a placebo. That is, the very belief in the negative action of the hormone made people behave more aggressively in social relationships.

Most researchers assume that excess testosterone contributes to higher self-esteem. It manifests itself in behavior aimed at securing a higher status in the social hierarchy. Simply put: whoever has a high content of testosterone in the blood wants to be a leader.

In many animal species, aggressiveness is the only way to climb the hierarchical ladder. And at the disposal of a person there are many other opportunities to achieve a higher social status.It is not necessarily the most aggressive individuals who enjoy special respect, but those who have qualities that are especially valued in a particular social environment. For example, generosity, personal integrity, a sense of justice. Sometimes in humans (as, by the way, in some species of monkeys), the one who has the most friends becomes the leader.

Hormone alone cannot explain behavior

There have been other studies that have shown that testosterone makes people more honest, generous, more cooperative, more collaborative.That is, perhaps the opposite is true, and an excess of testosterone turns men not into aggressive macho, but, speaking exaggeratedly, into “soft-bodied” subjects? This conclusion is too simplified and therefore incorrect. “The idea that a certain hormone causes only one, specific, kind of behavior is wrong in principle,” – emphasizes Markus Heinrichs.

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90,000 Are bald men really more masculine?

• Claudia Hammond
• BBC Fututre

18 breast 2015

Photo author, Thinkstock

There is a popular theory that the male hormone testosterone increases sex drive, but the payoff is thinning hair and balding. The truth is somewhat more complicated, scientists say.

Think of Bruce Willis, Andre Agassi or Michael Jordan – three men famous for their strength and courage who are adored by many women around the world. They have something else in common: all three are bald.

Men with bald spots are said to be more masculine. The popular theory explains this by the fact that they have higher levels of the male hormone testosterone, which makes them look more masculine and have more sex drive, but also lose hair earlier than other males.It turns out that in fact, everything is somewhat more complicated.

Baldness really depends on testosterone. Back in the 1960s, Yale University scientist Dr. James B. Hamilton observed 21 castrated boys. It is truly shocking, but this is the procedure used to treat boys with behavioral or mental disorders.

The scientist watched the fate of these patients for 18 years and found that they did not show a single sign of male pattern baldness, even in adulthood.Meanwhile, other men of the same age, who had not been subjected to the barbaric procedure and in whose body testosterone was produced, began to lose hair.

Author of the photo, Getty

Signs to the photo,

Some men undeniably adorn the bald head

Dr. Hamilton was far from the first to discover the connection between testosterone and baldness: many centuries earlier, the ancient Greek thinkers Hippocrates and Aristotle noted the same.

Dr. Hamilton’s discovery was that high testosterone levels can lead to baldness, but in fact, the amount of male hormone does not matter.Castrated men, in whose body testosterone is not produced, hardly lose hair, while men with any testosterone level, even low enough, can go bald.

This is because hair loss is not influenced by the amount of testosterone circulating in the blood, but by hereditary factors. Several genes are believed to influence the process by which hair follicles become especially sensitive to small amounts of testosterone.

This process is still not fully understood by scientists, but it is known that it involves an enzyme that converts testosterone into dihydrotestosterone.In some people, this substance causes the hair follicle to shrink, possibly because it prevents blood and nutrients from reaching it.

Author of the photo, Thinkstock

Pidpis to photo,

Some men are sensitive to the action of the enzyme dihydrotestosterone, which shortens the hair growth cycle

The follicle gradually degrades, which reduces the hair growth cycle. Thus, the hair becomes thinner and thinner, until only a thin, barely noticeable fluff remains on the head.Eventually, the follicle hibernates and no longer produces hair.

The process usually begins on the top of the head and then moves downward, following the pattern of male pattern baldness. The follicles on the head of bald men are genetically more sensitive to DHT, but this hormone does not destroy the follicles on the chin, so the beard continues to grow.

With the development of theories about the effect of testosterone, treatments for baldness began to be developed. In the 1960s, it was strangely decided to treat hair loss by adding testosterone directly to the scalp.At first, the researchers developed an ointment, but it was so heavy and oily that men refused to use it. Then the scientists replaced it with a cream.

However, most of the men stopped participating in the tests anyway before the completion of the 10-month study. The cream did not restore hair growth, and although half of the participants in the experiment believed that hair loss was reduced, the tests did not confirm this.

Since men who are not prone to baldness have low levels of DHT, researchers began to look for ways to block its action in people sensitive to it.Treatment is possible with Finasteride, but it is expensive and must be used constantly, otherwise the hair will fall out again.

Photo author, Thinkstock

Pidpis to photo,

More recently, scientists have discovered that hair follicle stem cells are preserved on bald areas of the scalp. This gives hope

Meanwhile, scientists continue to study the mechanism of hair loss. In 2010, they did an analysis of the scalp with and without hair, and found that stem cells are present in the follicles in both areas.But in areas without hair, they do not move on to the next stage of the cycle, at which they must turn into so-called progenitor cells (i.e., cells of a certain type).

This study gives hope that one day the hair in the place of the bald spot can be restored if scientists find a way to start their growth or block what is interfering with it. Researchers are now studying the properties of certain proteins that could promote hair restoration.

It seems that there are not so many myths associated with any other feature of the body as with baldness.Probably because we cannot explain why some men have it, while others do not. But, if you are still unlucky, courage, unfortunately, has nothing to do with hair loss. You can only blame your parents for your bald head. After all, you have these genes – from them.

Free testosterone

Free testosterone is a biologically active fraction of the steroid sex hormone testosterone, which is not associated with blood proteins.

Synonyms Russian

Testosterone direct.

Synonyms English

Testosterone Free, Testosterone Direct, Unbound Testosterone.

Research method

Enzyme-linked immunosorbent assay (ELISA).

Units

Pg / ml (picograms per milliliter).

Which biomaterial can be used for research?

Venous blood.

How to properly prepare for the study?

1. Do not eat for 12 hours before testing.
2. Avoid taking estrogens, androgens 48 hours before the study.
3. In the absence of special instructions from the doctor, it is recommended to donate blood for analysis before 11 o’clock in the morning.
4. Eliminate physical and emotional stress 30 minutes before the study.
5. Do not smoke for 30 minutes prior to examination.

General information about the study

Testosterone is a steroid hormone from the group of androgens (male sex hormones).In men, it is produced by Leydig cells in the testes and in small quantities in the adrenal cortex, in women – in the ovaries and adrenal glands. The main functions of testosterone are to control the correct development of male genital organs, increase the volume of skeletal muscles, stimulate spermatogenesis, hair growth on the skin in the face, armpits, and pubis. The secretion of the hormone changes with age – it increases up to 30 years, and after 50 it begins to decrease. Daily fluctuations in testosterone are also noted: a peak between 4 and 8 a.m. and a minimum between 4 and 8 p.m.

With excessive formation of androgens in women, virilization occurs (secondary sexual characteristics characteristic of men), hirsutism (excessive male-pattern hair growth), coarsening of the voice, clitoris hypertrophy. Since testosterone stimulates the function of the sebaceous glands, its increase is often associated with the development of acne. Reduced synthesis of testosterone in men leads to hypogonadism (underdevelopment of the gonads), female-pattern hair, poor development of skeletal muscles, underdevelopment of the external genital organs, infertility, breast enlargement, obesity.Insufficient production of this androgen in older men increases the risk of osteoporosis.

Total blood testosterone is divided into 3 types: free testosterone (not bound to protein, 1-4% of the total), testosterone combined with sex hormone binding globulin (60-70%), and testosterone bound with albumin (loosely bound testosterone , 25-40%). The free and loosely bound forms are bioavailable testosterone, that is, with biological activity. Bound testosterone, in turn, is not active.

The level of free testosterone does not depend on changes in the concentration of sex hormone binding globulin (SHBG). Therefore, if SHBG is increased (with hyperthyroidism, cirrhosis, taking oral contraceptives and antiepileptic drugs, hyperestrogenic conditions, including pregnancy) or decreased (with hypothyroidism, obesity, androgen excess, nephritic syndrome), the test for free testosterone will be more informative than to the general.

What is the research used for?

• To identify the causes of early puberty or delayed puberty in boys.
• To identify the causes of impotence and infertility in men.
• For the diagnosis of testosterone-producing tumors of the gonads.
• For detection of polycystic ovary disease and other causes of virilization in women.
• To control the treatment of prostate cancer with analogs of gonadoliberin and antiandrogens.
• To identify the causes of acne.
• For the diagnosis of hypothalamic-pituitary disorders, assessment of the function of the endocrine system of the body.
• To clarify the sex of newborns with ambiguous sex characteristics.

When is the study scheduled?

• Men:
  • with delayed development of secondary sexual characteristics or early puberty,
  • with a decrease in libido and sexual functions, impotence,
  • for suspected hypogonadism,
  • for infertility,
  • for andropause (“male menopause”),
  • for severe acne,
  • for osteoporosis.
• Women:
  • for irregular or absent menstrual periods,
  • for infertility,
  • with hirsutism and / or excessive development of male external signs, baldness,
  • for acne.
• For newborns with ambiguous sex characteristics, an analysis can be assigned along with the determination of the level of other sex hormones and instrumental diagnostic methods.

What do the results mean?

Reference values ​​

For Free Testosterone Test System (CAN-fTE-260), Diagnostics Biochem Canada Inc .:

Reasons for an increase in free testosterone levels

For men:

• tumors of the testicles and adrenal glands,
• congenital hyperplasia and dysfunction of the adrenal cortex (accompanied by a deficiency of 21- or 11-hydroxylase enzymes),
• early puberty in boys,
• Itsenko-Cushing’s syndrome,
• Reifenstein syndrome.

For women:

• polycystic ovary syndrome,
• tumor of the ovaries, endometrium and adrenal glands,
• adrenogenital syndrome (congenital hyperplasia of the adrenal cortex),
• Itsenko-Cushing’s syndrome.

Reasons for a decrease in free testosterone levels

For men:

• genetic disorders of sexual development and testosterone production (Klinefelter syndrome, Prader-Willi syndrome),
• pathology of the hypothalamic-pituitary system associated with the production of luteinizing hormone,
• testicular pathology (cryptorchidism, myotonic dystrophy),
• acquired pathology of the gonads (due to testicular trauma, with viral parotitis, radiation injury or toxic effects of ethanol with alcoholism),
• taking analogs of gonadoliberins or antiandrogens,
• old age.

In women, the decrease in free testosterone is not taken into account in clinical practice.

What can influence the result?

• Medicines that increase the level of testosterone: anticonvulsants, barbiturates, bromocriptine, clomiphene, danazol, estrogens, minoxidil, pravastatin, rifampicin, tamoxifen, bicalutamide, casodex, cimetidine, finasteride, luprone, anabolic steroids, anabolic sterolesterone , naloxone, mifepristone, oral contraceptives, phenytoin, valproic acid.
• Medicines that lower testosterone levels: antiandrogens, carbamazepine, corticosteroids, cyclophosphamide, digoxin, estradiol valerate, follicle-stimulating hormone, finasteride, gemfibrozil, interleukin, ketoconazole, leuprolide, drugs, stanaphylphenol, narcotylamine , diethylstilbestrol, glucose, ethanol, halothane, metoprolol, metirapone, phenothiazides.
• After physical exertion, the level of testosterone in the blood increases.

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