Talking With Your Doctor About Low Testosterone
After age 30, testosterone levels in men start to go down. That's normal. By age 60, about 20% of men have low testosterone (low T). There can be bothersome symptoms of low T, but not all men with low T need treatment. That’s why you should talk with your doctor if you are concerned about low T. Your doctor can make a diagnosis and, together, you can decide if treatment is a good choice for you.
You probably do not need to worry about low T if you don’t have symptoms. Doctors treat low T only when a man has symptoms and also blood tests that show low T. It's time to talk with your doctor if you:
Have lost interest in sex
Cannot achieve or maintain an erection
Have little energy
Have trouble with memory and concentration
Are moody or depressed
Low T also can cause physical changes over time. Tell your doctor if you notice:
Loss of muscle
Increased breast size
Shrinkage of your testicles
After you've talked about your symptoms, your doctor will examine you. Your doctor might order a blood test to check your testosterone level. Morning is the best time for this test. That's when the level of testosterone in your blood is highest. If your level is below normal, your doctor will probably repeat the test to confirm the results.
Even if you have low T, the doctor probably will not start testosterone replacement treatment right away. First, the doctor will try to find out what is causing your low T. It could be something other than aging. Other causes of low T can include:
Problems with testicles
Problems with the pituitary gland, which regulates how much testosterone the body makes
Chronic illness like diabetes
If your doctor does suggest testosterone replacement, you need to have a talk about the pros and cons.
Benefits of testosterone treatment may include:
More interest in sex
On the downside, low T treatment can make some conditions worse. These include sleep apnea and enlarged prostate. It also can make certain cancers grow faster. These include prostate cancer and male breast cancer. The risks of treatment may outweigh any benefits if you have these conditions or you are at risk of developing them.
Before starting treatment, your doctor will probably check your prostate for signs of enlargement or prostate cancer. The doctor may do a rectal exam and also a blood test called the PSA (prostate specific antigen) test.
If your doctor decides you may benefit from treatment, you will need to decide how to take the testosterone. Health experts do not advise taking it in pill form. That method can cause liver disease. The most common ways to take it are:
You get injections once or twice a month. They can cause mood swings because testosterone levels rise and fall quickly. You apply gels or skin patches once a day. Follow all instructions carefully. Both gels and patches can irritate your skin. Talk with your doctor about possible side effects so you can choose the method that's best for you.
Once you start treatment, you need to see your doctor on a regular basis. You will need blood tests and rectal exams every so often. This is to make sure there's no evidence of prostate cancer. You doctor also will check your testosterone level every so often. Make sure you store your testosterone replacement safely to prevent accidental exposure to pregnant women or children.
You should also talk with your doctor about other ways to treat low T, besides drugs. Whether other methods will work will depend on how bad your symptoms are. Some healthy lifestyle choices can boost testosterone naturally. These include:
Losing belly fat
Doing aerobic exercise and strength training
Getting enough sleep
Having no more than two alcoholic drinks a day
These lifestyle choices are good options even if you do decide on testosterone treatment.