Talking With Your Doctor About Low Testosterone

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Female doctor with male patient looking at results

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.

Starting a Conversation About Low T

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

  • Hair loss

  • Shrinkage of your testicles

How Your Doctor Will Diagnose Low T

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

  • Infections

  • Chronic illness like diabetes

  • Alcoholism

  • Drugs

  • Genetic abnormalities

  • Liver disease

  • Kidney diseases

  • Obesity

Talking About the Risks and Benefits of Treatment

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

  • Improved erections

  • Less fatigue

  • Better mood

  • Increased strength

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.

Recent studies also suggest that low T treatment may make some men more likely to have a heart attack or stroke. Tell your doctor if you have a history of heart disease or stroke

Looking at Treatment Options

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:

  • Gel

  • Skin patch

  • Injection

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.

Considering Treatment Alternatives

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

  • Reducing stress

  • Not smoking

  • Having no more than two alcoholic drinks a day

These lifestyle choices are good options even if you do decide on testosterone treatment.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 4
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

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