What does it mean to have Testosterone Deficiency (Low T)?

What is testosterone? 1

Testosterone is a hormone produced primarily in the testicles to help men maintain certain characteristics and functions, such as

  • Bone density
  • Facial and body hair
  • Fat distribution
  • Libido
  • Muscle strength and mass
  • Production of red blood cells
  • Sperm production

And what about testosterone deficiency? 3

Testosterone Deficiency, also called “Low T,” is a common condition (estimated to affect more than 200,000 men per year in the U.S.) in which the production of testosterone is reduced.  It is also a chronic condition that can last for years or a lifetime.  Deficiencies that begin before puberty, may impact growth and sexual development. After puberty, deficiencies may cause sexual difficulties and reduced fertility.

Confirmation of low testosterone requires a medical diagnosis using lab tests, and sometimes, imaging. Although Testosterone Deficiency can't be cured, treatment can help.

NOTE: The Testosterone Panel of the American Urological Association (AUA) chose to cease the use of the term hypogonadism, a term introduced decades ago to signify low testosterone levels associated with infertility. Hypogonadism has more recently been used interchangeably with the idea of low testosterone production alone. To be scientifically accurate, the Panel chose the term Testosterone Deficiency, 4 which is the term we use on this website.

Why would my testosterone levels decrease?

Testosterone levels generally peak during adolescence and early adulthood.  After age 30 or 40, your testosterone levels can gradually decline an estimated 1% per year. 1   This is a natural and expected result of aging.

Measured low testosterone should be accompanied by known symptoms to be referred to as “Testosterone Deficiency.”  Some studies have also documented an association between low testosterone, male sexual dysfunctions, and other metabolic risk factors.

While this association does not necessarily mean that one causes the other, low testosterone has been associated with obesity, loss of muscle mass, limited mobility, osteoporosis, frailty, cognitive impairment, depression, sleep apnea, reduced lifespan, greater risk of cardiovascular death, and other chronic diseases. 2

What does low testosterone do to a man?

Of the many signs and symptoms you may experience as you age, not all of them are related to testosterone.  However, those that may result from lower testosterone levels can include:

  • Changes in sexual function. Lowered sexual desire, fewer spontaneous erections, and infertility.
  • Changes in sleep patterns.  Insomnia or other sleep disturbances.
  • Safer risk profile, better than reported for surgical procedures like TURP
  • Physical changes.  Increased body fat, reduced muscle bulk and strength, decreased bone density, less energy, breast swelling, loss of body hair.
  • Emotional changes. Decreased motivation or self-confidence, sadness, depression, inability to concentrate, memory difficulties.
low testosterone treatment options

It’s also possible that some of these indicators, as well as a lowered testosterone level, are caused by other, various underlying factors, including medication side effects, obstructive sleep apnea. thyroid problems, diabetes, and depression.

Consequently, treatment of the underlying issue may improve the symptom and the testosterone level.   The only way to be certain is to have a diagnostic blood test for testosterone level and an evaluation by a urology specialist.

Is there a treatment for low T?

Young men with Testosterone Deficiency should be treated.2  In older men, it is important to determine if low testosterone levels are due simply to the gradual decline that is normal with aging or to a disease process.1  Men with sexual dysfunctions and/or with obesity and metabolic diseases should be screened for Testosterone Deficiency and treated.2  The degree of symptoms may determine if and what type of treatment is recommended.

Am I a candidate for treatment?

Testosterone testing and prescription supplements have nearly tripled in recent years.  However, data indicates that many men are supplementing their testosterone without a clear indication for it.

Some studies estimate that up to 25% of men who receive testosterone therapy do not have their testosterone level tested before beginning treatment. 4

Studies also indicate that up to a third of men currently receiving testosterone therapy do not meet the criteria to be diagnosed as Testosterone Deficient.  And of those who are treated with testosterone, nearly half are not getting testosterone levels checked after therapy begins. 4

As mentioned above, Testosterone Deficiency is not only low testosterone production but low testosterone levels combined with symptoms or signs associated with the low levels. You are considered a candidate for testosterone therapy only when you meet both criteria.  The challenge for physicians is that the symptoms associated with low testosterone levels are very non-specific and can be manifestations of other conditions like chronic fatigue, chronic stress, or depression. 4

There are still large numbers of men who need testosterone therapy but who never receive it because of assumptions made about specific symptoms and because of inadequate diagnostics to support treatment.  This is a key reason why you need a urology evaluation by a specialist like Dr. Paul Kenworthy.

What are the treatment options?

In addition to beneficial changes in lifestyle, testosterone therapy can be administered in several ways:

  • Transdermal (skin) patch
  • Oral patch
  • Nasal spray
  • Gels absorbed through the skin
  • Injections
  • Pellet implants

Although testosterone is available in an oral tablet, there is some concern that long term oral delivery of testosterone can negatively affect the liver. 5  The alternative delivery methods bypass the liver and release testosterone directly into the bloodstream.

Part of Dr. Kenworthy’s evaluation process is to discuss recommended treatment methods for you based on your testosterone levels and symptoms, as well as side effects and impacts of your quality of life.  He works to personalize treatment to fit your medical needs and your lifestyle.

What do I do now?

The place to start is with a specialty urology evaluation and consultation with Dr. Paul Kenworthy. He is a urology specialist with Northwoods Urology in their offices located in The Woodlands, TX and Huntsville, TX. Dr. Kenworthy’s practice covers the full evaluation and treatment of urological medicine including Testosterone Deficiency and other urological issues associated with aging.

Of special note is that Dr. Kenworthy includes treatment for men with Low T who are interested in preserving their fertility, and also, for men who are at risk for or have been diagnosed with prostate cancer.

Dr. Kenworthy is committed to providing the most personalized and medically sound treatment of Testosterone Deficiency for his patients. This includes diagnosis, in-office treatment, and monitoring. 3

If you have symptoms suggestive of Low T, contact us to schedule an evaluation with Dr. Kenworthy.  His thorough and compassionate approach to diagnosis and treatment can restore your comfort and well-being.

Dr. Kenworthy Treats Testosterone Deficiency to Improve Your Life!

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