Low Testosterone in Men

Dr. Nicholas Kaloudis

Testosterone is the most important sex hormone that men have. It is responsible for the typical male characteristics, such as facial, pubic, and body hair as well as muscle. This hormone also helps maintain sex drive, sperm production, and bone health. The brain and pituitary gland control the production of testosterone by the testes.

Low testosterone (hypogonadism) can cause: A drop in sex drive and desire, poor erections, low sperm count and enlarged breasts. Over time, low testosterone may cause a man to lose body hair, muscle bulk, and strength, and to gain body fat.

Chronic low testosterone may cause weak bones (osteoporosis) mood changes, less energy, and smaller testes.

Low testosterone can result from: testicular injury or infection, radiation or chemotherapy for cancer, medications, hormone disorders such as pituitary disease or high levels of prolactin, and chronic diseases such as liver and kidney dysfunction, Type 2 Diabetes, AIDS, and obesity.

Low testosterone is diagnosed by your endocrinologist during a physical exam. Τhe doctor will examine your body hair, the size of your breasts and testes. Your doctor may also check for loss of side vision, which could indicate a pituitary tumor.

Your doctor will also use blood tests, checking pituitary hormones, such as FSH and LH and of course total and free testosterone levels.

Once diagnosed with low testosterone, replacement therapy can be started which will improve sexual interest, erections, mood and energy, body hair growth, bone density and muscle mass. There are several ways to replace testosterone: gel that you apply on your skin, injections, tablets that stick to your gums, and pellets inserted under your skin.

There are risks with long-term use of testosterone. The most serious one being, prostate cancer. All men over the age of 50 need monitoring for prostate cancer during testosterone treatment. Men with known or suspected prostate cancer, or with breast cancer, should not receive testosterone treatment. Other possible complications of testosterone treatment include: a high red blood cell count, acne, breast enlargement, an increase in prostate size, sleep apnea, and fluid buildup in the ankles and feet.