What makes a man “feel like a man?” Some attribute it to body strength, a deep voice, a hairy chest and a healthy sex drive. It’s all thanks to a hormone called testosterone that is responsible for the physical changes in puberty that turn a boy into a man. When testosterone levels naturally begin to decrease after age 30, it can affect not only how a man feels about himself, but his physical strength, his mental health and acuity and even his desire for intimacy.
In recent years, men have been bombarded by advertising campaigns for products to treat erectile dysfunction, boost testosterone levels and improve symptoms of low testosterone or low T. Fortunately, as a result, more men feel less stigmatized and more open to discussing their symptoms with their doctors. If you are wondering if you could be suffering from low testosterone, knowing the symptoms can help prepare you to have an honest, informed conversation with your doctor.
Symptoms of Low T
The symptoms of low testosterone range from subtle to obvious. Because levels of the hormone decline gradually over the years, symptoms may appear gradually, sometimes making them hard to recognize. The most common symptoms include:
• Low sex drive • Erectile dysfunction • Fatigue and poor energy level • Difficulty concentrating • Depression • Irritability or moodiness • Low sense of well-being • Loss of muscle mass • Loss of bone mass • Thinning body hair • Trouble sleeping
It is important to note that some of these symptoms may be attributable to other medical problems such as diabetes, depression, high blood pressure, thyroid problems or coronary artery disease. Your doctor will want to rule out such conditions before treating your symptoms solely for low testosterone.
To determine the level of testosterone in the blood stream, a simple blood test is used. If symptoms are present and the test indicates low testosterone levels, your doctor may recommend treatment. (For millions of men who have low testosterone but have no symptoms, no treatment is currently recommended.)
Testosterone Replacement Therapy
Testosterone replacement is available in several forms that are approved by the FDA:
• A skin patch, worn on the arm or upper body, which releases the hormone into the bloodstream through the skin.
• Testosterone gels and solutions that come in packets, which when applied are absorbed directly through the skin. Gels also are available in pumps that deliver the amount of testosterone prescribed by your doctor.
• A mouth patch, which sticks to the upper gums, and continuously releases testosterone into the blood through the oral tissues.
• Testosterone, which is injected directly into the muscles, or implanted (in pellet form) in the soft tissue so it is slowly absorbed into the bloodstream.
The results of testosterone replacement therapy are highly individualized and can range from barely noticeable to a dramatic difference, with the majority of patients reporting generally positive outcomes.
The benefits and risks of long-term testosterone therapy are unknown, because large clinical trials have not been done. Testosterone replacement therapy may make some medical conditions such as enlarged prostate, prostate cancer, sleep apnea, high blood counts and congestive heart failure, worse. Before beginning hormone replacement therapy, it is important to discuss these risks with your primary care physician.
Take the “Is it Low T?”
1. Do you have a decrease in libido (sex drive)? o Yes o No
2. Do you have a lack of energy? o Yes o No
3. Do you have a decrease in strength and/or endurance? o Yes o No
4. Have you lost height? o Yes o No
5. Have you noticed a decrease in your enjoyment of life? o Yes o No
6. Are you sad and/or grumpy? o Yes o No
7. Are your erections less strong? o Yes o No
8. Have you noticed a recent deterioration in your ability to play sports? o Yes o No
9. Are you falling asleep after dinner? o Yes o No
10. Has there been a recent deterioration in your work performance? o Yes o No
If you answered “yes” to questions 1 or 7, or to at least 3 of the other questions, your symptoms may be caused by low testosterone, or Low T.