Low Testosterone In Women: Causes, Symptoms & Treatment

How to manage low testosterone level in men: a guide for primary care

After stopping the exogenous androgens, he has a baseline testosterone level of 168 ng/dL with a normal FSH. On clomiphene 50 mg daily his total testosterone increases to only 256 ng/dL, so he changes over to HCG 2,000 IU by injection three times per week. On this regimen, his total testosterone increases to 640 ng/dL with a normal free testosterone, but his estradiol has increased from 30 pg/mL to 85 pg/mL. He therefore decreases his HCG dosage to 1,500 IU three times per week and adds anastrazole 1 mg every other day to lower his elevated estradiol levels. On a repeat test, his lab values are now normalized, showing a total testosterone of 614 ng/dL with a normal free testosterone and estradiol of 48 pg/mL. Testosterone therapy in hypogonadal men has benefits, but it also has risks. It can increase the risk for blood clots, and increase hematocrit levels, particularly if patients are treated to supratherapeutic levels (either intentionally or unintentionally).

A decrease in testosterone level is a natural result of aging. This treatment is called testosterone replacement therapy, or TRT. TRT can be given as a pill, gel, patch, injection, or implant. Male hypogonadism is a condition in which the body doesn’t produce enough of the hormone that plays a key role in masculine growth and development during puberty (testosterone) or enough sperm or both. One combination that typically does not work very well to raise endogenous testosterone production are SERMs plus HCG. The reason is that SERMs work by increasing LH secretion from the pituitary, and HCG is already increasing the LH levels in the bloodstream directly.

Testosterone levels also play a role in libido, erectile function, and ejaculatory function. Your doctor will help you decide if measuring your testosterone levels is important. Blood tests are the only way to know for certain if testosterone levels are low. The normal range is above 300 nanograms per deciliter (ng/dL). Two blood tests on separate days must show low testosterone levels before a diagnosis is confirmed. Maintaining normal testosterone levels throughout a man’s life can support his sex drive and fertility, and build the strength of his muscles and bones. Always consult with a healthcare professional to determine the most appropriate treatment for your situation.

Most testosterone is protein-bound in the circulation and the unbound free testosterone (FT) represents only 2–4% of the total. Men with obesity and insulin resistance may have very low SHBG levels; hence normal FT despite having a low total testosterone. Conversely, men with high SHBG levels may have low FT despite normal total testosterone. On average, a testosterone level of 300–1,000 nanograms per deciliter (ng/dL) of blood is normal. Hypogonadism – reduced testicular function – generally occurs when the total testosterone is less than 300 ng/dL.

Testosterone is the primary male hormone and is made mostly by the testicles. It plays several important roles in life including increasing muscle mass and strength, enhancing sex drive, maintaining sperm production, improving bone density and producing new red blood cells. As belly fat increases, there is an increase in activity of the enzyme “aromatase” which converts testosterone in the fat cells to estrogen. This reduces testosterone and increases estrogen, which can increase fat deposition in typical female areas (breast, hips, thighs) and increase the risk of enlargement of the prostate and even prostate cancer. With every one-point drop in your body mass index (BMI) your testosterone level will increase by approximately 1 point. In fact, management of obesity may prevent declining total testosterone in the aging hot older male com.

It’s difficult for researchers to estimate how common low testosterone is since different studies have different definitions for low testosterone. Exercising more and losing weight can help slow the decrease of testosterone your body is experiencing. The deadline to have twice the impact to advance healthcare research is May 15. If any of these risk factors are in your family health history, tell your doctor.

Testosterone readings below the reference range on at least two different occasions, at least 4 weeks apart, are consistent with hypogonadism, but the underlying cause should then also be ascertained. In rare cases when neither therapy works, we can consider increasing the FSH level as well with injections of the FSH substitute hMG. According to the AUA, 7 in 10 people receiving treatment for low T are using TRT skin gels.

For men using gels, serum testosterone should be measured at least 4 hours after the last application. Other things being equal (haematocrit, bone density, and symptoms), treatment aims to achieve testosterone levels in the reference range (mid-range for gel; low end at trough for injectables). Decision to continue testosterone therapy requires ongoing holistic review of the original indications for initiating it — along with intended benefits of continuing — versus the potential risks of therapy. However, consistent hormone replacement therapy helps improve sex drive, ease symptoms of depression and increase energy levels for those experiencing low testosterone. Conditions that affect how your hypothalamus and/or pituitary gland cause secondary hypogonadism. This is known as hypogonadotropic hypogonadism because there are low levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

Females may also experience specific low testosterone symptoms, such as the following. Testosterone helps stimulate the production of semen, and reduced semen levels can indicate a reduction in testosterone. Testosterone stimulates the penile tissues to produce nitric oxide, which starts several reactions that result in an erection. If levels of the hormone are too low, a man may not be able to get an erection. Low testosterone can lead to reduced levels of energy and fatigue.

As a result, primary care physicians are seeing more patients like the one described above. This definition was proposed to help clinicians identify aging men with low testosterone who could potentially benefit from hormonal replacement therapy. The purpose of this article is to review the data on LOH, also known as low T, and present the most recent evidence and recommendations regarding the approach to the patient from our case scenario. First, your healthcare provider does a physical examination and talks to you about your symptoms and medical history.