Testosterone (T) is the main sex hormone in males, which is produced mostly in the testicles. This hormone is very important to normal sexual development and functions in men. In the time of puberty (approximately ten years), testosterone helps men to maintain and develop male characteristics like facial and body hair, changes in voice, muscle mass, and strength. This hormone also regulates men’s sperm production. Low testosterone levels (low T) drop as men become older. That’s why older men have more chances of having low T in blood. Many factors can cause low testosterone levels. One of them is Testosterone Deficiency Syndrome (TDS). When there is not enough of this substance in the man’s body, this condition is called TDS.
A normal level of testosterone is at least 300 ng/dl up to 1,000 ng/dl in men. The American Urology Association (AUA) appreciates low testosterone in blood when it is below the level listed above. In case you have been diagnosed with low T you may have the following symptoms:
- Fatigue
- Irritability
- Depression
- Low sex desire
- Reduced muscle mass and strength
Men may experience these symptoms not only from low T but also from other health conditions. Examples include diabetes, obesity, loss of or harm to the testicles, some congenital conditions, and opioid use. It is advised to consult a doctor if you notice any of the symptoms listed above.
Testosterone Therapy
In case you have low T, physicians may prescribe you Testosterone Therapy (TT). The AUA and the FDA advise using TT in case, you have been born with Klinefelter syndrome. In addition, healthcare providers may also prescribe TT if your testicles were removed because of a disease such as cancer or if you lose or harm your testicles.
Testosterone Therapy may give you certain negative effects. Check some examples below:
- Breathing problems
- Sleep apnea
- Chest pain
- Frequent urge to urinate
- Enlarged breasts
- Edema
Tell your doctor promptly if you experience any of the adverse reactions listed above or any other effects.
Symptoms of Low Testosterone Levels
There are several symptoms of low T. Consult a doctor to check if you have decreased T levels. More common symptoms of Testosterone Deficiency (TD). For example:
- Loss of body and facial hair
- Fatigue (feeling tired)
- Obesity (overweight)
- Mood changes or depression
- Loss of muscle mass and strength
- Decreased desire for sex
- Decreased erectile function
Check below for some examples of uncommon symptoms of TD. Examples include:
- Poor focus
- Poor memory
- Difficulties in speech
- Not doing well at work
- Decreased energy level, physical and endurance strength
Reduced sex desire alone does not mean you suffer from TD. It may occur due to psychological causes as well. However, consult a doctor if you experience two or more symptoms listed above.
Causes of Testosterone Deficiency
Some causes of Testosterone Deficiency (TD) can take place at birth. Check some examples below:
- Noonan syndrome
- Ambiguous genitalia (improper development of sex organs)
- Klinefelter Syndrome
Other medical conditions may also provoke low T in men. For example:
- Chemotherapy or radiation
- Infection
- Autoimmune disease (when the body attacks its cells by producing antibodies)
- Damage to testicles by accident
- Removal of testicles because of cancer
- Pituitary gland disease leading to hormone deficiency
- Obesity
- Aging
- Metabolic syndrome
In addition, if you administer medications such as antidepressants, low T also may occur.
Health History
It is advised to share your medical history before using any Testosterone-boosting medications. Examples include:
- Use of opiates
- History of unexplained anemia
- History of heart attack or stroke
- Traumas to your testicles
- If you use anabolic steroids now or used them in the past
- History of chemotherapy or irradiation
- Use of glucocorticoids (medications, like cortisone, used for treating inflammation)
- History of infection in your testicles
- Anosmia (losing the ability to smell)
- History of head injury, and others.
Administration Methods
There are five methods to administer testosterone. These methods are transdermal (through the skin), injection, oral/buccal (by mouth), intranasal (through the nose), and pellets under the skin. All five methods are equally good. Your doctor may prescribe tests to know the exact level of testosterone in the blood, while you are on testosterone therapy. Below you can find more information about these five ways to administer testosterone:
Transdermal
There are topical gels, liquids, patches, and creams. The lifetime of these topical medications is about four days. Covering with an air-on-water-tight dressing these medications have better assimilation. The skin should be dry and without injuries or scratches for using liquids and gels, creams, or patches. When it’s time for the upcoming dose you should clear the area. After using creams, gels or liquids clean out your hands. You should make sure that nobody touches these medications. Especially women and children.
Injection
There are two ways of acting forms of testosterone injection, the first form is short and the second form is long. The short-acting medication is often administered in the muscle or under the skin. The long-acting medicine is mostly administered in the muscle. Injections are often administered weekly, every two weeks, or monthly.
Oral
The buccal dose is packaged in a patch. The place for using medication is located above your incisor (canine or “eyetooth”). It’s not recommended to chew or swallow this drug because it looks like a pill. Twelve hours are needed to release the medication. This is the better way to administer this drug.
Intranasal
This is another testosterone form that is packaged into a gel. You need to administer the dose directly in both nostrils, often three times per day.
Pellets
Underneath the skin of your buttocks or upper hip, a doctor places the testosterone pellets. Your doctor will administer local anesthesia. Thereafter, he cuts a small place on the skin and introduces the pellets into the fat tissue. At least three to six months is needed to dissolve the medication. It depends on how many pellets the doctor applies under your skin.
Adverse Effects of Testosterone Therapy
Testosterone therapy has been used in many men to treat decreased libido and problems with erection or to increase physical functions and strength. But while you are on TT, you may notice certain adverse effects. Examples include:
- By using liquids as well as gel, you could have some redness on the skin. However, it is a small count of people who reported painful effects.
- Some negative effects of testosterone pellets may include bruising, swelling, pain, and sometimes hematoma (blood clots underneath the skin).
- While you are on TT, you have a high risk of erythrocytosis (blood hemoglobin and hematocrit are uncommonly growing).
Testosterone therapy may stop the normal production of sperm. If you were treated for low T your doctor could prescribe you additional treatment for producing sperm. Furthermore, you should not use Testosterone Therapy if you are planning children.
