Possible Side Effects From Low Testosterone Treatments:
With any medications or medical therapies, there are potential risks and adverse side effects. These may be, but are not limited to:
- Skin irritation
- Elevated red blood cell count
- Swelling of the lower extremities
- Elevated red blood cell count
- Changes in prostate symptoms
Patients are typically monitored every 3-6 months for symptom improvement and adverse events with examination, total testosterone, PSA, and hematocrit levels.
- Gels, creams, and patches
- Patches may be applied each night to your skin.
- Gels and creams can be applied to certain parts of your body. They absorb through your skin and cause fewer skin reactions compared to patches.
- A potential risk for gels and creams is transferring the testosterone to others you come into physical contact with. Gel is the most common type of treatment.
- Subcutaneous pellets
- Pellets containing testosterone can be implanted under the skin. This is a minor procedure done in our office. These pellets need to be implanted every 3-6 months.
What Are The Benefits Of Testosterone Replacement Therapy
Potential benefits of testosterone replacement therapy may include:
- In boys, avoiding problems related to delayed puberty
- Loss of fat
- Skin irritation
Laboratory abnormalities that can occur with testosterone replacement include:
- Increase in prostate-specific antigen
- Increase in red blood cell count
If you are taking hormone replacement therapy, regular follow-up appointments with your physician are important.
Guidelines suggest discussing the potential risk vs. benefit of evaluating prostate cancer risk and prostate monitoring. The doctor and patient will decide together regarding prostate cancer monitoring. For patients who choose monitoring, clinicians should assess prostate cancer risk before starting testosterone treatment, and 3 to 12 months after starting testosterone:
- PSA levels should be checked at 3, 6, and 12 months within the first year, and then every year after that.
- A digital rectal examination of the prostate should be done at 3-6 months and 1 year after beginning therapy, and then every year after that. This is recommended even for men who are not on testosterone replacement therapy, as an age-related prostate cancer screening. This usually begins at age 50.
- Hematocrit levels will be checked before testosterone therapy starts, and then on a regular basis to make sure red blood cell levels remain normal.
Erectile Dysfunction Vs Low Testosterone
ED and low testosterone are two very different conditions. As explained earlier, ED is when a man has trouble getting or maintaining an erection. On the other hand, low testosterone is when men have below average levels of the hormone.
Low T can be caused by low levels of free testosterone, which circulates in the blood. It can also be caused by low levels of bioavailable testosterone, which binds to protein.
Low testosterone has very different symptoms than ED. Some of the most common include:
- Weight gain
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How Do They Work
A testosterone test is a simple form of blood test. Doctors will first conduct a physical examination, looking for signs of low or high testosterone levels. They may ask about medical history and any medications the person takes before ordering the blood test.
Doctors tend to carry out tests in the morning when testosterone levels are highest. The blood test involves taking a sample of blood from the arm using a small needle. This process typically takes a few minutes.
Some people may have to follow some special instructions before the test. A doctor may ask the person to stop taking prescription drugs that could affect hormone levels, such as androgen or estrogen therapies.
Other prescription or recreational drugs and herbs and supplements may also affect testosterone levels, so people should always let their doctor know about anything they are taking.
Doctors may order more than one test, taken on different days. This may help get a more accurate average of testosterone levels.
Depending on the results, doctors may order further tests to confirm their diagnosis.
Does Testosterone Replacement Help With Erections
While testosterone replacement isnt generally the first-line therapy for treating ED, some studies suggest it may help. In men with both low testosterone and ED, some studies have found that testosterone injections can help with erections, as well as other symptoms of low T like fatigue and libido.
Research of using TRT for erectile dysfunction is still ongoing. However, one study found that 40-60% of men with both ED and low T noted improvements with erections. So, if you have ED and other symptoms of low testosterone like low libido, low energy, or loss of muscle, our provider may recommend starting a testosterone replacement regimen to help. However, not everyone notices significant improvements in erectile function with TRT, so you may need more traditional ED medications, like sildenafil.
Some men even respond better to sildenafil when taking testosterone if they have both ED and low testosterone. Researchers are still studying this, but it makes sense because though sildenafil helps increase blood flow to the penis, it likely wont help with low libido due to low T.
Low testosterone and age
When you think of declining levels of testosterone, you might think of middle-aged or older men. But men under 30 can also experience low testosterone, or low T.
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About Mens Health Center
The UPMC Mens Health Center is dedicated to male health and to the evaluation and treatment of conditions affecting mens sexual and reproductive health. With years of clinical experience in male sexual medicine and surgery, our team has treated a wide variety of conditions and performed thousands of surgeries, providing patients with the highest level of quality care. Our providers understand the intimate nature of male sexual difficulties, and we are dedicated to helping you restore your normal level of sexual function in a comfortable, educational, and discreet environment.
Other Factors That May Cause Low Testosterone In Females Include:
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Recovering Fertility After Testosterone Therapy
Regaining fertility is not guaranteed, but it is possible for some patients depending on their age and duration of testosterone use. The first step is to end any testosterone therapy and get baseline lab tests to know where your levels truly are. Often, we find that the patient’s LH production has been suppressed. In those cases, the next task is to increase it. Most patients start with Clomid. If that isn’t sufficient, we may consider hCG injections.
In rare cases when neither therapy works, we can consider increasing the FSH level as well with injections of the FSH substitute hMG. This drug is more expensive, and success is not guaranteed.
If you are concerned about low-T symptoms, or if you’ve tried therapies that didn’t work, talk with your primary care doctor or urologist. Feeling better starts with a conversation about your needs, goals, and lifestyle. Personalized care from a board-certified urologist or male fertility expert is the healthiest way to get there.
To visit with a men’s reproductive health specialist, call orrequest an appointment online.
Can Low Testosterone Cause Ed
Weve all heard that testosterone is the main hormone for men, right? So, could low testosterone cause erectile dysfunction ? The answer is a little more complex than you might think. However, theres some evidence that testosterone may play a role in sexual health and erections.
Low testosterone can affect your libido and erectile function, but testosterone injections may help you get back to normal.
Around of men in the U.S. suffer from ED. Your risk for ED increases with age, much like your risk for low testosterone. This has led many researchers to look into a possible link between testosterone levels and erectile dysfunction. The key to remember is that ED is a complex condition that can have multiple different causes and effects, so symptoms, severity, and treatment may be different for each person.
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Is It Normal For Tumor Markers To Rise With Testicular Cancer
AFP, ACG and LDH tumor markers rise with some cancers but many testicular cancers will not produce tumor markers. In other words, just because tumor markers are normal does not mean that you are free of cancer. Its of great value to ask your doctor about your tumor maker levels and learn whats normal vs. not normal.
Low Testosterone Treatment: Buccal Patches
Buccal patches are placed on the gums above the incisors about every 12 hours and slowly release testosterone. They are not effective if swallowed. Buccal patches may cause a bitter taste, irritation to mouth tissues and gums, and may cause headaches. Fortunately, these side effects lessen over time. The patient can eat, drink, and kiss others while using buccal patches because they are not directly exposed to testosterone.
Penis Growth And Development
Young boys are very similar to young girls. In fact, research suggests that before the age of 11 there arent really any differences between them in size or muscle strength at all .
But as soon as you hit puberty you started to see some drastic changes to your body. You started to become a man.
Over the 6 years or so it took you to mature, you saw big increases in the androgen hormone testosterone. And it was this hormone that is responsible for guiding you into manhood.
Polycystic Ovarian Syndrome Is Also Implicated
Another interesting outcome of the study was discovering that PCOS is the opposite disorder to endometriosis, in that the disorders appear to be largely caused by opposite levels of prenatal and postnatal testosterone. It is the opposite of endometriosis in that women with PCOS were more apt to have developed in utero with too much testosterone.
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What Causes Lower Testosterone In Females
Whatâs behind low testosterone levels in women? Here are a few possible causes:
- Long-term use of various methods of birth controlâsuch as oral birth control pills and contraceptive patches
- Ovarian failureâwhere your ovaries stop functioning correctlyâcan lead to low testosterone levels. Possible causes of ovarian failure include chemotherapy, radiation treatment, and eating disorders, but the most common cause of ovarian failure is menopauseâwhich happens to every woman as she ages. Thus, a menopausal woman may develop an imbalance in testosterone levels.
- Using certain medicationâsuch as anti-hypertensives and opiates
- Tumors on various glands in the bodyâsuch as the pituitary glandâcan also cause a hormone imbalance like low T levels in women
What Causes Low Testosterone
As men begin to age, the amount of testosterone in their bodies decreases. This natural aging process is often what causes low testosterone. Up to 40 percent of men in their 40s begin to experience a reduction in testosterone. However, deficient testosterone levels are less common, and they can happen for a number of different reasons. Read on to learn what causes low testosterone and testosterone deficiency and whether you could be at risk.
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Boosting Your T Levels Will Increase Libido Though
Whilst testosterone boosting supplements might not effect your penis directly, they will increase your libido and sexual performance.
Low T levels have been found to be one of the leading causes of low sex drive.
A large study of over 1,600 men based in greater Boston, Massachusetts found that 19% of them had low libido . And there was a significant relationship between those that reported low libido and the chances of them having low testosterone levels.
T supplementation was associated with increases in sexual functioning, mood, and strength .
How Low Can Testosterone Go
Unlike women, who have a rapid decline in estrogen at menopause, men may experience a gradual decline in testosterone. Studies show that about 20 percent of men have low T in their sixties and about 50 percent have low T in their eighties. In younger men, low T may be caused by common problems like obesity, diabetes, and stress. Altogether, low T may affect up to 5 million American men.
The lower your testosterone goes, the more likely you are to have the common symptoms like low energy and low libido,” says Daniel Shoskes, MD, a urologist at the Glickman Urological & Kidney Institute at the Cleveland Clinic in Ohio. “A deep reduction can cause less common symptoms like anemia, osteoporosis, depression, and confusion. But the idea that healthy mens testosterone levels need to be monitored to prevent these symptoms is probably nonsense.
When symptoms indicate that you may have a low T problem, a simple test can help make the diagnosis. A morning blood test is the best way to measure testosterone. There is a very wide range of normal, and testosterone levels change during the day, says Dr. Shoskes. The normal range is anywhere from 300 to 800 nanograms per deciliter . You would not be considered to have low T unless you had a number below 300.
At these lowest levels of testosterone, low T symptoms may include:
- Complete loss of libido
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Who Shouldn’t Take Testosterone Replacement Therapy
Testosterone replacement therapy may cause the prostate to grow. If a man has early prostate cancer, there is concern that testosterone may stimulate the cancer’s growth. Therefore, men who have prostate cancer should not take testosterone replacement therapy. It is important for all men considering testosterone replacement therapy to undergo prostate screening before starting this therapy.
Other men who should not take testosterone replacement therapy include those who have:
- An enlarged prostate resulting in urinary symptoms
- A lump on their prostate that has not been evaluated
- A PSA measurement above 4
Testosterone In Women: What It Does
In women, testosterone is produced in the ovaries and adrenal glands. This hormone helps the body with a number of different functions. For example, normal testosterone levels in women help regulate mood and supports the health of female reproductive tissue and bones. Because of this, symptoms can arise if thereâs a testosterone imbalance and levels get too high or too low.
Here are a few key roles testosterone can play in a womanâs health:
- Maintenance and growth of bones
- Increases muscle mass
- Supports a healthy libido or sex drive
- May help decrease vaginal atrophy
- May help support cardiovascular health
So as you can see, normal testosterone production in females can have many beneficial effects. But too much or too little of this hormone can have less-than-positive effects on the body.
Letâs start by discussing low testosterone symptoms.
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Hypoactive Sexual Desire Disorder And Low Testosterone In Women
Because testosterone plays a role in libido, women with lower-than-normal levels of testosterone can experience hypoactive sexual desire disorderâor HSDD.
HSDD is considered the most widespread sexual health problem among women, and estimates suggest it occurs in 8% to 19% of women. Itâs marked by fewer sexual fantasies and a lack of interest in sexual activityâalong with a lot of personal distress, frustration, sadness, and decreased self-confidence and self-worth. Depression and fatigue often occur with HSDD.
Researchers have yet to pin down the exact causes of HSDD. The extent to which testosterone levels contribute to HSDD is also not well-understood. Low testosterone levels are, however, linked with less sexual desire, and testosterone hormone therapy can boost sexual desire in both pre-menopausal and post-menopausal women. But there isnât an exact T level that can be used to diagnose HSDD.
How Is Testosterone Deficiency Treated
Early detection in boys can help prevent problems from delayed puberty. Testosterone treatment can stimulate puberty and the development of sex characteristics, such as increased muscle mass, beard and pubic hair growth, and growth of the penis.
Early diagnosis and treatment in adult men provide better protection against loss of bone density and cardiovascular disease. Treatment can also improve tiredness, general well-being, erectile dysfunction and sex drive.
The treatment for testosterone deficiency also depends on the underlying cause.
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Trt For Patients With Testosterone Deficiency And Prediabetes
Another interesting area of research is how testosterone therapy can assist those with prediabetes. Prediabetes is a condition where you have higher blood glucose levels than normal and is usually a sign that you are at risk for developing type 2 diabetes. Oftentimes, physicians recommend weight loss strategies for patients with prediabetes.
Researchers have studied the effects of TRT on a group prediabetic patients to determine the benefits of testosterone replacement treatment for those who are at risk of developing type 2 diabetes. This study concluded that testosterone injections may help slow down or prevent progression into type 2 diabetes.
For prediabetic patients, physicians often recommend weight loss strategies to help with prediabetes. Research has also shown that long-term TRT can lead to sustained weight loss, which can help prediabetic patients. Additionally, this study found that those with low T and prediabetes improved their glycemic control after testosterone replacement therapy. Patients in the group who received TRT also had a mortality rate of 7.4%, versus the 16.1% rates for those not treated for their low testosterone. Therefore, testosterone replacement therapy may be able to help your health management if you have both of these conditions.