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Low Testosterone – Should I Get Tested?

This is a complicated subject, which needs a discussion by a specialist, such as an Endocrinologist, to go over the nuances of this field before any investigation is initiated.  I have to answer this question quite often, and before I try to address this, there are a few questions that I have of my own.

Which symptoms are likely from low testosterone?

  • Reduced sexual desire (libido) and activity
  • Decreased spontaneous erections
  • Breast discomfort
  • Loss of body hair (axillary and pubic)/reduced shaving
  • Very small or shrinking testes
  • Inability to father children/low or zero sperm count
  • Height loss, low trauma fracture
  • Hot flushes, sweats

Is one blood test enough?  Testosterone, like any hormone in the body, fluctuates and has different levels day to day.  The best time to be tested is in the morning.  If the first test is abnormal, you might need to have a repeat test a few weeks apart with more sensitive testing to confirm the diagnosis, since this diagnosis means you might be taking testosterone long term!

How is low testosterone treated?  There are several options: injections, gels, or patches.  This depends on your preference and sometimes,  sadly, your insurance decides how you get testosterone.

What caused it?  This is the duty of an Endocrinologist to separate reversible from non-reversible causes.  Several medications and other conditions can cause this and these can be temporary.

And what will the treatment hope to achieve…

The benefits of testosterone replacement and its risks also deserve a detailed discussion with your Endocrinologist, since there are serious possible side effects that require careful monitoring.  But, treated the right way, you should notice an improvement in libido, body composition, muscle mass, and a sense of well being

Shahzad Ahmad M.D., F.A.C.E.

Clinical Endocrinologist

Thyroid Institute of Utah