Men’s Health: Let’s Talk About Testosterone

By Brian Jennings, MD – BMHD

A common concern I hear from men of all ages is if their testosterone levels are low.  The media and advertising have made us familiar with “low T,” so let’s talk a little about testosterone.

Testosterone is a hormone produced primarily in the testicles (and small amounts in the adrenal glands).  Testosterone helps to maintain men’s bone density, muscular strength, body and facial hair, sex drive, and sperm production.  As you age (generally starting around age 30-40) your testosterone starts to naturally decline.  Certain drugs can also cause low testosterone (for example prolonged high dose steroids, or prolonged extended release opiates). If your testosterone is abnormally low, you may notice decreased energy, libido, muscle mass, and body hair, as well as hot flashes, growth of breast tissue, and infertility.

Low testosterone is diagnosed by a blood test- you need to get 2-3 fasting, morning blood samples showing low levels.  It needs to be measured more than once because testosterone levels can sometimes fluctuate, and it is important to confirm that testosterone is consistently low before starting treatment.

The good news is- there are lots of natural ways to increase your testosterone, including eating a balanced diet, getting good sleep, decreasing stress, getting regular exercise/weight lifting, getting sunlight, drinking less alcohol, and losing weight.  These are all good for general health as well.

Testosterone replacement can improve symptoms if your testosterone is low.  Generally, testosterone is given as a gel or injection. The bad news is- there are multiple risks associated with treatment, including prostate enlargement, increased risk for prostate cancer (especially if already present), increased risks for blood clots, and possible increased risk for strokes and heart attacks.  These risks are higher if you are being treated when the testosterone level is not actually low which is why we carefully check beforehand.

So before starting and periodically during treatment, you and your doctor should decide together if the benefits to your quality of life outweigh the risks associated with testosterone replacement.

If you are worried about “low T,” feel free to talk to your doctor for more information.