The Journal of Clinical Endocrinology & Metabolism Vol. 89, No. 5 0
Copyright © 2004 by The Endocrine Society
Patient Information Page from The Hormone Foundation |
Low Testosterone and Men’s Health
Glenn R. Cunningham, MD,
Alvin M. Matsumoto, MD and
Ronald Swerdloff, MD
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What is the role of testosterone in men’s health?
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Testosterone is the most important sex hormone that men have. It is responsible for the typical male characteristics and helps maintain sex drive, sperm production, pubic and body hair, muscle, and bone. The brain controls the production of testosterone by the testes.
Low testosterone (also called hypogonadism) can cause:
- A drop in sex drive
- Poor erections
- Low sperm count
- Enlarged breasts
Over time, low testosterone may cause a man to lose body hair, bulk and strength, have weaker bones (osteoporosis), mood changes, and have less energy and smaller testes.
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What causes low testosterone?
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Low testosterone can be caused by injury (e.g., trauma, castration, radiation or chemotherapy), hormonal disorders (e.g., pituitary tumors or diseases, high levels of prolactin), or other diseases (e.g., mumps). Some medications, HIV/AIDS and several genetic conditions (e.g., Klinefelter syndrome, hemochromatosis, Kallmann syndrome, Prader-Willi syndrome, and mytonic dystrophy) also can cause low testosterone. In many cases, however, the cause is not known.
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How is low testosterone diagnosed?
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During a physical exam, your doctor will examine body hair, breast size, size and consistency of the testes, scrotum, penis size, and ability to see in all directions. Your doctor will also use blood tests to see if the total testosterone level is within the normal range. This is generally 300 to 1,000 ng/dL but this may differ depending on the laboratory. To diagnose low testosterone you may need more than one early-morning (7 – 10 AM) blood test and, sometimes, other tests of the pituitary gland.
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How is low testosterone treated?
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Testosterone replacement therapy can improve sexual interest, erectile function, mood and energy, body hair growth, bone density, and muscle mass. There are several methods of testosterone replacement:
- Injections
- Patches
- Gel
- Tablets (stick to the gums)
The best method will depend on the cause of the problem, the patient’s preference and tolerance, and cost.
There are risks with long-term use of any testosterone delivery method for men over 50.
Possible Risks of Testosterone Treatment:
- A high red blood cell count
- Occasional stopping of breathing during sleep (sleep apnea)
- An increase in prostate enlargement or prostate cancer growth
- Fluid build-up (rarely)
African American men and men over 40 years of age who have close relatives with prostate cancer, and all men over 50 years of age should be carefully monitored for prostate cancer during testosterone treatment. Men with breast cancer or known or suspected prostate cancer should not receive testosterone therapy
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What should you do with this information?
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If you have symptoms, talk with a specialist. An endocrinologist, an expert in hormones, can help determine the cause. Be open with your doctor about your medical history, all prescription and nonprescription drugs you are now taking, sexual problems, and any major changes in your life.
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Resources
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- "Find an Endocrinologist" (referrals):
www.hormone.org or call 1-800-467-6663
- Patient’s Guide to Low Testosterone:
www.hormone.org/pdf/patients_guide_low_testosterone.pdf
- American Foundation for Urologic Disease:
www.reproductive-health.org
- MedlinePlus:
www.nlm.nih.gov/medlineplus
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Footnotes
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For more information on how to find an endocrinologist, download free publications, translate this fact sheet into other languages, or make a contribution to The Hormone Foundation, visit www.hormone.org/bilingual or call 1-800-HORMONE. The Hormone Foundation, the public education affiliate of The Endocrine Society (www.endo-society.org), serves as a resource for the public by promoting the prevention, treatment, and cure of hormone-related conditions. The development of this fact sheet was supported by an unrestricted educational grant from Solvay, and may be reproduced non-commercially by healthcare professionals and health educators to share with patients and students. Translation by MEDI-FLAG Corp.
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What is the role...
What causes low testosterone?
