Low Testosterone

Low Testosterone

Overview of Low Testosterone

Male hypogonadism is another name for low testosterone. This condition is characterized by the body not producing enough testosterone. This is a condition that you may be born with or it is something that develops later in life. The various effects will depend on when in life this occurs. Testosterone replacement therapy is the most common treatment for this. However, your physician will work with you to see what is the best form of treatment depending on your health, side effects of treatments, and what you are desiring. Be sure to keep a log of your symptoms and questions when you are preparing for your appointment.

About Testosterone

Testosterone is the hormone in males that is responsible to masculine growth and the development that occurs during puberty. The cause of low testosterone is found either in the brain or testicles. Low testosterone can develop at any age � even before birth.

Symptoms of Low Testosterone

Male hypogonadism can occur at any point in the life. Symptoms will depend on the time in which it occurs.

If low testosterone occurs during fetal development, then it is likely that the external sex organs will not be fully developed. A genetically male born child may have female genitals, underdeveloped male genitals, or genitals that are neither male or female.

If low testosterone occurs during puberty, then there may be incomplete or development that is not normal. Some symptoms that occur during this time are:

  • Development of breast tissue, also called gynecomastia
  • Voice does not deepen
  • Impaired growth of penis, testicles, and body hair
  • Growth of arms and legs in relation to trunk
  • Lack of development of muscle mass

If this occurs during adulthood, the following symptoms are common:

  • Infertility
  • Decrease of muscle mass
  • Erectile dysfunction
  • Gynecomastia, which is the development of breast tissue
  • Osteoporosis

There are also many mental health problems that may arise. These symptoms are very similar to the symptoms that women experience during menopause. These symptoms include: hot flashes, fatigue, decrease in sex drive, or difficulty concentrating.

If you are experiencing any of these symptoms, then you will want to notify your physician immediately. Once the symptoms have been discussed with your physician, then treatment can begin.

Causes of Low Testosterone

There are two main types of hypogonadism, or low testosterone. Primary hypogonadism is known as primary testicular failure, which originates in the testicles. The other type of hypogonadism is considered secondary. This means that there is a problem with the pituitary gland or hypothalamus, which are both parts of the brain that signal the testicles to produce the testosterone. These two types may be inherited or something that is acquired later in life. In some cases, both types of low testosterone can occur together.

Primary hypogonadism is typically caused by Klinefelter syndrome, mumps orchitis, undescended testicles, cancer treatment, injury to the testicles, or hemochromatosis.

Secondary hypogonadism is when the testicles are normal but do not function correctly because of a problem in the brain. The causes of this may include obesity, aging, Kallmann syndrome, HIV/AIDS, pituitary disorders, inflammatory diseases, medications, or a concurrent illness. Testosterone declines can vary between difference men. Nearly 30% of men that are older than 75 years old have a low testosterone. In some cases, physicians will not treat these cases because of age.

Risk Factors of Low Testosterone

There are many risk factors with low testosterone, which include:

  • HIV/AIDS
  • Injury to testicles
  • Kallmann syndrome
  • Undescended testicles in infants
  • Untreated sleep apnea
  • Chemotherapy
  • Radiation treatments
  • Testicular or pituitary tumors
  • Klinefelter syndrome
  • Hemochromatosis
  • Mumps infection that affected the testicles

Diagnosis of Low Testosterone

Diagnosis will begin with a physical exam. The physician will look at the sexual development, which includes muscle mass, pubic hair, or size of testes. Your physician may then recommend a blood test to see the level of testosterone if you have signs of low testosterone. Early diagnosis is key in treatment. If the blood test and physical examination shows there are signs of low testosterone, then your physician may recommend further testing. Some of these tests can include genetic tests, hormone tests, semen analysis, pituitary testing, or a testicular biopsy. Testing is so important especially in managing your condition. This will allow your physician to choose the correct medications for you.

Treatment of Low Testosterone

Treatment of low testosterone depends on which type you have, your age, and if you are concerned about fertility. For men, there are two main options. The first is hormone replacement, which is used if low testosterone is caused by the testicular failure. This can help to prevent bone loss and restore strength. This treatment can also see an increase in energy, erectile dysfunction, and sex drive. If pituitary is the problem, then pituitary hormones may help to stimulate the sperm production and fertility. This is not necessary if fertility is not a problem. The other way to help men with low testosterone is to proceed with assisted reproduction. This helps couples that have been unsuccessful in conceiving.

In boys, testosterone replacement therapy, or TRT, can aid in stimulating puberty and develop secondary sex characteristics. This helps to increase beard growth, pubic hair growth, penis growth, and muscle mass. Pituitary hormones aid in stimulating testicular growth. An initial dose of testosterone may help to avoid any adverse effects and better mimics what happens naturally.

There are many types of testosterone replacement therapy, or TRT. Your physician will help you to pick the correct treatment for you based on the cost, delivery system, and side effects. Oral testosterone is not recommended for long-term because of the damage to the liver. There are also many risks, that may include sleep apnea, enlarging breasts, growth of the prostate, blood clots, and limiting sperm production.

Injections are typically very safe and also effective. They are given directly into the muscles. The symptoms will vary between each dose and depending on how often you are doing injections. Injections can be given at home, unless you are uncomfortable doing so, and a physician or nurse can administer these injections.

A patch can be given and applied every night to the thigh, upper arm, back, or abdomen. The site can be rotated to lessen skin reactions.

Implantable pellets are surgically implanted under the skin every three to six months.

Buccal cavity, or the gum and cheek, can be filled with a putty-like substance that delivers the TRT to the bloodstream from the gumline.

TRT can be delivered right into the nostrils as a gel. This reduces the risk of transferring the medication to another person through the skin contact. This is typically done three times daily, making it the most inconvenient of treatments.

Lastly, there are many gels that are available. You can typically rub the gel into the upper arm, shoulder, armpit, or thigh. When the gel dries, it is absorbed through the skin. It does not cause as many reactions as the patch. You will not be allowed to shower for a few hours. The side effect of this gel is transferring it to another person through skin contact.

Support with Low Testosterone

The first step to dealing with low testosterone is to find ways to reduce the stress and anxiety that comes with the conditions. It may be best for you to go through counseling alone or with your family. There are also many support groups for people that are going through similar situations. Also, talk with your family about what you are going through. It will take time to adjust, as things are changing pretty rapidly.

Another huge part of coping with low testosterone is to learn all about what you are going through. Ask your physician plenty of questions when you go in for your appointment. Ask for directions of where to learn more about your diagnosis. The best advice is to also begin a notebook. In this notebook, you can write down all of your symptoms and questions. During your appointment, you can write down everything that your physician says. Keep this journal up to date and you can see the changes that are occurring. You may also want to pick someone to go to your appointments with you. This person can help you remember any directions that your physician says and also remember any concerns that you have had since your last appointment.

Summary of Low Testosterone

The first step after your diagnosis, is to learn more about your diagnosis. Ask your physician plenty of questions. Begin a journal and write down the information your physician gives you. You should also write down any questions you think of for your next appointment. It is also important to take care of yourself and also to take time for yourself. Your friends and family will also want to help you. Be open to talking to them about your thoughts and feelings. If you begin to feel overwhelmed, then it is best to go and get mental health counseling.

Request An Appointment

To request an appointment with Urology, call 251-343-9090. To request an appointment with Radiation Oncology, call 251-414-5665.

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