What is testosterone deficiency?
Though testosterone production typically decreases with age, with deficiency noticeably affecting up to 40% of men over age 40 and 50% of men over age 80, some men experience a noticeable lack of or decline of testosterone earlier in life or at a more rapid pace than usual. The deficiency may affect bone mass, physical appearance, virility, and confidence.
Sandhurst Urology offers diagnosis, management, and medical intervention for testosterone deficiency from our clinic in Bendigo. To book an appointment, please ask your GP for a referral.
Testosterone deficiency can present in a number of ways and vary significantly between affected men. If they present, symptoms may include:
- Hot flashes and sweating
- Decreased sex drive
- Decrease in muscle mass and overall strength
- Breast enlargement (gynecomastia)
- Weaker erections
- Reduced volume of semen when ejaculating
- Mood changes (particularly increased anxiety, irritability, and depression)
- Lethargy and fatigue
- Erectile dysfunction
- Increased body fat around the abdomen
- Decrease in size of the testicles
- Low sperm count (azoospermia) and resulting fertility issues
- Difficulties with concentration and memory
- Poor self-image
- Hair loss and balding (including thin beard growth)
Remember that your own experience with testosterone deficiency is individual – you may not experience every symptom and may experience slightly different symptoms to those specified. For further advice and diagnosis, book an appointment at Sandhurst Urology.
How testosterone deficiency is diagnosed
Though the testicles are the primary producers of testosterone, other bodily structures can impact how much of it is produced and how it is used in the body. For example, conditions of the pituitary gland or hypothalamus can prevent the testicles from receiving chemical signals which prompt them to produce testosterone. To effectively treat testosterone deficiency, your doctor may request a series of tests to help identify its underlying cause.
Diagnosing a testosterone deficiency typically begins with a physical exam. This may involve assessing the penis and testicles for signs of malformation, or examining the prostate for signs of hyperplasia. Based on their findings and after questions about your medical history, your doctor may request some of the following tests:
- Total testosterone level blood test – this test involves taking blood samples at particular times of the day when your testosterone levels naturally beak (typically between 8 and 10am). By comparing results across several days, it can determine whether your testosterone deficiency is caused by deficiencies in the pituitary gland.
- Luteinising hormone (LH) blood test – by assessing other hormone levels, this test may help determine whether your low testosterone levels are caused by a pituitary gland issue or tumour.
- Prolactin blood test – high levels of the hormone prolactin in your blood can indicate pituitary gland disorders which may inhibit testosterone production. Identifying this issue can inform how your doctor treats testosterone deficiency and which treatments will yield the best results.
- Semen analysis – while this test does not measure your testosterone levels outright, analysing the amount and quality of sperm in your semen can help identify whether other fertility issues accompany the hormonal deficiency.
- Checks for other health problems – many other conditions, such as sleep apnoea, diabetes, and some cancers, can cause symptoms similar to those of testosterone deficiency. Your doctor may request other tests to rule these causes out.
Preventing testosterone deficiency
Though some causes of testosterone deficiency are genetic and cannot be reliably prevented, others are contingent on environmental and lifestyle factors and may respond to preventative measures. In addition to specific advice provided by your medical team, the following strategies may reduce your likelihood of developing testosterone deficiency:
- Use appropriate protection during physical activities – damage to the testicles can hamper their testosterone production capabilities. As a result, protecting the testicles in situations where they may suffer damage can decrease your risk of developing a testosterone deficiency.
- Practice safe sex – some sexually transmitted infections, including chlamydia and HIV/AIDS, can damage the Leydig cells and cause them to produce less testosterone. Using barrier contraceptives to prevent disease transmission may prevent this.
- Maintain a healthy lifestyle – studies show a link between low testosterone and obesity. Maintaining a healthy weight, a balanced diet, and an active lifestyle may therefore decrease the risk of testosterone deficiency.
- Avoid drug use – opioid, steroid, tobacco, and excessive alcohol use have all been associated with low testosterone. If you use any of these substances regularly, cutting back or quitting them entirely may improve your testosterone levels.
- Monitor existing health conditions – genetic and lifestyle diseases such as diabetes and obesity can also impact testosterone production. If you suffer from such a condition or are at risk of developing one, careful monitoring may prevent hormonal imbalances.
As with any condition, always seek medical guidance to prevent and treat testosterone deficiency effectively. Ask your GP for a referral to Sandhurst Urology for individualised advice.
Treatments for testosterone deficiency
Testosterone deficiency is very rarely treated with surgery. Typically speaking, surgery is only performed if the deficiency’s cause is traced to a tumour inhibiting hormone production. To improve your testosterone levels without major intervention, your doctor at Sandhurst Urology may recommend one or more of the following therapies:
- Lifestyle changes – as testosterone deficiency can be impacted by factors such as obesity, your doctor may recommend adopting a healthier diet and increased physical movement to increase your testosterone levels.
- Testosterone therapy – this medical treatment aims to increase your testosterone levels by adding a synthetic version of the hormone to your body. Delivered through topical creams and gels, oral medications, short- and long-acting injections, or a variety of other methods, the wide range of therapies available can suit almost all men with testosterone deficiency. As this medication may increase your PSA levels and make prostate cancer harder to detect, your doctor will discuss your medical history before commencing treatment.
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