Testosterone: High or Low, What’s the Big Deal?
Testosterone is important to a man’s health, says UNC Health urologist Marc J. Rogers, MD. Here’s the real deal about why, and what to do if you’re concerned about low testosterone.
Hypogonadism is a condition associated with low serum testosterone levels and symptoms such as fatigue, decreased libido, weakness, and weight gain. It is known to occur with aging, as most men have declining testosterone levels beginning in their 30’s. Low testosterone levels have been associated with decreased muscle mass and strength, osteoporosis, depression, decreased cognition, ED, and metabolic syndrome. Testosterone replacement therapy (TRT) has been shown to increase lean body mass, improve bone mineral density, increase cognitive performance, and improve sexual function.
Historically, the concern for TRT was its effect on the prostate. Despite evidence that the prostate does enlarge slightly on TRT, no studies have shown any significant worsening of urinary symptoms while on therapy. Studies have also demonstrated no significant change in PSA while on therapy. An increasing PSA while on TRT may indicate underlying malignancy and warrants evaluation. There has been no increased risk of prostate cancer demonstrated with TRT. Additionally, studies have demonstrated no increased risk of recurrence in men on TRT after undergoing treatment for prostate cancer. Small studies of men with active prostate cancer have shown no progression of disease on TRT.
There are many options for TRT, each of which has its benefits and disadvantages. The decision about which one is right for you will depend on your personal preferences and a discussion with your physician. In some cases, different insurance companies may cover one option and not another, which may also be taken into consideration. If the desired effects are not achieved with your initial choice, a different option can be tried to see if it is a better fit for you. A summary of the most commonly used TRT options is provided below.
Regardless of the type of testosterone replacement therapy chosen, you will need to be monitored at regular intervals (usually every 3-6 months); both to confirm good control of your symptoms and to ensure that there are no potentially dangerous side effects.(Read More)
The follow-up regimen usually consists of the following: