Low testosterone levels in the aging male can result in symptoms such as decreased libido or sex drive, lack of energy, erectile dysfunction, impaired sleep, depression, cognitive decline, easy fatigability or lack of endurance as well as decreased muscle and bone strength. Miami urologists David Robbins, MD, and Amery Wirtshafter, MD are board-certified urologists specializing in the diagnosis, management, and treatment of testosterone deficiency in the aging male also known as male andropause.
Low testosterone is not just a problem for geriatric-aged males. After the age of 30, most men will begin to develop declining levels of testosterone that are measurable on blood tests. The American Urological Association defines low testosterone as blood levels of testosterone below 300 nanograms per deciliter (ng/dL). This drop in testosterone value may be at the root of patient complaints such as decreased libido and energy level. Low T levels can additionally result in decreased bone density known as osteoporosis, decreased muscle mass, depressed mood, and impaired cognition. It should be noted however that there are many additional possible causes of the symptoms listed above that are not related to decreased levels of testosterone such as diabetes, obesity, hypothyroidism, and other chronic medical conditions.
Low testosterone (Low T) levels often set in gradually as a man ages so that they do not even notice the slow changes over time. Men often just assume that the symptoms they are experiencing including decreased sex drive and energy levels are simply a normal manifestation of the aging process. Current data indicates that the prevalence of low testosterone in adult men is about 2% but increases to up to 50% of men over 80 years old. Patients with chronic medical conditions such as diabetes, HIV/AIDS, chronic narcotic use, and chronic steroid use have a higher risk for a testosterone deficiency and should be screen more aggressively. Although there is no cure for low testosterone, there are certainly effective treatments available that can result in significant and noticeable changes in the quality of life of aging men.
The American Urological Association recommends testosterone replacement therapy (TRT) for men with low blood testosterone levels (less than 300ng/dL) and specific signs and symptoms of low testosterone highlighted above and including low libido, low energy, and depressed mood. Patients with conditions such as anemia, diabetes, osteoporosis, testicular radiation, narcotic use, pituitary disorders, and/or steroid use are more likely to benefit from testosterone replacement therapy. Prior to considering TRT, patients may want to consider starting an exercise regimen as increased physical activity and result in improvements in testosterone levels. It is important for a doctor to check baseline levels of your hematocrit, PSA, liver function tests, and pituitary hormone panel prior to starting TRT.
There are several different methods for taking testosterone replacement therapy:
Miami urologists David Robbins, MD, and Amery Wirtshafter, MD have broad experience in the diagnosis and treatment of men with low testosterone (low t). After a formal hormonal evaluation that may include testosterone, free testosterone, SHBG, PSA, and pituitary hormones such as LH, FSH, and prolactin, testosterone replacement therapy may be recommended. Testosterone replacement comes in the form of topical gels and patches, injectable agents, and even long-acting pellets that are placed under the skin known as Testopel.
Low testosterone manifestations are certainly treatable and can result in improvements in a man's quality of life and health. In addition to improvements in libido, energy, and cognition testosterone replacement therapy can promote improvements in muscle and bone strength and potentially improve cardiovascular and metabolic health. Miami urologists David Robbins, MD, and Amery Wirtshafter, MD are experts in the field of testosterone deficiency and hormone replacement therapy. They are available for consultation regarding low testosterone (low T) at our North Miami office.