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Low Testosterone (Low T)

Testosterone is the hormone responsible for a man’s sex drive. When a testosterone deficiency is present, a man may experience low libido, lack of energy and erectile dysfunction. There is also a strong association between diabetes and obesity and low testosterone which is why it is important to be seen by a physician for regular health exams.

Symptoms of Low Testosterone

Common symptoms of low testosterone may include:

  • Decreased energy
  • Decreased libido (sex drive)
  • Erectile dysfunction
  • Loss of muscle mass
  • Decreased exercise tolerance
  • Change in mental acuity or cognitive function

Low testosterone has also been linked to metabolic syndrome (obesity, high blood pressure, diabetes, and high cholesterol) as well as decreased bone density, or osteoporosis.


Low testosterone is often underdiagnosed because other psychiatric and medical conditions, as well as medications, can cause these same symptoms. A simple measure for hypogonadism is a blood test to check an early morning testosterone level. A general recommendation is that a testosterone level less than 300 is considered low. Low testosterone levels combined with clinical symptoms may warrant testosterone replacement therapy (TRT).


Accepted methods of testosterone replacement therapy (TRT) in the United States include:

  • Skin patches
  • Topical gels
  • Injectable medications

Oral testosterone medications are currently not FDA approved due to potential liver toxicity. Your testosterone level and other factors will determine which therapy is used. Testosterone treatment can decrease sperm counts and even render men sterile (which is usually reversible), and so men desiring fertility should be given alternative medications to help boost their own natural testosterone levels. Testosterone replacement therapy should never be used in men desiring fertility, and other treatments may be indicated such as an aromatase inhibitor or HCG.

Monitoring TRT

TRT requires close monitoring for changes in blood count, prostate-specific antigen (PSA) level, and liver enzymes.  This blood testing should take place two to four times per year, and a digital rectal examination in needed every 6 months for prostate cancer screening.

Did You Know?

Hypogonadism, or testosterone deficiency (Low T), affects two to four million men in the U.S. and the prevalence increases with age.  It is estimated that while testosterone deficiency can affect up to 38 percent of the population, only five percent of affected men receive treatment.

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