Low Testosterone (Low-T)

  • Medical Author:
    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

What are low testosterone (Low-T) symptoms and signs?

It is important to distinguish between a normal decline of testosterone levels and hypogonadism.

Signs and symptoms of low testosterone include:

  1. Change in sleep patterns: insomnia or sleep disturbances
  2. Physical changes: increased body fat and reduced muscle bulk
  3. Sexual changes: reduced sexual desires, sexual dysfunction, or infertility
  4. Emotional changes: decreased motivations, depression
  5. Worsening of sleep apnea
  6. Worsening of congestive heart failure

Although testosterone therapy helps with hypogonadism, whether it helps in the reversal or slowing of normal effects of aging and lower testosterone levels is unclear. Several published research articles have conflicting results and more research is needed to make a final determination about the use of testosterone for healthy aging males.

How do you know if you have low testosterone (Low-T)?

The diagnosis of low-T is based on correlating a low blood level (300 ng/dl or below) with symptoms.

Most of the symptoms are very apparent (see previously), but some need to be further investigated (such as low bone density).

What are the treatment options for low testosterone (Low-T)?

Treatment of low testosterone in hypogonadism is a fully accepted therapy. Treatment in older men is more controversial. Discuss your testosterone levels, symptoms, and side effects of treatment with your doctor to establish whether you should receive therapy and what form of therapy.

There are several ways that testosterone therapy can be administered:

  • Transdermal (skin patch): Usually applied once a day (for example, Androderm). Tends to be clean and easy to apply. There is an available mouth patch which sticks to the upper gums and is applied twice daily.
  • Gels: Applied directly to the skin and then absorbed through the skin (for example, Androgel, and Axiro)n. Dosing is more difficult although these gels are available in single applications packages or premeasured pumps.
  • Injections: Testosterone can be delivered by direct injection.
  • Pellets: Pellets can be implanted into the soft tissue and release the testosterone.

Why no pills? Testosterone is available as a pill but some experts believe long term oral delivery of testosterone can have negative effects on the liver. These other delivery methods bypass the liver (as they don't involve a pill being absorbed through the stomach/intestine) and go directly into the blood stream.

Medically Reviewed by a Doctor on 10/19/2016
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