Men are typically diagnosed with low testosterone (hypogonadism) if their testosterone levels are below 300 ng/dL and they have symptoms, like low sex drive and fatigue. At this point, patients may consider testosterone therapy to bring those levels back to a normal range.
Many men diagnosed with hypogonadism find that testosterone therapy helps recover their sex drive and improve their mood. However, it may not help with erectile function if there are underlying causes of that condition, such as diabetes or heart disease.
Like any treatment, testosterone can have risks and side effects.
Testosterone therapy can be administered in several ways:
• Gels. Most men choose this option. A testosterone gel is applied to the skin daily, usually on the upper arm or shoulder. Men using a gel should wash their hands thoroughly after applying it. They should also be careful to cover the area and make sure that the gel does not rub off on another person’s skin.
• Patches. Testosterone patches stick to the skin on a man’s upper arm, back, stomach, or thigh. Used daily, patches should be rotated to different areas so that the same spot isn’t used more than once every seven days.
• Injections. Testosterone shots can be administered by a doctor or by the man himself. They are usually needed every one to three weeks, though longer-acting preparations may be used every four to six weeks.
• Pellets. Testosterone pellets offer a continuous, steady release of testosterone for several months. They are implanted by a doctor, usually in the hip area, just under the skin.
Depending on the treatment method, testosterone levels may remain constant throughout the day or they may rise in the morning and decrease in the evening, as is typical in the body.
A man’s doctor can help him decide which method is best for him.
Men should not take testosterone if their levels are normal or if they haven’t been tested. The diagnosis of low testosterone should always be made by a qualified healthcare provider.
Following up with a physician is important for men on testosterone therapy. Generally, these men should have their testosterone levels checked every 3-4 months during the first year. This can be done with a simple blood test.
The best time of day for the blood test depends on the type of therapy being used. For men using a patch, testosterone levels tend to be highest about four to eight hours after application. However, men using gels can usually have their levels checked at any time, since this delivery system tends to keep levels constant throughout the day.
It’s also recommended that men on testosterone therapy periodically have digital rectal exams and PSA (prostate-specific antigen) tests to keep an eye on their prostate health.
Because testosterone therapy can increase red blood cell counts, men should also have their hematocrit and hemoglobin levels checked regularly.