Depending on the health system of the country you are living in, there are several ways to get a diagnosis for testosterone deficiency. Visiting your family doctor is always a good first step. If necessary, they can refer you to a specialist. Those specialising in men’s health are generally urologists and endocrinologists. However, increasingly, many general practitioners and internists are also specialising in male health issues.
Urologists specialise in disorders of the reproductive organs, kidneys and urinary tract. Erection problems, screening for prostate cancer and the treatment of prostate diseases are also the province of the urologist.
Endocrinology is the branch of medicine dealing with hormone function and hormone-related diseases. Physicians therefore often refer patients to an endocrinologist for further investigations, e.g. in the case of testosterone-related developmental disorders in puberty.
The doctor will begin with a medical interview. He/she will ask about your symptoms and take a full medical history. A physical examination follows where the doctor will look out for physical features of hypogonadism such as body hair, dry skin, body fat and posture. After this, laboratory test will be ordered, particularly for the determination of hormone levels.
any previous diseases (e.g. inflammation of the testes)
any previous relevant operations which can influence your testosterone production
any risk factors such as systemic diseases and certain types of medication
your lifestyle, including exercise, diet, stress and alcohol consumption
your ability to maintain an erection
the occurrence of morning erections
your sexual satisfaction
the amount of ejaculate
the frequency of sexual intercourse or masturbation
The doctor may also check the body hair pattern, muscle mass and strength, and the hardness and size of your testicles. Your doctor may want to determine your blood testosterone level more accurately. For this, you will need to give a small amount of blood to be sent off to a laboratory for analysis. This is best taken in the morning, as blood testosterone levels are at their highest then. If you have a testosterone concentration between 11 and 35 nmol/l, you are considered normal. Testosterone treatment is recommended if your morning testosterone is below 11 nmol/l.