Frequently asked questions about testosterone deficiency
Diagnosis of testosterone deficiency
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 tests will be ordered, particularly for the determination of hormone levels.
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 12 and 35 nmol/l, you are considered normal. Testosterone treatment is recommended if your morning testosterone is below 12 nmol/l.
Treatment of low testosterone
The effectiveness of testosterone treatment has been proven in several studies and more than 50 years of experience. The treatment can considerably improve mental and physical well-being and performance in men with testosterone deficiency and associated symptoms. Many patients report positive effects on general mood, self-esteem and vitality. Body shape and proportions become more masculine again. Muscle mass and muscle strength increase, whereas fat decreases. Long term effects of a testosterone deficiency (such as osteoporosis) can be prevented. Testosterone treatment leads to a marked improvement in sexual desire and erections.
No. Only men with testosterone deficiency and related symptoms will notice improvements in their general health and well-being from testosterone treatment. Furthermore, as any medical product can have side effects, regular monitoring is essential while testosterone treatment is taking place.
Your doctor will regularly monitor the progress of your treatment and check for any side effects. If you experience any discomfort or inconveniences during treatment, please report it to your doctor as soon as possible.
No. As long as there are no other contraindications, there is no age limit to receiving testosterone treatment.
Yes. Some studies even suggest that testosterone treatment received in combination with ED medication may improve how your ED drug works. However, discuss with your doctor before combining therapies.
As pointed out in the British Society for Sexual Medicine guidelines on Adult Testosterone Deficiency, termination of testosterone therapy results in reappearance of symptoms and reversal of benefits within 6 months; therefore, testosterone therapy is likely to be required lifelong for persistent symptom resolution and maintenance of health benefits in most men.8
Not only menopausal women have hot flushes. Men with testosterone deficiency may experience hot flushes too, sometimes with sweating attacks too, though it is more rare than that in women.
No, testosterone deficiency does not have any effect on penis size. However, it can have a negative effect on sexual performance, libido and erectile function.
No. All men suffer declining testosterone levels with age. How quickly the levels decline depends on various factors, including genetics, lifestyle and predisposing medical conditions.
- Yassin A, Almehmadi Y, Saad F, Doros G, Gooren L. Effects of intermission and resumption of long-term testosterone replacement therapy on body weight and metabolic parameters in hypogonadal in middle-aged and elderly men. Clin Endocrinol (Oxf). 2016;84(1):107-114. Return to content
- Hackett G, Cole N, Mulay A, Strange RC, Ramachandran S. Long-Term Testosterone Therapy in Type 2 Diabetes Is Associated with Decreasing Waist Circumference and Improving Erectile Function. The world journal of men's health. 2018. Return to content
- O'Connell MD, Roberts SA, Srinivas-Shankar U, et al. Do the effects of testosterone on muscle strength, physical function, body composition, and quality of life persist six months after treatment in intermediate-frail and frail elderly men? J Clin Endocrinol Metab. 2011;96(2):454-458. Return to content
- Morgunov LY, Denisova IA, Rozhkova TI, Stakhovskaya LV, Skvortsova VI. Hypogonadism and its treatment following ischaemic stroke in men with type 2 diabetes mellitus. The aging male : the official journal of the International Society for the Study of the Aging Male. 2018:1-10. Return to content
- Francomano D, Bruzziches R, Barbaro G, Lenzi A, Aversa A. Effects of testosterone undecanoate replacement and withdrawal on cardio-metabolic, hormonal and body composition outcomes in severely obese hypogonadal men: a pilot study. J Endocrinol Invest. 2014;37(4):401-411. Return to content
- Yassin A, Nettleship JE, Talib RA, Almehmadi Y, Doros G. Effects of testosterone replacement therapy withdrawal and re-treatment in hypogonadal elderly men upon obesity, voiding function and prostate safety parameters. The aging male : the official journal of the International Society for the Study of the Aging Male. 2016;19(1):64-69. Return to content
- Ng Tang Fui M, Hoermann R, Zajac JD, Grossmann M. The effects of testosterone on body composition in obese men are not sustained after cessation of testosterone treatment. Clin Endocrinol (Oxf). 2017;87(4):336-343. Return to content
- Hackett G, Kirby M, Edwards D, et al. British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice. The journal of sexual medicine. 2017;14(12):1504-1523. Return to content