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Testosterone deficiency is common over the age of 40, and affects up to 12% of men aged 50 and over. Affecting more than 790,000 men in the UK, this treatable condition can cause symptoms of tiredness, irritability, depression, low sex drive,, loss of muscle and weight gain.
What is testosterone deficiency?
Testosterone plays an important role in physical and emotional wellbeing. Its roles include maintaining muscle and bone strength, sperm production, and the desire to have sex (libido). Testosterone deficiency is a failure of the body to produce enough testosterone to maintain healthy levels.
Who gets testosterone deficiency?
The reasons for having testosterone deficiency are not always clear. After the age of 30 our testosterone levels begin to drop, however, the chances of it being present are higher in men who have certain other conditions, including:
- Diabetes (up to 50% of men with type 2 diabetes have low testosterone levels)
- High blood pressure / cholesterol
- Heart diseaseHeart disease
- Any chronic inflammatory condition (such as asthma or arthritis)
- Medications (a large number of prescription drugs can also reduce testosterone levels)
- Cancer treatments
How can testosterone deficiency be treated?
Testosterone deficiency can be diagnosed easily in most cases by listening to your symptoms and arranging simple bloods tests. Based on these, we can decide whether testosterone replacement therapy (TRT), is suitable for you. There is excellent evidence that, when used properly, TRT can help alleviate all of the symptoms listed above.
Recent good quality evidence suggests that safe use of TRT in men may be associated with a decreased risk of cardiovascular events, such as heart attacks and stroke.
There are different treatments for testosterone deficiency; the one that’s best for you can be discussed during your consultation:
- Gels applied to the skin each day
- Injections into the muscle (every 2-3 weeks or every 10–14 weeks)
Once you start treatment it is important to attend follow-up appointments so that we can make sure your treatment is working, and doing so in a safe manner.
What can you do to increase your testosterone levels naturally?
Improving your overall health can help to boost testosterone levels:
- Maintain a healthy weight. Losing weight can help increase testosterone levels.
- Stay active. Regular physical activity helps your brain send out testosterone-boosting signals.
- Reduce stress.
- Eat a healthy balanced diet. Your doctor can advise on this.
Testosterone deficiency can be treated.
If you want further information or wish to make an appointment please contact me below
Should I take testosterone replacement therapy?
This is really the question when it comes to testosterone deficiency. It is hard to get testosterone replacement in the NHS, and it can be too easy to get it from private clinics. Therefore how do you know if testosterone replacement is for you?
1. You need a blood test to prove you have low testosterone levels. No clinic of value will give you testosterone replacement therapy if you have normal testosterone. That’s just taking steroids.
2. What is normal? Sadly the reference range for what a normal level of testosterone is varies widely in the NHS with no real agreement. This is because patients can be asymptomatic with low levels and may not need therapy. However, it can also stop legitimate patients being treated. If in doubt ask.
3. Don’t assume that low levels of testosterone mean that taking testosterone replacement is the best option. The key is to find out why levels are low. For example, if you are obese, drink a lot of alcohol, and take anti-depressants, changing these triggers may be the key to improving your hormone profile, rather than taking testosterone.
4. Evidence is equivocal. Testosterone replacment does not work for everyone. Despite best efforts, for some people, replacement therapy does not provide the improvement in lifestyle and wellness that we hope for. The important thing in these cases to look for other causes of symptoms.
5. So what should I do? If you have symptoms of low testosterone, get tested, check your value with a nationally agreed reference range (not your local NHS level), consider testosterone replacement treatment, but be open to the possibility of other causes for your symptoms, and don’t just take your clinic’s word for it if you don’t feel better.
What are the signs and symptoms of testosterone deficiency?
Testosterone deficiency is associated with sexual, physical and mental symptoms that can affect your everyday life:
Your sex life
- Low sex drive
- Problems with erections
- Difficulty achieving orgasm
How you feel
- Low mood or irritability
- Reduced wellbeing
- Loss of concentration
- Hot flushes and sweats
How you look
- More body fat
- Male breasts
- Loss of muscle and strength
Common myths around testosterone levels in men
Abstinence increases testosterone levels
- In the short term there is some evidence being abstinent can temporarily increase testosterone levels, but over longer periods, testosterone levels actually decrease.
Different types of exercise
- There has been widespread debate around what type of exercise is best to produce increases testosterone levels. However, current evidence suggests it is the intensity that is most beneficial for health rather than the type of exercise. Short bursts of high impact/high intensity exercise appear to the produce the best results in metabolic stimulation and hormone production.
- There is no evidence that any over the counter supplements, including tribulus, taurine, fenugreek, or ginger will produce increases in testerone levels
Vitamins and Minerals
- For healthy individuals on a balanced diet, additional vitamins and minerals will make no difference to testosterone production in men. However, there is some evidence that additional zinc or selenium linked to sperm quality, but not overall testosterone production.