• Feeling fat/weight gain
• Problems sleeping
• Less interest in sex
• Feeling irritable or angry
• Loss of motivation
• Loss of drive at work
• Erection problems
• Nervousness
• Problems with memory and concentration
• Indecisiveness
• Lower self-confidence
• Tiredness
• Muscle loss
• Increased urination
• Depression
• Mood swings
• Loss of energy
• Bone loss
• Hair loss

Tests for Testosterone Levels

If you’re having these symptoms of low testosterone, talk to your doctor. You can get your testosterone level tested. It’s a simple blood test. Get the test in the morning, when the testes release more testosterone. Because a normal level of testerosterone is different for each man, it may be hard to know if you have low testorsterone¯it helps if you had a testosterone test earlier in your life, so you'll be able to see any change. If you do have low testosterone, think about visiting a specialized doctor, like an endocrinologist or urologist, who can work with you to treat this problem.

Treatment for Low Testosterone

Testosterone replacement therapy is an option for men whose natural testosterone level is not within the normal range. Talk to your doctor to find out if testosterone therapy is the right treatment for you. TRT comes in these forms:

• Skin Patch. Applied daily to the upper arm, back, thigh, scrotum, or abdomen. It’s easy to use, and you maintain a balanced amount of testosterone in your body. Your skin could get irritated from the patch. In some men, the testosterone doesn’t get absorbed well through the skin.
• Injections (shots). Injections are given either every week or every two to three weeks. The cost is low. You will need to visit your doctor for injections. With injections, your symptoms of low testosterone may fluctuate because it creates abnormal highs and lows in hormone levels.
• Testosterone Buccal System. You place a tablet in the upper gum area of the mouth. It sticks to your gum or cheek. It stays in place for 12 hours and releases testosterone into your body. The tablet can fall off and shouldn’t be chewed or swallowed.
• Gel. Applied daily to the skin on the shoulders, upper arms, and abdomen. It’s easy to use, and you maintain a balanced amount of testosterone in your body. In some men, the testosterone doesn’t get absorbed well through the skin.
• Oral preparations of testosterone. This is rarely prescribed because it can severely damage the liver.

Benefits and Risks of Testosterone Therapy

There have been no large, long-term studies to tell us the benefits and risks of using testosterone replacement therapy. For the studies that have been done, researchers are not always in agreement about the benefits and risks of TRT. More research needs to be done. At this point, here’s what studies are reporting.

Benefits
Testosterone replacement therapy may have these benefits:

• Improved libido
• More energy and improved sense of well-being
• Increase in bone and muscle mass
• Improved body composition
• Better mood
• Rise in hemoglobin levels to the normal range. Hemoglobin helps red blood cells carry oxygen from your lungs to all parts of your body.

Risks
Testosterone replacement therapy might have these risks:

• Higher chance of prostate cancer
• Rise in hemoglobin levels above the normal range
• Problems passing urine, also called voiding symptoms. This includes poor urine flow, feeling like you can’t empty your bladder, or hesitancy before urinating.
• Liver damage from oral preparations of testosterone
• Sleep apnea (stopping breathing during sleep)
• Breast tenderness and swelling
• Testicles get smaller
• Fertility problems while using TRT
• Skin reaction from patches or gel
• Pain, soreness, or bruising from injection
• Fluid retention
• Acne
• Oily skin
• Increased body hair

Some experts recommend following these guidelines when taking TRT:

• Before you start taking TRT:
  • Get a Prostate-Specific Antigen ( PSA) test and digital rectal exam.
  • Have your hemotocrit or hemoglobin level tested.
  • Tell your doctor if you have sleep apnea. If you’re not sure, ask to be tested.
  • Talk to your doctor about voiding (urination) problems.
• One to two months after you’ve started taking TRT:
  • Visit your doctor to see if the TRT is working.
• Every three to six months:
  • Visit your doctor to see how you’re responding to treatment.
  • Get your testosterone levels measured.
  • Get your hematocrit or hemoglobin levels tested.
  • Get a PSA and digital rectal exam.
  • Let your doctor know if you have sleep apnea or problems passing urine.
• Get liver function tests if you’re using oral preparations of testosterone.
• If you’ve had heart failure or renal inconsistency, use TRT with caution.
• Men with an abnormal result on a digital rectal exam or elevated PSA level should have a negative prostate biopsy before they use TRT.

Last Updated: June 2005

The following resources can help you learn more about aging male syndrome:

Publications

1.   Aging changes in the male reproductive system - This on-line publication contains the definition and information about Andropause.
   
   
2.   Frequently Asked Questions about Testosterone and the IOM Report - This report contains information about testosterone. It includes what testosterone is, “male menopause”, whether one should use hormone therapy, and the latest investigation conducted by the National Institute on Aging (NIA) on the risks and benefits of testosterone therapy.
   
   
3. Low Testosterone and Men's Health (Copyright © Hormone Foundation) - This bilingual fact sheet provides information about low testosterone. It contains what the role of testosterone is in men's health, causes, how it is diagnosed, and the available treatment for this condition.
   
   
4. Patient's Guide to Low Testosterone (Copyright © Hormone Foundation) - This report contains information on testosterone, its production, treatments for low testosterone, symptoms, and data from clinical trials.
   
   
5. Testosterone (Copyright © AACC) - This on-line publication contains information about the testosterone lab test. It explains how it is used, when it is ordered, and what the results mean.
   
   
6. Testosterone Replacement Therapy (Copyright © DUJ) - This on-line article explains what testosterone is and its function. It describes the diagnosis of testosterone deficiency, types of testosterone replacement therapy, and the risks and benefits of this type of therapy.
   
   
7. What Men Should Know About Low Testosterone (Copyright © Men's Health Network) - This brochure contains information about low testosterone, the symptoms, and a quiz that you may take to see if you are at risk for low testosterone.
   
   

Organizations

1. Endocrine Society
   
   
2.   Food and Drug Administration, HHS
   
   
3. Hormone Foundation
   
   
4. Men's Health Network