It’s a topic that seems to be getting more attention recently, but it’s one that many men might be too shy to bring up at their annual check-up. Low testosterone is a condition that impacts millions of Americans and Ben Meyerink, MD, with Avera Family Medicine explains what it is and the treatment options that can help correct it.
What exactly is low testosterone?
Testosterone is a hormone we all have, men and women both, and it tends to peak in those puberty years and then declines later in life just very gradually. But in some people this decline is much more expedited, quicker, and testosterone can become lower and problematic, especially throughout middle age and later years of life. And so both men and women do ask questions about it often because it can cause a number of symptoms that many people experience in their day-to-day lives.
What are the common symptoms?
The list of symptoms that testosterone, low T, can create is pretty extensive. The other difficult piece of this is a number of different other things that can go on throughout the body can cause these symptoms. Fatigue, low libido, erectile dysfunction, maybe it's something with muscle mass or weight. Certainly all can be influenced by testosterone, but there can also be other causes of those as well, which makes it tough to piece out the influence testosterone has and doesn't have.
How do you determine if someone has low testosterone?
Blood work, lab work is the most common way to measure testosterone accurately. The timing matters because it actually varies throughout the daytime with our sleep and wake cycles. So most of the time we will check these labs in the morning. There are certain types of testosterone as well. There's not just a one size fits all lab. And there are other hormones that sometimes we will check with it to make sure there's not a genetic disorder or something else going on at the same time. And so that is something that's really important to talk to your doctor about because you need somebody who is knowledgeable with this lab work and timing and what types to order. That way you know what information you're dealing with.
How is low testosterone treated?
You can do medication therapy and many of us do prescribe it and patients do well on it. But before that, a lot of our discussion is often on natural ways to either reverse this or raise it. And those are very common things that we all deal with and need to work on every day. The biggest one I see is often sleep. One of the leading causes if not the leading cause of low testosterone is untreated or undiagnosed sleep apnea. As far as symptoms though, you still have to work on the other things with the testosterone therapy. So maybe it's working on your sleep. Maybe it's working on your exercise pattern, your diet. I often see people maybe who aren't using alcohol daily, maybe they're just social drinkers, but if they cut that out or down their levels will come up significantly on their own. So it's just a complex puzzle. It's not a "medication will cure everything" type issue most of the time. And so it's something that you often need a doctor or somebody else with you to help work on these other things in addition to the medications and the labs and everything else that we do.
What should you do if you're being impacted by low testosterone?
So this is a really common problem. I do think most physicians are happy to address it because it can have an impact on people's lives. It just needs to be done safely, correctly and in conjunction with a number of lifestyle habit changes as well, sleep, diet, exercise, weight, alcohol use. And those are things we love talking about with patients anyway, because those impact a number of health issues, not just testosterone.
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