Hypogonadism, or Low Testosterone

Dr. Raymond Costabile and Dr. Ryan Smith specialize in the diagnosis and treatment of low testosterone.

Hypogonadism, also known as low testosterone or low T, can lead to symptoms of decreased energy and libido, difficulty building lean muscle mass, moodiness, difficulty concentrating, and even loss of bone density. Men who have some or all of these symptoms and demonstrate low testosterone on a blood draw are candidates for testosterone replacement therapy (TRT).

There are many options for TRT, each of which has its benefits and disadvantages. The decision about which one is right for you will depend on your personal preferences and a discussion with your doctor. In some cases, different insurance companies may cover one option and not another, which may also be taken into consideration. If the desired effects are not achieved with your initial choice, a different option can be tried to see if it is a better fit for you, your health, and your lifestyle.

Regardless of the type of testosterone replacement therapy chosen, you will need to first be evaluated by your doctor and then monitored at regular intervals (usually every 3-6 months) to confirm good control of your hypogonadal symptoms, check levels of testosterone and perform other related bloodwork, and to ensure that there are no potentially dangerous side effects.

The evaluation and follow-up regimen usually consists of the following:

Follow this link:
Testosterone Replacement Therapy - Department of Urology

TRT can be administered in a variety of ways, says Judson Brandeis, M.D., a board-certified urologist and sexual medicine expert in San Ramon, California. Consult with your health care provider to determine the best option for you.

TRT injections, self-administered under the skin or muscle, can be short-acting (one to two injections per week) or long-acting (one injection every two weeks), explains Dr. Brandeis. Testosterone levels are inconsistent with this delivery, with levels being highest right after injection and lowest before the next injection, he says.

Topical gels, creams, liquids and patches often last for about four days, says Dr. Brandeis. Theyre easy to apply and produce relatively steady levels.

Though tablet-like in appearance, buccal patches are placed on the gum line above your incisor teeth, says Dr. Brandeis, adding that the drug needs to be used every 12 hours.

Delivered as a gel thats pumped into each nostril, intranasal TRT is usually taken three times a day, says Dr. Brandeis, adding that this therapy can be expensive.

Pellets are fast-acting and placed under the skin of the upper hip or buttocks in about five to 10 minutes in a physicians office, says Dr. Brandeis. Over the course of four to six months this pellet dissolves, providing a consistent and stable level of medication, he says.

The FDA has approved two testosterone capsules that may be taken orally for the treatment of low testosterone. The capsules can be taken twice daily with food.

More:
Testosterone Replacement Therapy (TRT): Is It Right For You?