TESTOSTERONE DEFICIENCY

Testosterone Deficiency: Diagnosis & Treatment

Testosterone levels,Low Testosterone, Low testosterone diagnosis, Low testosterone deficiency, low testosterone treatment, testosterone health, Low testosterone Doctor, London TESTOSTERONE DOCTOR, sexual pleasure, cardiometabolic health.

Testosterone plays a critical role in sexual pleasure, as well as cardiometabolic, psychological and musculoskeletal health. How do you know if you have low testosterone? What are the symptoms and treatment options? What do you need to be looking for in a clinic and doctor when considering TRT?

What is Testosterone Deficiency?

Testosterone deficiency, also known as male hypogonadism or sometimes low testosterone is when your body isn’t producing enough testosterone. Testosterone is crucial to sexual function, so men with low testosterone often have sexual difficulties as a result.

What are the symptoms of low testosterone?

The three key symptoms are:

  1. Low or absent desire for sex

  2. Erection difficulties

  3. Loss of morning erections

Others symptoms include:

  • Low mood & anxiety

  • Lacking energy, loss of motivation, fatigue

  • Loss of muscle mass, increase in fat

  • Hot flushes

What causes low testosterone?

Testosterone levels peak in your late teens to early twenties, and most men then experience a gradual decline over their lifetime. For many men this doesn’t cause a problem. Some men experience low testosterone for many different reasons.

Accurate diagnosis and thinking about underlying causes of low testosterone rather than just treating symptoms is important.

Possible causes include:

  • Conditions affecting the testicles including genetic conditions such as Klinefelter’s, infections, testicular cancer treatment including surgery and chemotherapy, testicular injuries & trauma

  • Conditions affecting the pituitary such as prolactinomas

  • Medications such as opiates

  • Anabolic Androgenic Steroids & Peformance Enhancing Drugs

  • Metabolic syndrome - obesity, diabetes

  • Exposure to environmental endocrine disrupting chemicals

How is low testosterone diagnosed?

Testosterone levels can vary over time, for many different reasons. Having at least two blood tests, 4 - 12 weeks apart, taken before 11am is important to diagnosis. BSSM guidance is that men with symptoms and a total testosterone level <8nmol/L are likely to benefit from treatment. Men with symptoms and total tesosterone level of 8-12nmol/L may well benefit from a trial of treatment.

However blood tests on their own are insufficient. Just treating blood tests is bad medicine. A careful history by an experienced clinician is important to working out whether testosterone is the cause of symptoms or not. Ruling out other diseases and exploring other aspects is important to a solid diagnosis and management plan.

How is low testosterone treated? What is testosterone replacement therapy (TRT?)

There are multiple ways of treating low testosterone. Some men opt for a trial of lifestyle changes with regular follow up.

For men where fertility is a concern, the use of medications to stimulate your own testosterone production can be helpful.

However, for men with true testosterone deficiency, treatment with testosterone replacement therapy can be life changing.

There are multiple types of testosterone replacement and you can find further details about different types of TRT here.

Why I’m different from most TRT Clinics

There are many “testosterone clinics” filling the gap in care the NHS often leaves behind.

But there are problems with many private testosterone clinics:

  • There is often only one diagnosis: testosterone deficiency. Clinics are keen to fit men’s symptoms into a testosterone box

  • Inadequate training: most doctors don’t have a training in sexual medicine let alone clinical sexology or internal medicine

  • Inadequate follow up: many clinics are very happy to start men on testosterone but offer inadequate follow up or don’t offer follow up with the same doctor at regular intervals

  • Inadequate knowledge or experience to understand why testosterone replacement isn’t working

I offer a very high standard of care, offering a unique combination of:

  • Highly qualified:

    • European certified sexual medicine specialist (FECSM)

    • Trained in both internal medicine (MRCP) & general practice (MRCGP)

  • Thorough, supportive follow up:

    • I see all patients at regular intervals ( at least 1, 3, 6 and 12 months in the first year) and more regularly if needed

    • All appointments are with me directly with adequate time to get to know each other, and explore any concerns

  • Comprehensive assessment and treatment

    • Thorough assessment of both medical and psychosexual issues

    • If testosterone is the issue, a full range of treatments, licensed and unlicensed can be discussed

    • If there are issues other than testosterone, either medical or psychosexual, these can be explored and treated too