Low Testosterone

Brought to you by

Harvard

Risks & Side Effects

Monitoring Treatment

Testosterone therapy has potential risks and side effects:

If you decide to try testosterone therapy, your doctor should perform:

Prostate cancer. It remains uncertain as to whether treatment with testosterone increases the risk of developing prostate cancer. However, for men who already have prostate cancer, there is reason to avoid starting testosterone treatment. This is because it may encourage the cancer to spread.

An excess of red blood cells. Testosterone helps stimulate the body’s production of red blood cells. Too many red blood cells in circulation can make blood too thick. This makes it easier for blood clots to form. Such clots can cause a heart attack or stroke.

Infertility. Testosterone is absolutely necessary for producing sperm cells. But raising testosterone with injections, gels, patches, or other replacement methods signals the body to turn off production of another hormone necessary for sperm production. If you plan to expand your family in the near future, postpone testosterone therapy.

Fluid retention. A small number of men on testosterone therapy experience swollen legs or other signs of fluid retention. This can be a big problem for men with heart failure, kidney failure, or advanced liver disease.

Acne. Some men may experience acne when they begin testosterone therapy.

Breast enlargement. An uncommon side effect is an enlargement of the breasts. This occurs because the body converts some testosterone into estrogen, which stimulates the growth of breast cells. This can be countered in several ways.

Skin irritation or rash. Some men experience irritation or develop a rash where they apply a testosterone patch or gel. These men usually do better with a different form of testosterone therapy.

Written by Medical School

• A prostate exam and PSA test before starting testosterone therapy, once or twice during the first year, and once a year after that.

• Occasional blood tests to check your testosterone level and check the number of red blood cells in circulation.

Low Testosterone

• A bone density test around the time you begin testosterone therapy. If it is normal, the test should be repeated every 2 years. If bone density is low, it should be repeated every year. Low testosterone can cause bones to thin, making it easier for them to break.

This is called osteoporosis.

The benefits of taking testosterone vary from man to man.

Most men experience a stronger sex drive and improvements in erectile function. Some (but not all) have more energy and improved mood. Work with your doctor to be sure that the benefits outweigh the risks of testosterone therapy for you. If you try it and don’t feel better in 3 to 6 months, talk to your doctor about discontinuing the treatment.

Brought to you by:

Patient Education Center & Harvard Medical School Patient Education Center 2127 Second Avenue North Fort Dodge, IA 50501 service@patientedu.org About This Brochure: This brochure was written by practicing physicians from Harvard Medical School. It is part of a series developed and distributed by the Patient Education Center. All the information in this brochure and on the associated Web site (www.patientedu.org) is intended for educational use only; it is not intended to provide, or be a substitute for, professional medical advice, diagnosis, or treatment. Only a physician or other qualified health care professional can provide medical advice, diagnosis, or treatment. Always consult your physician on all matters of your personal health. Harvard Medical School, the Patient Education Center, and its affiliates do not endorse any products.

Consulting Physician: Anthony L. Komaroff, MD Senior Director, Editorial Operations: Jonathan Nichol Editorial Director: Keith D’Oria

www.patientedu.org

© Copyright Harvard Medical School.

Printed on 10% post-consumer recycled paper.

Read this brochure online. Scan the QR code or visit:

PEC-PC-LT-001

www.patientedu.org/low-t

L

ow testosterone is a condition that occurs when the amount of the testosterone circulating in a man’s bloodstream falls below the normal range and causes noticeable problems. In most men, the amount of testosterone circulating in the bloodstream stays normal for life. In others, however, it falls below normal. When this happens, a man may feel tired, lose interest in sex, or develop other problems that affect quality of life.

What Causes Low Testosterone?

The cause of the natural, aging-related slowdown of testosterone production is unknown. In younger men—and some older men—a low testosterone level can be caused by damage to the testes. Other possible causes include infection, testicular cancer, and conditions that cause abnormal levels of two other hormones: LH and prolactin.

Symptoms Symptoms of low testosterone include: • Decreased sexual desire.

• Increased irritability.

• Trouble getting or sustaining an erection (erectile dysfunction).

• Accumulation of fat around the midsection or in the breasts.

• Depressed mood.

• Trouble sleeping.

• Lack of energy.

• Poor concentration and memory.

• Decreased muscle strength.

• Hot flashes.

Finding the Cause If you have low testosterone, it’s important to find out why. Testosterone is measured with a blood test.

The most common test measures the total amount of testosterone in the bloodstream. Your doctor will ask you questions about past or present illnesses, your family’s medical history, your use of medications and other drugs, and if you are having any sexual problems.

A physical exam will be given. If your answers and the exam raise any red flags, your doctor may recommend other tests, such as those that look at other hormones and/or CT or MRI scans.

If you have low testosterone, it’s important to find out why.

Treatment Generally, your doctor will consider treatment only if you have symptoms of low testosterone and if your blood test shows a low testosterone level. If you aren’t having any symptoms, testosterone therapy isn’t going to make you feel better. If your testosterone level isn’t low, then another condition likely is causing your symptoms.

The goals of testosterone therapy are to: • Improve interest in sex.

• Produce more frequent or sustained erections.

• Increase muscle mass and bone density.

• Reduce depression and fatigue.

Taking Testosterone Low testosterone is treated by adding more testosterone to the body. There are several ways to do this.

Oral lozenge. You place this testosterone supplement between your gums and upper lips twice a day. The testosterone is slowly absorbed through the skin and into the blood.

Patch. A patch containing testosterone releases small amounts of the hormone into the skin.

The patch is applied once every 24 hours to the back, stomach, thigh, or upper arm. Women and children should avoid coming in contact with the patch.

Gel. Gel should be applied daily and rubbed into the skin of the upper arms and shoulders. It’s important to wash your hands carefully after applying a gel and to cover the treated area with clothing to prevent exposing others to testosterone. Women and children should avoid coming in contact with the skin where the gel was applied. If they absorb this “male” hormone into their systems, it can cause changes such as excessive facial and body hair.

Injection. Testosterone is injected into a buttock or thigh once every 7 to 14 days, either at home or in your doctor’s office.

Pellets. Small pellets containing testosterone can be implanted under the skin, usually around the hips or backside. They slowly release testosterone over the course of 3 to 6 months.

L

ow testosterone is a condition that occurs when the amount of the testosterone circulating in a man’s bloodstream falls below the normal range and causes noticeable problems. In most men, the amount of testosterone circulating in the bloodstream stays normal for life. In others, however, it falls below normal. When this happens, a man may feel tired, lose interest in sex, or develop other problems that affect quality of life.

What Causes Low Testosterone?

The cause of the natural, aging-related slowdown of testosterone production is unknown. In younger men—and some older men—a low testosterone level can be caused by damage to the testes. Other possible causes include infection, testicular cancer, and conditions that cause abnormal levels of two other hormones: LH and prolactin.

Symptoms Symptoms of low testosterone include: • Decreased sexual desire.

• Increased irritability.

• Trouble getting or sustaining an erection (erectile dysfunction).

• Accumulation of fat around the midsection or in the breasts.

• Depressed mood.

• Trouble sleeping.

• Lack of energy.

• Poor concentration and memory.

• Decreased muscle strength.

• Hot flashes.

Finding the Cause If you have low testosterone, it’s important to find out why. Testosterone is measured with a blood test.

The most common test measures the total amount of testosterone in the bloodstream. Your doctor will ask you questions about past or present illnesses, your family’s medical history, your use of medications and other drugs, and if you are having any sexual problems.

A physical exam will be given. If your answers and the exam raise any red flags, your doctor may recommend other tests, such as those that look at other hormones and/or CT or MRI scans.

If you have low testosterone, it’s important to find out why.

Treatment Generally, your doctor will consider treatment only if you have symptoms of low testosterone and if your blood test shows a low testosterone level. If you aren’t having any symptoms, testosterone therapy isn’t going to make you feel better. If your testosterone level isn’t low, then another condition likely is causing your symptoms.

The goals of testosterone therapy are to: • Improve interest in sex.

• Produce more frequent or sustained erections.

• Increase muscle mass and bone density.

• Reduce depression and fatigue.

Taking Testosterone Low testosterone is treated by adding more testosterone to the body. There are several ways to do this.

Oral lozenge. You place this testosterone supplement between your gums and upper lips twice a day. The testosterone is slowly absorbed through the skin and into the blood.

Patch. A patch containing testosterone releases small amounts of the hormone into the skin.

The patch is applied once every 24 hours to the back, stomach, thigh, or upper arm. Women and children should avoid coming in contact with the patch.

Gel. Gel should be applied daily and rubbed into the skin of the upper arms and shoulders. It’s important to wash your hands carefully after applying a gel and to cover the treated area with clothing to prevent exposing others to testosterone. Women and children should avoid coming in contact with the skin where the gel was applied. If they absorb this “male” hormone into their systems, it can cause changes such as excessive facial and body hair.

Injection. Testosterone is injected into a buttock or thigh once every 7 to 14 days, either at home or in your doctor’s office.

Pellets. Small pellets containing testosterone can be implanted under the skin, usually around the hips or backside. They slowly release testosterone over the course of 3 to 6 months.

L

ow testosterone is a condition that occurs when the amount of the testosterone circulating in a man’s bloodstream falls below the normal range and causes noticeable problems. In most men, the amount of testosterone circulating in the bloodstream stays normal for life. In others, however, it falls below normal. When this happens, a man may feel tired, lose interest in sex, or develop other problems that affect quality of life.

What Causes Low Testosterone?

The cause of the natural, aging-related slowdown of testosterone production is unknown. In younger men—and some older men—a low testosterone level can be caused by damage to the testes. Other possible causes include infection, testicular cancer, and conditions that cause abnormal levels of two other hormones: LH and prolactin.

Symptoms Symptoms of low testosterone include: • Decreased sexual desire.

• Increased irritability.

• Trouble getting or sustaining an erection (erectile dysfunction).

• Accumulation of fat around the midsection or in the breasts.

• Depressed mood.

• Trouble sleeping.

• Lack of energy.

• Poor concentration and memory.

• Decreased muscle strength.

• Hot flashes.

Finding the Cause If you have low testosterone, it’s important to find out why. Testosterone is measured with a blood test.

The most common test measures the total amount of testosterone in the bloodstream. Your doctor will ask you questions about past or present illnesses, your family’s medical history, your use of medications and other drugs, and if you are having any sexual problems.

A physical exam will be given. If your answers and the exam raise any red flags, your doctor may recommend other tests, such as those that look at other hormones and/or CT or MRI scans.

If you have low testosterone, it’s important to find out why.

Treatment Generally, your doctor will consider treatment only if you have symptoms of low testosterone and if your blood test shows a low testosterone level. If you aren’t having any symptoms, testosterone therapy isn’t going to make you feel better. If your testosterone level isn’t low, then another condition likely is causing your symptoms.

The goals of testosterone therapy are to: • Improve interest in sex.

• Produce more frequent or sustained erections.

• Increase muscle mass and bone density.

• Reduce depression and fatigue.

Taking Testosterone Low testosterone is treated by adding more testosterone to the body. There are several ways to do this.

Oral lozenge. You place this testosterone supplement between your gums and upper lips twice a day. The testosterone is slowly absorbed through the skin and into the blood.

Patch. A patch containing testosterone releases small amounts of the hormone into the skin.

The patch is applied once every 24 hours to the back, stomach, thigh, or upper arm. Women and children should avoid coming in contact with the patch.

Gel. Gel should be applied daily and rubbed into the skin of the upper arms and shoulders. It’s important to wash your hands carefully after applying a gel and to cover the treated area with clothing to prevent exposing others to testosterone. Women and children should avoid coming in contact with the skin where the gel was applied. If they absorb this “male” hormone into their systems, it can cause changes such as excessive facial and body hair.

Injection. Testosterone is injected into a buttock or thigh once every 7 to 14 days, either at home or in your doctor’s office.

Pellets. Small pellets containing testosterone can be implanted under the skin, usually around the hips or backside. They slowly release testosterone over the course of 3 to 6 months.

Brought to you by

Harvard

Risks & Side Effects

Monitoring Treatment

Testosterone therapy has potential risks and side effects:

If you decide to try testosterone therapy, your doctor should perform:

Prostate cancer. It remains uncertain as to whether treatment with testosterone increases the risk of developing prostate cancer. However, for men who already have prostate cancer, there is reason to avoid starting testosterone treatment. This is because it may encourage the cancer to spread.

An excess of red blood cells. Testosterone helps stimulate the body’s production of red blood cells. Too many red blood cells in circulation can make blood too thick. This makes it easier for blood clots to form. Such clots can cause a heart attack or stroke.

Infertility. Testosterone is absolutely necessary for producing sperm cells. But raising testosterone with injections, gels, patches, or other replacement methods signals the body to turn off production of another hormone necessary for sperm production. If you plan to expand your family in the near future, postpone testosterone therapy.

Fluid retention. A small number of men on testosterone therapy experience swollen legs or other signs of fluid retention. This can be a big problem for men with heart failure, kidney failure, or advanced liver disease.

Acne. Some men may experience acne when they begin testosterone therapy.

Breast enlargement. An uncommon side effect is an enlargement of the breasts. This occurs because the body converts some testosterone into estrogen, which stimulates the growth of breast cells. This can be countered in several ways.

Skin irritation or rash. Some men experience irritation or develop a rash where they apply a testosterone patch or gel. These men usually do better with a different form of testosterone therapy.

Written by Medical School

• A prostate exam and PSA test before starting testosterone therapy, once or twice during the first year, and once a year after that.

• Occasional blood tests to check your testosterone level and check the number of red blood cells in circulation.

Low Testosterone

• A bone density test around the time you begin testosterone therapy. If it is normal, the test should be repeated every 2 years. If bone density is low, it should be repeated every year. Low testosterone can cause bones to thin, making it easier for them to break.

This is called osteoporosis.

The benefits of taking testosterone vary from man to man.

Most men experience a stronger sex drive and improvements in erectile function. Some (but not all) have more energy and improved mood. Work with your doctor to be sure that the benefits outweigh the risks of testosterone therapy for you. If you try it and don’t feel better in 3 to 6 months, talk to your doctor about discontinuing the treatment.

Brought to you by:

Patient Education Center & Harvard Medical School Patient Education Center 2127 Second Avenue North Fort Dodge, IA 50501 service@patientedu.org About This Brochure: This brochure was written by practicing physicians from Harvard Medical School. It is part of a series developed and distributed by the Patient Education Center. All the information in this brochure and on the associated Web site (www.patientedu.org) is intended for educational use only; it is not intended to provide, or be a substitute for, professional medical advice, diagnosis, or treatment. Only a physician or other qualified health care professional can provide medical advice, diagnosis, or treatment. Always consult your physician on all matters of your personal health. Harvard Medical School, the Patient Education Center, and its affiliates do not endorse any products.

Consulting Physician: Anthony L. Komaroff, MD Senior Director, Editorial Operations: Jonathan Nichol Editorial Director: Keith D’Oria

www.patientedu.org

© Copyright Harvard Medical School.

Printed on 10% post-consumer recycled paper.

Read this brochure online. Scan the QR code or visit:

PEC-PC-LT-001

www.patientedu.org/low-t

Brought to you by

Harvard

Risks & Side Effects

Monitoring Treatment

Testosterone therapy has potential risks and side effects:

If you decide to try testosterone therapy, your doctor should perform:

Prostate cancer. It remains uncertain as to whether treatment with testosterone increases the risk of developing prostate cancer. However, for men who already have prostate cancer, there is reason to avoid starting testosterone treatment. This is because it may encourage the cancer to spread.

An excess of red blood cells. Testosterone helps stimulate the body’s production of red blood cells. Too many red blood cells in circulation can make blood too thick. This makes it easier for blood clots to form. Such clots can cause a heart attack or stroke.

Infertility. Testosterone is absolutely necessary for producing sperm cells. But raising testosterone with injections, gels, patches, or other replacement methods signals the body to turn off production of another hormone necessary for sperm production. If you plan to expand your family in the near future, postpone testosterone therapy.

Fluid retention. A small number of men on testosterone therapy experience swollen legs or other signs of fluid retention. This can be a big problem for men with heart failure, kidney failure, or advanced liver disease.

Acne. Some men may experience acne when they begin testosterone therapy.

Breast enlargement. An uncommon side effect is an enlargement of the breasts. This occurs because the body converts some testosterone into estrogen, which stimulates the growth of breast cells. This can be countered in several ways.

Skin irritation or rash. Some men experience irritation or develop a rash where they apply a testosterone patch or gel. These men usually do better with a different form of testosterone therapy.

Written by Medical School

• A prostate exam and PSA test before starting testosterone therapy, once or twice during the first year, and once a year after that.

• Occasional blood tests to check your testosterone level and check the number of red blood cells in circulation.

Low Testosterone

• A bone density test around the time you begin testosterone therapy. If it is normal, the test should be repeated every 2 years. If bone density is low, it should be repeated every year. Low testosterone can cause bones to thin, making it easier for them to break.

This is called osteoporosis.

The benefits of taking testosterone vary from man to man.

Most men experience a stronger sex drive and improvements in erectile function. Some (but not all) have more energy and improved mood. Work with your doctor to be sure that the benefits outweigh the risks of testosterone therapy for you. If you try it and don’t feel better in 3 to 6 months, talk to your doctor about discontinuing the treatment.

Brought to you by:

Patient Education Center & Harvard Medical School Patient Education Center 2127 Second Avenue North Fort Dodge, IA 50501 service@patientedu.org About This Brochure: This brochure was written by practicing physicians from Harvard Medical School. It is part of a series developed and distributed by the Patient Education Center. All the information in this brochure and on the associated Web site (www.patientedu.org) is intended for educational use only; it is not intended to provide, or be a substitute for, professional medical advice, diagnosis, or treatment. Only a physician or other qualified health care professional can provide medical advice, diagnosis, or treatment. Always consult your physician on all matters of your personal health. Harvard Medical School, the Patient Education Center, and its affiliates do not endorse any products.

Consulting Physician: Anthony L. Komaroff, MD Senior Director, Editorial Operations: Jonathan Nichol Editorial Director: Keith D’Oria

www.patientedu.org

© Copyright Harvard Medical School.

Printed on 10% post-consumer recycled paper.

Read this brochure online. Scan the QR code or visit:

PEC-PC-LT-001

www.patientedu.org/low-t