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Should Men Treat Low Testosterone?

At the end of their childbearing years, women go through menopause as a drop in female hormones ends their fertility.

Men, on the other hand, experience a more gradual reduction in the male sex hormone testosterone as they age. The result: a condition known as low testosterone, or andropause.

There’s no medical consensus on whether low testosterone should be treated. Some experts suggest treatment isn’t needed unless the man’s sexual desire has dropped or he’s experiencing erectile dysfunction. But some research shows most men with these sexual problems have normal testosterone levels. Meanwhile, many men with low testosterone have little trouble with sexual function.

Learning about low testosterone — including the risks and benefits of treatment — may help you determine whether you could have the condition and what, if anything, you should do about it.

Q. What is a healthy testosterone level?
A: Unfortunately, there’s no agreement on a “healthy” level. Various medical associations have yet to agree on the level at which a man’s testosterone should be considered “low,” either. What’s more, blood testosterone readings can vary in the same man from day to day, even from hour to hour.

Q. What are the signs of low testosterone?
A: Possible symptoms include:
• Anemia
• Depression
• Decreased bone density
• Low energy and fatigue
• A drop in well-being and vitality
• Decreased muscle mass and strength
• A drop in cognitive function
• Decreased sexual function

However, other chronic diseases can cause many of these symptoms. Your doctor should conduct tests to rule out these causes.

Q. Is testosterone therapy safe?
A: There are significant risks associated with testosterone therapy that you should be aware of. Testosterone therapy has the potential to cause serious health problems in certain patients. It’s important to discuss both the risks and the benefits of therapy with your healthcare provider to determine if therapy would be safe for you. 

Q. Should men be treated for low testosterone?
A: Treatment decisions should be made after a clinical evaluation by your healthcare provider of how low your testosterone is, why it is low and your current medical condition. The clinical practice guidelines from the Endocrine Society, published in the Journal of Clinical Endocrinology & Metabolism, advise against recommending testosterone therapy for all older men with low testosterone levels. Such therapy should be considered for men with significant symptoms caused by a testosterone decrease.

Q. What steps should men take to protect their health as they age?
A: These proactive steps can help older men stay healthy as they age:

• See a doctor regularly to keep up with health screenings and vaccines.
• Exercise regularly, eat a healthy diet, and maintain a healthy weight.
• Talk with a doctor about sexual function. Effective treatments exist for men with problems.

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Sources

“Testosterone Therapy in Men with Androgen Deficiency Syndromes: An Endocrine Society Clinical Practice Guideline.” S. Bhasin et al. Journal of Clinical Endocrinology & Metabolism. 2010, vol. 95, no. 6, pp. 253659. www.ncbi.nlm.nih.gov/pubmed/20525905.

“The Lowdown on Low Testosterone.” Berkeley Wellness Alerts. www.berkeleywellness.com/self-care/sexual-health/article/lowdown-low-testosterone?showcomments=1.

“Testosterone treatment in the aging male: myth or reality?”
Swiss Medical Weekly. www.ncbi.nlm.nih.gov/pubmed/22430839.

“Testosterone Therapy in Men: The Endocrine Society.
www.hormone.org/patient-guides/2010/testosterone-therapy-in-men.