Download Low Testosterone - Patient Education Center

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
[email protected]
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.