Hormonal imbalances, specifically low testosterone, can have an adverse affect on a man's overall sexual health. Testosterone deficiency, or hypogonadism, affects two to four million men in the U.S. and the prevalence increases with age. Testosterone is the hormone responsible for a man's sex drive. Men who have symptoms should be evaluated by a male sexuality expert such as Dr. Brad Lerner who can successfully diagnose and treat men suffering from any of these common symptoms of low testosterone:
- Decreased energy
- Decreased libido (sex drive)
- Erectile dysfunction
- Loss of muscle mass
- Decreased exercise tolerance
- Change in mental acuity or cognitive function
Low testosterone has also been linked to the metabolic syndrome (obesity, high blood pressure, diabetes, and high cholesterol) as well as decreased bone density, or osteoporosis.
Low testosterone is often an under diagnosed condition. Dr. Lerner typically recommends a blood test to check your testosterone levels. A testosterone level less than 300 is usually considered low. Dr. Lerner may recommend testosterone replacement therapy (TRT) when levels of the male hormone test low and are coupled with clinical symptoms.
Testosterone replacement therapy is an FDA-approved treatment available through several different options, including:
- Skin patches
- Topical gels
- Injectable medications
Oral testosterone medications are currently not FDA approved due to potential liver toxicity.
While each treatment option offers sufficient levels of hormone replacement, they also have different advantages and disadvantages, as well as side effects. Dr. Lerner will go over these options to see which therapy is right for you.
It's important to know that testosterone treatment can decrease sperm counts and even render men sterile (which is usually reversible), so men desiring fertility will often be given alternative medications, such as an aromatase inhibitor or HCG, to help boost their own natural testosterone levels.
When on TRT, Dr. Lerner will closely monitor you for changes in blood count, prostate-specific antigen (PSA) level and/or liver enzymes. This blood testing should take place two to four times per year, and Dr. Lerner will also perform a digital rectal examination on a regular basis.