Low T
Are you more easily fatigued than you should be? That is just one of the many symptoms of low testosterone? Surprisingly, men of all ages, even in their 20’s, are increasingly being diagnosed with Low T or Low Testosterone levels. Some of the symptoms associated with low T include: gradually increasing fatigue; decreasing sex drive (libido); decreasing mental sharpness; and, weight gain due to slowing metabolism.
The first question, before beginning any low T treatment, is to determine if a man needs to preserve his fertility. Effective Testosterone replacement therapy will diminish the affected male’s sperm count to zero or very low levels. If known ahead of time, your doctor can take measures to increase a man’s low Testosterone level by stimulating the testicles to make more of their own Testosterone, and this is the “sperm friendly” way to treat Low T.
The effects of just adding Testosterone to a male with Low T begin with the brain sensing a high level of testosterone and therefore it shuts down testicular stimulation. This shutdown causes the testes to stop producing their own testosterone and sperm. The shutting down of sperm production will result in severe male infertility, often reducing sperm counts to zero and testicle shrinkage also occurs. The shrinking of the testicles may not be reversible.
One of the “sperm friendly” treatments is the use of oral pills such as Clomid, Tamoxifen, or Letrizole, which is discussed further in the aforementioned blog post. These pills can be used effectively to improve testosterone levels and preserve fertility. However, there is a chance (about 40%) that these medications could have estrogen effects at the brain level, resulting in reduced sex drive. If this happens, the pills are stopped and sex drive returns to normal within 1-2 weeks. In such cases, we then switch to HCG (human chorionic gonadotropin) which is a biological equivalent to one of the normal brain hormones that stimulate the testicles (LH). With the use of HCG, there are no negative effects on the man’s sex drive.
Estrogen (Estradiol) is present in males as well as females, and must be taken into careful consideration. Too high a level of Estrogen in a man can lead to moodiness and significant water weight gain. Rarely, if the Estradiol goes too low, then the man may experience ED.
In all cases, low testosterone is best handled by an expert in Low T and male health rather than by your Primary Care Physician. Contact a local urologist for more information or a consultation regarding Low T or other male health issues.
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