Low testosterone, or “low T,” has become a buzzword in modern-day society. It seems as though you can’t watch any program without seeing an ad for testosterone replacement, and the marketing makes it seem as though it is the solution to all your problems. But is that truly the case, and can a healthcare practitioner other than a urologist honestly give you the best options for testosterone therapy? The answers may surprise you, so let’s dive right in.
The Myth of Ubiquitous Low Testosterone
While there are some men with clinically low testosterone, also known as hypogonadism, the truth is that most men who are feeling the effects of aging have perfectly normal testosterone levels. Unfortunately, testosterone therapy has become an easy way for unscrupulous men’s health clinics and some physicians to prescribe a profitable product. Similarly, many online purveyors of testosterone therapy do not consider a patient’s entire medical history or needs before prescribing testosterone. Of course, patients can’t be blamed for believing that testosterone is the answer to all their questions because it is being marketed as such. However, it’s essential to understand that normal testosterone is not a single number for everyone and can differ from individual to individual.
Even though you may be tested for testosterone and your levels are pretty low, it does not necessarily mean that you have too little testosterone…for you. We have seen patients who have testosterone levels in the 200s who are feeling just fine, while patients in the 500s feel terrible. It’s all dependent on your circumstances and your body. As such, when you come back from a lab test, and you see your testosterone on the low end of the reference range, you can’t make a definitive call.
Understanding Testosterone Decline with Age
Similarly significant, we must remember that we all experience some testosterone decline as we age. It is most certainly not as precipitous as the estrogen decline that female patients experience during perimenopause and menopause. However, this is also perfectly normal; we don’t want to treat it unnecessarily. We’re not looking to turn you into Superman at 60. Instead, we’re trying to treat a clinical issue holding you back.
Risks of Improper Testosterone Therapy
It’s important to remember that testosterone dosages need to be customized to the patient and how they feel. This means that men’s clinics and online providers that do not follow up with you may not provide adequate care. While the idea of “roid rage” from too much testosterone is a myth—since it would take an enormous amount of testosterone to have any life-altering mood changes—there are still serious considerations when taking too much testosterone:
- Testosterone can cause blood to thicken (polycythemia), which may lead to cardiovascular issues, including an increased risk of stroke.
- Though not common, some mood changes can be disruptive to daily life.
- There are fertility concerns that will be discussed below.
As such, getting the correct doses of testosterone is critical, and this is best managed under the close supervision of a urologist.
The Role of Testosterone Therapy in Fertility
For our younger patients who are still of childbearing age and who are looking to have a family, testosterone replacement requires a very delicate balance. When we administer external testosterone, the androgen receptors that would have naturally produced testosterone start to slow, leading to decreased natural production. This explains why many patients wonder why they are unable to conceive while on testosterone therapy. You need your natural testosterone production to conceive.
As such, under the care of a urologist, we can help wean you off external testosterone to increase the likelihood of conception while also considering lifestyle changes and other therapies to support testosterone.
The Bottom Line
For some, testosterone therapy is vital, and Rick’s story is a perfect example of it. I encourage you to watch his video above to understand how it worked for him. However, patients mustn’t believe that testosterone is the be-all, end-all and that just because they don’t feel like they used to when they were 20, they must have a testosterone issue.
Most patients benefit dramatically from improved exercise, diet, and sleep habits, each of which increases free testosterone production naturally. For patients who genuinely have low testosterone levels or hypogonadism, we have appropriate therapies that can change their lives.
The most important thing is to visit a qualified urologist to ensure that you get the proper diagnostic testing, the appropriate dosages, and the follow-up care that ensures your continued health. Testosterone therapy should always be tailored to the individual, not offered as a blanket solution without careful consideration.
