For Men Only: Could You Have Low Testosterone?

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When levels of this male hormone drop, you won't just have sexual problems. It can also affect your mood, weight, and concentration.

Normal Testosterone Levels

Age-related loss of testosterone, is gradual, dropping by about 1% to 1.5% per year beginning at age 40. The result? Low testosterone levels can leave men feeling less energetic, less self-assured, less manly.

In some labs, the normal levels (determined by a simple blood test) of a man's testosterone will measure 300 to 1,000 nanograms per deciliter. However, it's important to confirm low levels of testosterone since many men will have normal levels on repeated testing due to fluctuations of the hormone.

"I felt like something had been taken away from me," Evans says, and it wasn't just about the sex. "I didn't have the strength I once had, and I was not able to build muscle mass."

The Role of Testosterone

Evans's description resonates with Edmund Sabanegh, MD, chair of the urology department and director of the Center for Male Infertility at the Cleveland Clinic in Ohio. 

"I look at testosterone as jet fuel. It keeps men running. Diminished mental clarity, motivation, drive -- all of these things can be related to low testosterone."

Testosterone plays a big role throughout a man's life. The hormone is the prime driver of puberty, responsible for the deepening of the voice, the development of muscles, and the growth of pubic hair. Without testosterone, there would be no beards or moustaches, since it regulates facial hair. Sperm production falls under testosterone's control. In sum, it's the hormone that makes a man a man, and it is what gives men their appetite for sex.

While a decline in blood testosterone may be a normal part of aging and the most common cause of low testosterone, it is not the only one. Testicular cancer, as well as the chemo and radiation used to treat it, can deplete a man's levels of the hormone. Pituitary and thyroid diseases, as well as injuries to the testes, can also drain your testosterone.
 
The Hidden Effects of Low Testosterone

Guys, can you try to think of something other than sex for just a moment? Testosterone is more than just fuel for a sex machine. Low testosterone levels can also cause:

Decreases in bone density, which can lead to osteoporosis.
Diminishing ability to concentrate, as well as irritability and depression.
Increases in body fat, particularly in the midsection, where the buildup puts them at heightened risk for type 2 diabetes, heart disease, and certain cancers.
 
Treating Low Testosterone

Fortunately, there are effective remedies to raise testosterone back up to a normal level. Sabanegh likes his patients' levels to hover around 300 to 500 ng/dl. Treatment comes in several different forms, each with its own pros and cons.

Deep muscle injections are the oldest and least expensive treatment. Given every one to three weeks, they give patients the biggest boost in the first few days, after which levels begin to drop. They're not for the needle shy, and they can be painful when receiving the injection itself.

Patches and gels are applied daily to the skin, and the testosterone is absorbed into the bloodstream. They're easy to use, but some men develop rashes, itching, and other skin irritations. Also, they have to be careful that their partners and children don't touch the gel.

Buccal tablets are placed between the gums and upper lip -- like chewing tobacco (not that anyone should be chewing tobacco). These 12-hour tablets slowly release testosterone into the bloodstream, but they can be bitter-tasting as well as an irritant to your gums.

Subcutaneous (under the skin) implants are the latest treatment in the testosterone-boosting arsenal. Once these implants are in place, they work continuously for approximately six months. Sabanegh says that infections, bleeding, or bruising can occur at the insertion point, though rarely.

Potential Side Effects of Testosterone Treatments

Sabanegh steers patients with sleep apnea away from testosterone therapies, as it may worsen the condition. He also discourages men who are trying to conceive a child with their partners. "In some men," says Sabanegh, "testosterone treatment will turn off the body's own testicular function -- both sperm production as well as testosterone production."

Long-term use of testosterone boosters may increase a man's red blood cell count, thickening the blood and potentially increasing the risk of blood clots. It also can accelerate age-related enlargement of the prostate, a condition known as benign prostatic hyperplasia. However, there is little evidence, according to Sabanegh, that testosterone treatments put men at higher risk of developing prostate cancer.

"We used to worry about prostate cancer, that [testosterone] treatment might accelerate its progress [or onset], but that has not been borne out," he says.

Still, your doctor will likely want to keep a close watch on your prostate and monitor it for any suspicious changes for as long as you are taking testosterone. Other potential adverse effects of treatment can include acne and breast tenderness.
 
The Relationship Between Fat and Testosterone

Maintaining a normal testosterone level is not simply a matter of choosing and sticking with the right treatment. Getting and staying fit is also essential.
According to Sabanegh, fat speeds up the metabolizing of testosterone. The more fat you carry around, therefore, the faster you'll burn through the already-depleted hormone.

"Your general health makes a difference," Sabanegh says. In other words, if you want to get the most out of your treatment and your testosterone, exercising, eating right, and keeping your weight down must be a big part of the prescription.