Testosterone Replacement Therapy
Why is Testosterone important?
Testosterone is an important sex hormone. In men, it has many important roles: libido, strong penile erections, regulation of muscle mass, strong bones, cardiac health, and regulation of body fat.
What is Andropause ?
Andropause in men is equivalent to menopause in women and is due to declining levels of testosterone, hence andropause is also called male menopause or adult onset hypogonadism. Testosterone levels decline with aging at the rate of 1% per year and this decline is more pronounced in free testosterone levels because of alterations in sex hormone binding globulin (SHBG).
What age does andropause occur ?
Andropause is still a subject of debate. Most studies have reported that the andropause starts at 40-60 years of age.
How can I check my testosterone levels?
Testosterone levels can be checked in early morning blood sample (7am-10am). Ideally two tests to be done on two different days to confirm low testosterone levels to initiate testosterone replacement therapy.
What are the common symptoms and signs of low testosterone ?
Low libido, erectile dysfunction, easy fatiguability, unable to lose weight inspite of diet restriction and exercises, and soft bones on bone mineral densitometry are the common manifestations of low testosterone. One should have both symptoms and low blood levels to initiate on testosterone replacement therapy.
What are the natural ways to boost or improve testosterone?
Exercises and diet may help in improving testosterone levels. Any exercise helps but muscle training or endurance training exercises may improve testosterone significantly. Some of the dietary items which boost testosterone levels are ginger, oysters, pomegranates, leafy green vegetables, fish oil, extra-virgin olive oil and onions.
How can I improve testosterone if natural ways don’t help?
Testosterone replacement therapies cause negative feedback inhibition thereby resulting in reduction of sperms counts, so testosterone replacement therapy cannot be initiated in men who haven’t completed family or still want to preserve fertility.
If a man does not prefer preservation of fertility, then various treatment options available are tablets, injections (most-preferred), patches, gels and subcutaneous pellets.
Who is the best doctor for testosterone replacement therapy?
Dr Pramod Krishnappa is the best andrologist dealing with Men’s’ Sexual Health and Male Fertility. He has been trained extensively in high volume Andrology centres in Madrid (Spain), Belgrade, Budapest, Chicago, and New York. It is preferable to consult a urologist who is exclusively trained or specialized in Andrology to seek treatment for low testosterone levels.
Frequently Asked Questions
Symptoms such as reduced libido, erectile difficulties, fatigue, difficulty losing weight, and reduced bone strength can be associated with low testosterone, but symptoms alone are not enough to diagnose testosterone deficiency. Both compatible symptoms and confirmed low blood testosterone are needed before considering low testosterone treatment.
Testosterone levels vary during the day and are generally assessed using an early-morning blood sample. Testing between 7 am and 10 am, with two tests on different days, can help confirm persistently low levels before treatment is considered. Morning testosterone testing can therefore provide a more reliable basis for evaluation.
No. Testosterone levels tend to decline with age, but aging alone does not mean that every man needs replacement therapy. Andropause is generally discussed around 40–60 years, while treatment should be based on appropriate symptoms and confirmed low testosterone rather than age alone.
Yes. Exercise and dietary measures may help support healthy testosterone levels. Muscle or endurance training and a balanced diet containing foods such as leafy greens, fish, onions, pomegranates, ginger, and extra-virgin olive oil are mentioned as potential supportive measures. Natural testosterone support may be considered before replacement therapy when medically appropriate.
This is particularly important because testosterone replacement can suppress sperm production through negative feedback. Testosterone replacement should not be initiated in men who have not completed their family or still wish to preserve fertility. Men concerned about testosterone therapy and fertility should discuss fertility-preserving alternatives with an andrologist.
Yes. Testosterone replacement can reduce sperm production because externally supplied testosterone suppresses the hormonal signals needed for normal sperm production. This makes fertility planning an important part of any testosterone replacement treatment decision.
Options can include tablets, injections, patches, gels, and subcutaneous pellets. Injections are the most preferred option in the treatment approach described on the page, but the appropriate form should be selected according to the patient's needs and medical assessment. Testosterone replacement options can therefore be discussed individually with a specialist.
Yes. Reduced libido and erectile dysfunction can both be associated with low testosterone. However, erectile dysfunction can have several causes, so a low testosterone level should not automatically be assumed to be the sole reason for erection difficulties.
Age-related decline generally develops gradually, whereas a single low test result may not establish persistent testosterone deficiency. Two early-morning tests on different days can help confirm consistently low levels before starting therapy, making testosterone deficiency diagnosis more reliable than relying on one blood-test result.
A urologist or andrologist with specific expertise in men's sexual health and fertility is appropriate for evaluating low testosterone and deciding whether replacement is suitable. The page specifically recommends consulting a urologist who is exclusively trained or specialized in andrology.
