Low Testosterone

You’re fatigued. You fall asleep soon after dinner. You have trouble concentrating, or remembering. Your work performance is diminished. So is your sex drive. You’re experiencing erectile dysfunction or bone density loss.

Any or all of these symptoms could indicate low testosterone. To healthcare professionals, this condition goes by other names: hypogonadism, andropause and androgen deficiency in the aging male (A.D.A.M.). No matter what it is called, it doesn’t all have to be attributed to normal aging. And there is effective therapy.

Age and Low Testosterone

As early as age 30, a man’s testosterone level can begin to decline. Studies show that it can decrease approximately 1% per year after 30. By age 60, there is a 30% of having low testosterone. While this hormonal decline in women is called menopause, in men it is called andropause—though andropause happens at a much slower rate.

Common Conditions Associated with Andropause

  • Aging
  • Chronic Infections
  • Chronic Opiod Use
  • COPD/Sleep Apnea
  • Diabetes Mellitus
  • Kidney Disease
  • Metabolic Syndrome
  • Obesity
  • Sickle Cell Disease
  • Stress

The A.D.A.M. Questionnaire

This health inventory questionnaire called the A.D.A.M questionnaire was designed to identify patients who potentially might have low testosterone levels. If you answer yes to any three questions or to any single sexual question, there is a strong possibility that you have a low testosterone level. Your physician will order lab tests to confirm the condition and to help decide upon appropriate therapy.

Treatment Options

To deliver hormones and regulate their absorption, your physician may try one or a combination—all designed for your situation.

  • Oral medication
  • Buccal (a patch applied to the upper gum)
  • Transdermal gel
  • Patch
  • Intramuscular injection
  • Subcutaneous pellet


Testosterone replacement therapy is generally safe. This type of therapy is not at all like the kind that makes headlines in sports pages. Your potential therapy isn’t designed or intended to raise levels above what should be normal.

You may also be concerned that therapy will adversely affect prostate health or lead to an increased risk of prostate cancer. While hypogonadal, men may experience slightly worse urinary symptoms or an increase in PSA. However, replacing testosterone into the normal range only increases urinary symptoms and PSA into the range where they would be if the testosterone level was not low in the first place.

Men with testosterone levels in the normal range are at no greater risk of developing prostate cancer than their hypogonadal counterparts. Hypogonadism is not only not protective against prostate cancer, there is some evidence to suggest that hypogonadal men might develop a more aggressive form of prostate cancer.

Also, men on testosterone replacement therapy appear to have improved angina-free exercise periods and better cholesterol profiles than their hypogonadal counterparts. The risks of osteoporosis and fractures are reduced in men on testosterone replacement therapy.