Testosterone Replacement Therapy Isn’t for Everyone

Posted by Oliver Wu, M.D. on Oct 1, 2016, 8:47:00 AM

Millions of men suffer from low testosterone. It can be physically, emotionally and mentally draining and worse – there isn’t a cure. However, men of all ages find relief from a form of treatment called “testosterone replacement therapy.” How do you know if you’re a good candidate for testosterone replacement therapy? Basically, it’s a combination of symptoms and your testosterone number. 

Signs to Watch for

Low testosterone can manifest itself in a lot of different symptoms. The symptoms most men notice first are physical symptoms. Here’s what you should be on the lookout for: 

  • Erectile dysfunction
  • Back pain
  • Increased body fat
  • Fatigue
  • Reduced muscle mass and strength
  • Gynecomastia (or the development of male breasts) 

Oftentimes it’s a combination of these symptoms that help doctors diagnose low testosterone so it’s important to take note of everything you’re feeling. Your doctor needs a clear picture of your health. 

In addition to the physical symptoms associated with low testosterone, mental and emotional symptoms also exist, but sometimes men are either reticent to recognize these as issues or they don’t notice them as symptoms at all. Here are some mental and emotional symptoms of low testosterone to be aware of: 

  • Difficulty concentrating
  • Decreased libido
  • Trouble with memory
  • Depression
  • Irritability
  • Decreased motivation and ambition


Good Candidate Criteria Is Debatable

If you’re noticing the physical and/or mental symptoms of low testosterone creeping up in your day-to-day life, it’s time to schedule an appointment with your doctor. They will likely give you a blood test to measure the total level of testosterone in your body. While there’s some debate on the threshold for low testosterone, the most widely-accepted number is anything below 300 ng/dl. The reason doctors haven’t been able to nail down a specific number to indicate an issue, like with diabetes, is because the hormone levels in everyone’s body is specific to their own chemistry, so what’s low for one person isn’t necessarily low for another. To help put this into perspective, the range of testosterone in most men is 270 ng/dl to 1070 ng/dl. 

You’re likely a good candidate for testosterone replacement therapy if you have a combination of symptoms and a testosterone number below 300 ng/dl. 

Undergoing Treatment: What to Expect

If your doctor decides that you’re a good candidate for testosterone replacement therapy, there are several options available to deliver the testosterone. Injections, topical gels, patches and tablets are among the most popular methods, but each one delivers a different dose and needs to be specially selected for each individual patient. The benefits of testosterone replacement therapy vary from patient to patient, but it is likely that if you are otherwise healthy, you can see an improvement in your mood as well as in muscle mass, fatigue, sleep cycles and erectile dysfunction. 


Dr. Oliver Wu is a board-certified Family Medicine at Kelsey-Seybold’s Clear Lake Clinic. His clinical interests include adult medicine, preventive care, men’s health, diabetes and hypertension.


Topics: low testosterone, testosterone replacement therapy


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