Also known as Androgen Deficiency (AD), Testosterone Deficiency affects men more commonly than you might think; 1 in 200 men under 60 years of age have low levels of testosterone. Unlike hormonal deficiencies in women, the clinical presentation – that is, the symptoms can be harder to recognise.
There are a number of reasons for this – the symptoms come on more gradually, can be mistaken for other health problems and sometimes men and their doctors don’t even think about testing for AD.
What is testosterone?
Testosterone is a sex hormone produced by the testicles and the adrenal glands (on top of the kidneys). As men get older, there can be a 1% decline in total testosterone blood levels each year. For some men, this doesn’t cause any problems, other men experience symptoms such as low mood, irritability, poor concentration, hot flushes and sweats, decreased libido (sex drive), reduced beard or body hair growth, reduced muscle strength and gynecomastia (man boobs).
Interestingly, low testosterone levels don’t always cause erectile dysfunction. And studies have shown that replacing testosterone in older men doesn’t fix erectile dysfunction. It’s a bit more complicated than just hormones.
Medical conditions linked with Testosterone Deficiency
There are some medical conditions that can increase the risk of developing AD. For example chronic illness, long term use of opiates (morphine and morphine like drugs) for pain, obesity, surgery to the testicles and recreational drug use.
Some men have low testosterone because of problems with the pituitary gland or chromosomal/genetic abnormalities. This is different to the AD associated with just getting older.
How do I find out if I have low testosterone?
Testing is easy to do. You will need to have two early morning bloods tests, as least six weeks apart to check your levels. Testosterone levels fluctuate normally over the course of the day, so have the blood tests done before 9am. To qualify for testosterone injections subsidised by the Federal Government, i.e. on the PBS, the levels need to be below 6 mol/L in men aged over 40 years.
How is AD treated?
Replacing testosterone is important for well being and for the prevention of osteoporosis – brittleness of the bones due to lack of hormones.
Over replacing testosterone is not safe. It can cause a range of health problems such as polycythemia (thickening of the blood) and potentially increases the risk of prostate cancer. This is because prostate cancer is a hormonally dependent cancer.
Treatment is either with injections, creams or gel.
Men receiving testosterone treatment need to have regular blood tests and bone mineral density scans.
Who can prescribe testosterone?
If you think that you have AD, make an appointment with your doctor to arrange testing. Prescriptions for testosterone can only be issued on a PBS prescription by a qualified specialist – either a Sexual Health Physician, Urologist or an Endocrinologist.
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Dr Tonia Mezzini has been helping men with AD for years. If you think that you may have AD, make an appointment to see Dr Tonia Mezzini today.
Dr Tonia Mezzini is known for offering the best possible advice and treatment options for a person’s sexual health care needs. In particular, she cares for patients with:
- Premenstrual Syndrome and Premenstrual Dysphoric Disorder
- Vulval pain syndromes and vulval skin conditions
- Low libido and pain with intercourse
- Polycystic Ovarian Syndrome
- Gender-affirming hormone therapy
- Complex contraceptive choices
- Sexually transmitted infections such as recurrent genital herpes
- Recurrent bacterial vaginosis
- Recurrent thrush
- Menopause and hormonal concerns
- Chronic pelvic pain in men and women
- Painful periods and endometriosis
- Information about sexual health
- Women's Health after cancer treatment
- Androgen deficiency in men