While your total testosterone level may remain “normal” the number of your bioavailable testosterone declines due to an increase in SHBG (sex hormone-binding globulin) with age so despite “normal” total levels you get symptoms.
Even worse estrogen levels tend to increase with age or the ratio of estrogen to testosterone increases, which are both are bad news. Estrogen levels in excess can cause a venous leak in the penis preventing erections and increase prostate cancer risk. Low estrogen on the other hand can cause problems with erections possibly and can cause bone loss (osteoporosis).
It is estimated that about 5% of us men with low testosterone receive treatment. This is a disturbing figure considering the benefits I have seen with patients receiving testosterone therapy, which include:
Of course, we never just do testosterone replacement alone because we want to treat the whole person but a shot of testosterone can be life-changing for some men. The decline in your testosterone was likely so insidious that some of your problems may not even be evident until we get you treated. Some of the treatments commonly used include:
For those of you who want to increase your growth hormone levels (HGH) there are several ways to do this and many of the above-mentioned treatments, including testosterone replacement, will help increase growth hormone levels naturally.
We also monitor treatment with lab tests and physical exams to improve results and decrease risks. Some doctors may only monitor your testosterone levels. The problem with this is that estrogen levels may increase or may already be elevated before treatment but when we keep an eye on estrogen with lab tests it can easily be reduced.
The other problem we always want to address is keeping your testosterone levels fairly stable. Basically, we want to copy nature. When we get your testosterone levels optimal you can expect to have daily morning erections (men only). The two main approaches we use most often for men are cream or injections. With testosterone cream, we can use a daily dose applied to the skin or mucosal surface so your daily levels stay pretty consistent. For injections, we usually do this once weekly along with a couple of doses of hCG injections later in the week to help keep your levels from dropping off. If we need to do treatments to prevent the conversion of testosterone to estrogen we have natural and prescription approaches.
It could be said that testosterone is what makes men, men. It gives them their characteristic deep voices, large muscles, and facial and body hair. It plays a role in sperm production, fuels libido, and contributes to normal erections. It also fosters the production of red blood cells, boosts mood, and aids cognition.