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A large percentage of men, who would benefit from testosterone therapy, do not receive it due to concerns of prostate cancer and cardiac events (Mulhall et al., 2018). There is a lack of evidence to support these concerns. Symptoms of low testosterone can be caused by multiple conditions. Low testosterone, also know as “low T,” can include loss of sexual desire, fatigue, or decreased muscle mass. With the use of
testosterone therapy, these symptoms may be reduced.

Low T is more then a blood test. Low T is also measured by the symptoms being experienced. What is your energy level? Is there decreased sexual desire? Have you noticed your muscle mass decreasing despite routine exercise? Testosterone levels, which is measured through a
blood test, combined with symptoms, is an important part of the evaluation process. Morning levels of Testosterone are most effective for
measurement.

Routine monitoring of testosterone levels are important while having testosterone therapy. Knowing how effective therapy is would be identified through these lab results. A condition called polycythemia can develop and these lab results can also alert the provider if this has become a concern. Further evaluation and treatment may be necessary to identify the cause of polycythemia. Literature from the American Urology Association supports the absence of evidence linking testosterone therapy to prostate cancer or cardiovascular events (Mulhall et al., 2018). Low testosterone however, does increase the risk of bone density loss (Mulhall et al., 2018). Discussing the benefits of testosterone therapy will be discussed at your initial visit. Ongoing concerns will be addressed and therapy routinely evaluated.

Some common questions by patients:

How do you know where a testosterone level should be?

The American Urological Association recommends using a lab value of total testosterone lower than 300 ng/dL to identify who would benefit from testosterone therapy (2018).

What is a therapeutic level for testosterone therapy?

Therapeutic levels are considered 450-600 ng/dL and improved symptoms voiced by patient.

How often should I have labs drawn after starting treatment?

Prior to treatment patients should have specific labs drawn and then follow up labs every 6-12 months. At times more frequently if there are any abnormalities.

Citation

Mulhall JP, Trost LW, Brannigan RE et al: Evaluation and management of testosterone deficiency: AUA
guidelines. J Urol 2018; 200:423

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