Low Testosterone

Testosterone helps develop and maintain your sex organs, muscle mass, bone density, sex drive and even red blood cell levels. It can also affect your overall sense of well-being. Your testicles make and release testosterone. And your pituitary gland and hypothalamus control the amount of this hormone in your body.

Hormone levels decline as you age, but that isn’t the only reason you may have low testosterone. Maybe you injured your testicles or have an infection. Or you might’ve been born with undescended testicles or a genetic condition that causes your testicles not to make enough testosterone.

When testicular conditions cause low testosterone, it’s called primary hypogonadism. If it turns out low testosterone levels are linked to your hypothalamus or pituitary gland, then you have secondary hypogonadism.

A low sex drive and erectile dysfunction (ED) are two main signs of low testosterone, but you may have other symptoms, too, like, low energy, fuzzy thinking and increased body fat with less muscle mass. When you notice these symptoms, it’s time to get help.

What to expect at your first visit

Talking about your testicles and your sex life may feel a bit uncomfortable. But we’re used to it. That’s what we do every day. You can count on us to make you feel at ease and more confident in sharing your story with us.

At your appointment, your provider will answer your questions and ask a few of their own, like:

• What symptoms have you noticed?
• How long have you had them?
• How are they affecting your life?
• What prescription or over-the-counter medications do you take?
• Do you smoke or take recreational drugs?
• Do you drink alcohol and, if so, how often?
• What other health conditions do you have?

During this visit, your provider will also do a physical exam to look for any signs and symptoms of low testosterone. You may also get orders for different blood tests to check your testosterone levels and rule out other conditions with similar symptoms. These could include:

• Testosterone tests.
• Luteinizing hormone (LH).
• Prolactin blood test.
• Prostate-specific antigen (PSA) test.
• Blood counts.

Meet Our Low Testosterone Team

When you come to Cleveland Clinic, you’ll get a handpicked care team of providers from different specialties who’ll guide your diagnosis, treatment and follow-up care. These providers are chosen based on your needs and may include:

• Urologists.
• Endocrinologists.
• Pathologists.
• Primary care providers.

This team works together to confirm your diagnosis. Once they pinpoint the cause, they’ll craft a treatment plan based on your specific needs.

Treating low testosterone isn’t a “one-and-done” process like taking a single pill. You’ll start ongoing testosterone replacement therapy (TRT) to rebalance your hormone levels and reduce or eliminate the symptoms that come with it. You may have:

• Testosterone skin gel.
• Intramuscular testosterone injections.
• Testosterone patches.
• Testosterone nasal gel.
• Testosterone pellets.
• Oral testosterone (pills).
• Buccal testosterone tablets (pills applied to your gums).

Your care team will go over which of these treatments is best for you based on your symptoms, test results and treatment goals. We’ll also work with you to help you stop smoking, avoid too much alcohol and drug use, manage your weight and eat a healthy diet. We’ll even diagnose and help treat sleep apnea, if you have it.

Taking the Next Step

Even though testosterone levels drop throughout your life, you don’t have to live with the symptoms. We’re here to help you find out what’s causing your low testosterone and start the right testosterone replacement treatment for you. Our skilled and compassionate healthcare providers listen carefully and guide you through what to expect as you move ahead with treatment.