Who suffers from testosterone deficiency, what are the symptoms and how common is it? Best sexologist in Delhi, Dr. P K Gupta, answers seven common questions about testosterone deficiency.
- What are the most common symptoms of testosterone deficiency?
Dr. P K Gupta, sexologist in Delhi, explains, symptoms of testosterone deficiency are usually quite vague. It is often noted that increasing fatigue and lack of initiative come over time.
Reduced sexual desire and erection problems may occur but are not always clearly correlated to serum testosterone levels as there are usually several interacting factors such as explanation.
In blood sampling, a mild anemia is usually noted where the blood value (hemoglobin value) of men with symptomatic testosterone deficiency is most often in the lower reference range.
At very low levels of testosterone in the individual man (the levels in men vary widely, partly due to receptor-level sensitivity that is partially genetically controlled), there is an increased risk of osteoporosis, impact on sperm production, weight gain with increased fat mass relative to muscle.
- Who is suffering from testosterone deficiency?
Testosterone deficiency in an otherwise healthy man who does not have regular medication that can affect testosterone levels is very uncommon, says top sexologist in Delhi.
Classic causes of symptomatic testosterone deficiency (so-called male hypogonadism) are either that there is some form of disease in the testicular leydig cells where the testosterone is formed, such as after chemotherapy, radiation or due to genetic disease to name just a few examples. We then call the testosterone deficiency a primary hypogonadism.
Another reason may be that the pituitary gland (a hormone-producing gland that is part of the brain) or hypothalamus (region of the brain) cannot produce hormones that signal to the leydig cells to form testosterone.
The most common diseases in this group are so-called pituitary tumors, but also genetic diseases such as radiation are other reasons why testosterone cannot be produced at the level needed by the body. We then call the state of secondary hypogonadism.
- How common is testosterone deficiency?
In the absence of other illness and medication with drugs affecting the formation of testosterone (glucocorticoids, opioids, etc.), symptomatic testosterone deficiency is uncommon, even with increasing age, as most endocrine organs have an overcapacity in the event of increased need, explains sexologist doctor in Delhi.
How common is it with symptom-causing testosterone deficiency (hypogonadism) is difficult to answer simply because many studies have only based on the testosterone value to define deficiency and not at the same time more objective symptomatology.
However, its relative rarity was clearly reflected in a large academic study called “Testosterone Trials” published a couple of years ago, which was based on a total of 790 men. The recruitment took place through millions of invitation letters and more than 50,000 telephone interviews to find men who were 65 or older with low testosterone levels (<9.54 nmol / l on two measurement occasions) without any obvious reason other than high age.
- How is testosterone deficiency treated?
According to sex specialist in Delhi, the goal of the treatment is to restore testosterone levels in the body.
There are several different treatment options:
- Testosterone gel used every day
- Testosterone injection usually injected intramuscularly every three months
- Pituitary hormone injection (gonadotropins) in childhood and in so-called secondary hypogonadism. Given as injections one to three times a week. This treatment does not work if the defect is primarily in the testicles.
Which treatment method is most appropriate is discussed with the sexologist in Delhi.
- Can testosterone deficiency lead to other diseases?
Symptomatic testosterone deficiency that occurs in adulthood primarily affects the quality of life that often becomes worse with reduced mental and physical energy and poorer sleep.
Redistribution of body configuration with reduced muscle mass and increasing fat mass. Sex desire and ability can also be affected.
If there is a pronounced deficiency, the risk of osteoporosis increases. Whether there is any connection between testosterone deficiency and cardiovascular disease is debated.
In men with type 2 diabetes, low testosterone levels have been found to be more common than those who do not have diabetes. However, treatment with testosterone has not shown unequivocally that blood sugar, blood pressure or blood fat disorders improve with testosterone treatment, explains sexologist in Delhi.
- Can testosterone treatment cause side effects?
Testosterone therapy may increase blood levels (hemoglobin, Hb). There may also be an increased risk of venous thrombosis for the first time after treatment.
Sensitivity to testosterone and testosterone levels means that some men may have an increase in blood pressure and in men with untreated heart failure increasing difficulty.
The risk of getting prostate cancer has not been shown to increase with testosterone treatment, but in case of already diagnosed prostate cancer, this treatment is usually not given.
In case of tendency to male hair loss, this can be accentuated by the introduction of testosterone treatment, as well as acne, says sexologist in Delhi.