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Testosterone is a hormone produced by the testicles and is responsible for
the proper development of male sexual characteristics. Testosterone is also
important for maintaining muscle bulk, adequate levels of red blood cells, bone
growth, sense of well-being, and sexual function.
Inadequate testosterone production is not a common cause of erectile
dysfunction (ED). When ED does occur with decreased testosterone production,
testosterone replacement therapy may improve the ED.
What causes testosterone deficiency?
As a man ages, the amount of testosterone in his body gradually
declines. This natural decline starts after age 30 and continues throughout
life. The significance of this decline is controversial and poorly understood.
Among the potential causes of testosterone deficiency are:
- injury or infection to the
testicles
- chemotherapy or radiation
treatment for cancer
- genetic abnormalities such as
Klinefelter’s Syndrome (extra x chromosome)
- hemochromatosis (too much iron in
the body)
- dysfunction of the pituitary
gland (a gland in the brain that produces many important hormones)
- medications, including hormone
analogues used to treat prostate cancer and steroids
- chronic illness
- cirrhosis of the liver
- chronic renal (kidney) failure
- AIDS
- inflammatory disease such as
sarcoidosis (a condition that causes inflammation of the lungs and other
organs)
- stress
- alcoholism
- congenital conditions, Kallman’s
Syndrome (low hormones, inability to smell and other abnormalities)
What are the symptoms of testosterone deficiency?
Symptoms of testosterone deficiency include the following:
- decreased sex drive
- decreased sense of well-being
- depressed mood
- difficulties with concentration
and memory
- erectile dysfunction
What are the changes that occur in the body with testosterone
deficiency?
Changes that occur with testosterone deficiency include:
- a decrease in muscle mass, with
an increase in body fat
- variable effects on cholesterol
metabolism
- a decrease in hemoglobin and
possibly mild anemia
- fragile bones (osteoporosis)
- a decrease in body hair
How do I find out if I have a testosterone deficiency?
The
only accurate way to detect the condition is to have your doctor measure the
amount of testosterone in your blood. It sometimes may take several measurements
of testosterone to be sure if a patient has a deficiency, since levels of
testosterone tend to fluctuate throughout the day. The highest levels of
testosterone are generally in the morning. This is why doctors prefer, if
possible, to obtain early morning levels of testosterone.
What options are available for testosterone replacement?
The options available for testosterone replacement are:
- intramuscular injections,
generally every two or three weeks
- testosterone patches worn either
on the body or on the scrotum (the sac that contains the testicles). These
patches are used daily. The body patch application is rotated between the
buttocks, arms, back or abdomen.
- testosterone gels that are
applied daily to the shoulders, upper arms, or abdomen.
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