Not so fast. A low testosterone level by itself doesn't need treatment. Testosterone replacement therapy can have side effects, and the long-term risks and benefits aren't known. Only men with symptoms of low testosterone and blood levels that confirm this as the cause of symptoms should consider testosterone replacement. Talking with your doctor is the only way to know if testosterone therapy is right for you.
Men rarely see Thomas J. Weida, MD, for medical tests without prodding from a wife or girlfriend. When they do show up, Weida jokes that he “can see the drag marks on the carpet.”
It’s amusing, of course. But it can quickly turn serious when a man ignores important symptoms. Weida says he knows of men who got away with ignoring chest pain for a couple of weeks. Eventually, though, they died of heart attacks.
The symptoms of low testosterone are sometimes obvious, but they also can be subtle. Testosterone levels decline naturally in men as they age over decades, and symptoms may appear slowly. Low testosterone symptoms include:
If a man has symptoms of low testosterone and tests show he has a low testosterone level, a doctor may suggest treatment. For millions of men who have low testosterone levels but no symptoms, no treatment is currently recommended.
Forms of Testosterone Supplements
Testosterone replacement therapy is available in several forms. All can improve testosterone levels:
Skin patch (transdermal): Androderm is a skin patch worn on the arm or upper body. It's applied once a day.
Gels: AndroGel and Testim come in packets of clear testosterone gel. Testosterone is absorbed directly through the skin when you apply the gel once a day. AndroGel, Axiron, and Fortesta also come in a pump that delivers the amount of testosterone prescribed by your doctor. Natesto is a gel applied inside the nose.
Mouth patch:Striant is a tablet that sticks to the upper gums above the incisor, the tooth just to the right or left of the two front teeth. Applied twice a day, it continuously releases testosterone into the blood through the oral tissues.
Injections and implants: Testosterone can also be injected directly into the muscles, or implanted as pellets in the soft tissues. Your body slowly absorbs the testosterone into the bloodstream.
Why not a simple testosterone pill? Oral testosterone is available. However, some experts believe oral testosterone can have negative effects on the liver. Using other methods, such as skin patches, gels, orally disintegrating tablets, or injections, bypasses the liver and gets testosterone into the blood directly.