Getting older brings many changes in life, including reduced hormone production. Age brings wisdom, experience, and, unfortunately for many people, physical or cognitive decline. Testosterone deficiency is a condition that affects men and women alike. Low T is not just for males. Testosterone levels typically peak by the time puberty ends, leveling off in the twenties, and then beginning a slow and gradual decline before that decade of life comes to an end.
Testosterone deficiency syndrome, also called hypogonadism and andropause (men), occurs when the body does not produce enough testosterone to meet the demand of the androgen receptors. Every hormone in the body has corresponding receptor cells. These target cells await the signal (binding) from their hormone to initiate an action. Without enough of the hormone, testosterone, in this case, the binding and subsequent action do not occur.
Because testosterone plays a role in a variety of bodily functions, it can have varying effects. That is why two people can have the same diagnosed Low T yet have very different symptoms.
One area we want to point out is that of testosterone deficiency and depression. What many people do not know is that before pharmaceutical companies invented anti-depressants, doctors prescribed testosterone to treat depression. The reason is that testosterone is one of the hormones that work on receptors in the brain. Androgen receptors require testosterone to help maintain a proper serotonin/endorphin balance. Low testosterone often leads to an increase in serotonin and a decrease in critical endorphins that help to maintain a happy and positive emotional state. Also, as you will see as we continue this report, many of the signs of hypogonadism are issues that can further lead to feelings of depression.
Testosterone deficiency can affect men and women when their bodies no longer produce enough testosterone to supply the androgen receptor cells.
What Is Testosterone Deficiency?
Testosterone deficiency is a very specific medical condition – symbolized by the presence of clinically low serum testosterone levels along with associating symptoms of the decline. Because testosterone production decline is a natural occurrence, it is quite possible for many people to have lower levels of testosterone without any issue. Then, what is a testosterone deficiency and how do you know if you have it? That is the question we address in this section.
Testosterone deficiency effects manifest in the body in many ways. It occurs when the decline in testosterone production limits the amount of the hormone available to the androgen receptors. When that happens, the receptor cells that do not receive enough testosterone cannot enact their functions. Since testosterone affects multiple bodily systems, it is possible that energy levels, health, metabolism, emotional state, or brain functions could be involved.
Unlike a cold or virus, testosterone deficiency does not go away on its own. Because the decline in testosterone production continues at a rate of 1 to 2 percent a year, most symptoms of Low T will only worsen with time. The only way to know if you have low testosterone is by undergoing a physical examination, blood test, and symptom review.
Testosterone deficiency is a medical condition symbolized by clinically low blood testosterone levels associated with corresponding Low T symptoms.
Why Does Testosterone Deficiency Occur?
There is not always a direct reason why one person experiences Low T, and another does not. How the body produces and metabolizes its hormones makes a difference. Unlike menopause which brings on a rapid decline in progesterone and estrogen levels (as well as a further decline in testosterone), the gradual decrease in testosterone often allows the body to adjust naturally. It is only when testosterone levels decline rapidly, or the body cannot adjust, that you have problems.
A variety of testosterone deficiency causes are possible, including:
- A tumor in the hypothalamus, pituitary gland, testicles, or ovaries that interferes with testosterone production
- Failure of the hypothalamus or pituitary gland to secrete testosterone-signaling hormones
- Chemotherapy or surgery for a tumor
- Conditions such as Klinefelter or Kallmann syndrome
- Injury damage to the brain or testicles
- Aging and testosterone production decline
- Steroid use
- Opioid abuse
- Obesity
- Diabetes
- Genetic disorders
- Menopause or oophorectomy – women
A unique fact about testosterone that differs from many other hormones is that a person can have normal total testosterone levels yet still be diagnosed with Low T. The reason is testosterone, being a fat-soluble hormone, cannot move freely on its own through the bloodstream. Testosterone must attach to a protein for blood transport. When it arrives at a target cell, testosterone unbinds from the protein (either sex hormone-binding globulin or albumin) and the newly free testosterone molecule can then bind with the androgen receptor. A person can have Low T symptoms because they do not have enough free testosterone available for the binding.
The way the hormone doctor handles the treatment of a testosterone deficiency also depends on whether a person has both low total and free testosterone or just low free testosterone levels. Sometimes, low free testosterone can be the result of too much estrogen conversion. An enzyme called aromatase, produced by belly fat, converts testosterone into estradiol, the body’s primary type of estrogen. When this occurs, it reduces the amount of testosterone available for the androgen receptors to use, resulting in Low T.
There is often no determination of an exact cause of testosterone deficiency.
What Are the Symptoms of Testosterone Deficiency?
The signs of a testosterone deficiency are relatively easy to recognize, but not always so easy to diagnose. That is because testosterone deficiency symptoms are the same as those of growth hormone deficiency and other medical conditions. The only way to know for sure that Low T is the cause is through blood analysis that measures various hormone levels.
Most of the symptoms of testosterone deficiency are the same for men and women, and include:
- Low sex drive
- Decreased sexual pleasure
- Hair loss or thinning
- Reduced bone density
- Joint pains
- Bodily stiffness and loss of flexibility
- Hot flashes (yes, men too)
- Decreased lean muscle mass
- Reduced strength
- Unexplained weight gain
- Insomnia or other sleep difficulties
- Low energy levels, fatigue, lack of endurance
- Difficulty concentrating
- Impaired memory, forgetfulness
- Trouble with cognitive functions
- Slow learning
- Lack of motivation or drive
- Decreased productivity
- Social isolation
- Mood changes
- Depression
- Increased anxiety, irritability, stress
- Bleak outlook for the future
- Poor quality of life
The following are additional signs of testosterone deficiency in men:
- Prostate enlargement
- Urinary trouble
- Loss of morning erection
- Erectile dysfunction
- Low sperm count – infertility
- Gynecomastia (excess estrogen can lead to male breast enlargement)
Here are the additional symptoms of testosterone deficiency in women:
- Vaginal dryness
- Night sweats
- Irregular menstrual cycle
- Menopausal symptoms
- Infertility
If the symptoms of testosterone deficiency are ignored, there is an increased risk of developing any of the following medical conditions:
- Atherosclerosis
- Cardiovascular disease
- Dementia
- Elevated LDL and total cholesterol
- High blood pressure
- Infertility
- Obesity
- Osteopenia
- Osteoporosis
- Type 2 diabetes
Most of the symptoms of testosterone deficiency are the same in men and women.
How Do You Diagnose Testosterone Deficiency?
The diagnosis of testosterone deficiency requires two conditions to be met:
- The individual has symptoms of low testosterone
- Blood analysis shows that testosterone levels are lower than normal
The range of what is considered normal for testosterone levels is a vast spectrum. A person does not have to be below the lowest normal levels to have testosterone deficiency. Doctors know that some men will exhibit signs of Low T once their testosterone levels get below the 400 ng/mL mark. Other men may still be doing fine even below 250 ng/mL. As we mentioned earlier, it is all about how the body metabolizes and uses testosterone, and how it adjusts as production declines.
Hormone specialists look at the entire picture, not just the biochemical evidence of blood tests. The physician takes into consideration the results from a physical examination, information provided on a health history questionnaire, and what is shared during the consultation, as well. By comparing all aspects of the situation, the doctor can then determine if low testosterone is an issue in need of treating.
Many doctors who are not hormone specialists tend to overlook testosterone deficiency in women. It is vital that a woman over 40 who experiences signs of a hormonal imbalance seek the expertise of a qualified and experienced specialist.
To diagnose testosterone deficiency, the hormone specialist will run blood tests, and review the physical examination, consultation, and medical questionnaire findings.
How Do You Treat Testosterone Deficiency?
Hormonal deficiency is best treated by boosting the level of that hormone in the body. To that end, the treatment for a testosterone deficiency consists of a predetermined amount of bioidentical testosterone medication.
The type of treatment will vary considerably from males to females due to the significant difference in the amount of testosterone in their bodies. Men have considerably higher testosterone levels than women. Their treatment dosage will need to reflect that fact. For both women and men, testosterone replacement therapy prescribed by a hormone specialist is extremely safe and effective.
Here are the various types of testosterone treatment available for men:
- Testosterone Injections:
- Testosterone cypionate injections are administered typically once every 10 to 14 days
- Testosterone enanthate injections are administered more often, typically once every 5 to 7 days
- Transdermal Testosterone:
- Testosterone skin patches – once a day, a new adhesive testosterone patch is applied to an area of the skin without hair
- Testosterone gel – a dosage of testosterone gel is rubbed into the skin once a day
- Testosterone nasal gel – a relatively new option is administered into the nasal passage three times a day
- Transbuccal Testosterone – an oral tablet that adheres between the gum and the cheek and replaced twice a day
- Implantable Testosterone Pellets – tiny, rice-sized pellets surgically inserted under the skin every few months
Of all these options for testosterone deficiency treatment for men, the most widely recommended and used are testosterone cypionate injections. Not only are they convenient to use, but they are the lowest in cost of all treatment options. Additionally, there is the least risk of side effects and cross-contamination to others.
Skin patches and gels can cause rashes and other forms of skin irritation. They also increase the risk of others who come into contact with the treated skin receiving an excess of testosterone into their bodies. The result could be problematic for children, women, and pets.
Transbuccal testosterone could lead to gum irritation, sensitivity, and changes in taste, there is also a slight risk of liver toxicity should a tablet be accidentally swallowed. Finally, implantable pellets, although convenient, you could face adverse reactions, necessitating a difficult removal process. In addition to the much higher cost factor, the pellets could accidentally work their way out of the body, reducing the benefits.
Treatment of testosterone deficiency in females is accomplished with transdermal testosterone cream, prepared by a compounding pharmacy to the strength prescribed by the doctor. A woman will most likely rub just a tiny bit of cream to a small area of skin once a day.
It does not take long before the benefits of treating testosterone deficiency begin to appear. Most people will notice that halfway through the first month, they start to sleep better, have more energy, and see a significant change in mood. As time passes, the symptoms associated with Low T begin to decline.
To learn more about testosterone deficiency, please contact RXHormone medical center for a free, no-obligation consultation by phone. We offer simplified and affordable diagnostic testing and treatment options for women and men.