Men are living longer than their ancestors. With increased life expectancy we are discovering new challenges and approaches to support optimal aging. One such approach to sustaining vibrancy is to address testosterone levels and low testosterone treatment.
Dr. Philip Rabito is a Mount Sinai trained endocrinologist with over 25 years of clinical practice experience who is an expert in testosterone replacement therapy. To explore the causes and treatment options for low testosterone in our New York, NY office on the Upper East Side of Manhattan, please call 877.703.3775.
What is Low Testosterone and Why Do My Levels Matter?
Testosterone is the primary male hormone which imparts typical male characteristics including muscle mass, facial hair and sexual characteristics. Testosterone is produced directly by the testes, however there is a complex homeostatic feedback loop involved in hormone level regulation that also includes the hypothalamus and pituitary glands in the brain. A normal testosterone level ranges from 300–1,000 ng/dl, however these levels are age-dependent.
Maintaining a normal testosterone level is important for many reasons beyond optimizing sexual health. Testosterone supports optimal bone density and reduces fracture risk, optimizes reproductive health (male fertility), maintains muscle mass and red blood cell production.
Testosterone is also essential for improving energy levels, mental health and optimizing an overall sense of well-being.
Low Testosterone Treatment - Important facts:
- Aging is associated with lower levels. In fact, levels decrease by approximately 1 percent every year after the age of 30.
- Testosterone production can be adversely affected by several factors, including conditions affecting the brain (pituitary and/or hypothalamus glands) or testicles. It is imperative to understand the cause in order to rule out significant underlying pathology, instead of simply replacing testosterone without knowing such vital information.
- Your testosterone levels vary according to the time of day. Testosterone levels typically peak in the early morning and nadir at the hour of sleep.
- To accurately assess testosterone levels, it is necessary to test more than once, and to test in the morning after fasting for at least 8 hours.
Low Testosterone Treatment - What are the Signs and Symptoms?
The most commonly associated symptoms include those related to sexual health, such as low libido and erectile dysfunction. However there are many others. The short list includes:
- Enlarged and/ or tender breasts (gynecomastia)
- Decreased testicle size
- Decreased muscle/ lean body mass
- Increased abdominal fat
- Reduced facial and/or body hair
- Diminished muscular strength
- Mood changes, including anxiety and/or depression
- Sleep disturbance
- Diminished mental focus and memory
- Increased insulin resistance and risk of Type 2 diabetes (due to reduction in lean body mass and increase in fat mass).
Low Testosterone Treatment - How is It Diagnosed?
Endocrinologists are experts at diagnosing and treating hormone disorders. As part of his esteemed wellness, anti-aging, preventative medicine practice, Dr. Rabito starts the process by obtaining a thorough history at the initial consultation. As part of a comprehensive laboratory workup, Dr. Rabito then orders appropriate tests to assess the testosterone axis and to elucidate the potential causes of testosterone deficiency.
Is Low Testosterone Treatment the Only Way to Treat Low Testosterone?
It can be irresponsible and dangerous to administer testosterone in the absence of documented deficiency. Once the diagnosis is established, the treatment options vary according to the clinical scenario. For instance, a common cause of testosterone deficiency is obesity, for which the appropriate treatment would be an intensive weight loss program. For other patients, who are interested in preserving fertility, testosterone treatment for hormone deficiency is not the best option. In this instance, there are other agents employed that raise testosterone levels while preserving fertility. It is important to also note that many “anti-aging” clinics are using testosterone in a cavalier fashion without appropriately monitoring labwork, and thus creating significant risk. It is imperative to be diagnosed, treated and closely monitored during this treatment by a physician who is an expert in the field.
As an experienced endocrinologist and expert in hormone replacement therapy, Dr. Rabito will manage your testosterone replacement in a safe and effective manner.
Frequently Asked Questions
What Are the Potential Side Effects of Testosterone Replacement Therapy?
Potential side effects include acne, oily skin, fluid retention, breast tenderness, and increased red blood cell production. Testosterone therapy can also reduce sperm production and may worsen untreated severe sleep apnea. Dr. Rabito evaluates your health history and monitors laboratory results to help manage treatment risks.
What Are the Different Forms of Testosterone Replacement Therapy?
Testosterone replacement therapy is available in several forms, including:
- Injections: Testosterone administered at scheduled intervals.
- Topical gels: Applied to the skin daily.
- Skin patches: Deliver testosterone through the skin.
- Pellets: Implanted beneath the skin to release testosterone gradually.
Each option has different dosing requirements and considerations. Dr. Rabito can help determine the right approach based on your medical history and treatment needs.
Will I Need Testosterone Replacement Therapy for the Rest of My Life?
Not necessarily. Treatment duration depends on the underlying cause of your testosterone deficiency. Some men have permanent conditions requiring long-term therapy, while others may improve after addressing contributing factors such as obesity. Dr. Rabito evaluates the cause of your deficiency before recommending a treatment plan.
How Often Will My Testosterone Levels Need to Be Monitored During Treatment?
Testosterone levels are typically checked within the first few months of treatment and periodically afterward. Monitoring may also include red blood cell counts and other tests based on your age, health history, and treatment method. Dr. Rabito adjusts your monitoring schedule based on your response and lab results.
What Happens if I Stop Testosterone Replacement Therapy?
After stopping treatment, testosterone levels may decline, and symptoms such as fatigue, reduced libido, or low energy may return. Your body's natural testosterone production may take time to recover, particularly after prolonged therapy. Dr. Rabito can evaluate your hormone levels and discuss next steps before discontinuing treatment.
Can Sleep Apnea or Poor Sleep Contribute to Low Testosterone?
Yes. Poor sleep and obstructive sleep apnea are associated with lower testosterone levels in some men, although the relationship is complex. Untreated severe sleep apnea is also an important consideration before starting testosterone therapy. Dr. Rabito can review your sleep history and determine whether you need further evaluation.
Schedule your Consultation Today
Low testosterone is a common problem, that is not diagnosed often enough, and deserves due diligence in diagnosis and treatment. For more information regarding Dr. Rabito's approach to treating low testosterone, as part of his overall wellness and preventative medicine practice, please contact our New York, NY office at 877.703.3775.
