If you require testosterone therapy? Some questions to ask
What men know about testosterone is heavily influenced by the media, especially since the FDA allowed direct consumer advertising of prescription drugs 20 years ago. Have you seen the ads: Do you fall asleep after dinner? The sex drives down? Enjoying life less than before? Work performance in the tank? It has to be testosterone, right?
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Unfortunately, the answers to those questions are really not as simple as advertisers might make you believe. It is true here as much as with the rest of the medicine, the problems related to testosterone become a little more complicated as it deepens. Think of it as a “tip of the iceberg” problem in which there is much more than is obvious at first glance.
Consider it a guiding light while navigating this uneven path.
- Is your T really low? T levels vary like ocean tides. Then, along with your physical symptoms, your doctor will need at least two levels of testosterone in the morning to make the diagnosis.
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- is something else going on? None of the symptoms of low T that you hear are specific to low T. Up to a dozen other fairly serious medical conditions can mimic the symptoms of low T. Do your body well and make sure your medical provider has ruled out other reasons to feel how it feels
- Why does your T go down? Testosterone levels may fall because the testicle is not doing its job … or because it is not told to do its job. Maybe the engine is not running because the gas tank is empty. This is an important distinction, with real implications for treatment, so make sure your doctor explores the “why” before treating your low.
- Can you increase your T? If the testicle cannot produce enough T, then you need testosterone. But, if the testicle is inactive without enough gas, there is much you can do to improve things without prescription drugs. For example, good sleep hygiene, weight loss and stress reduction are excellent ways to naturally increase testosterone levels.
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- Am I ready for a lifetime treatment? Testosterone replacement stops the body’s natural production of testosterone, reduces the testicles and produces male infertility. Its effects on the heart, blood clots and strokes are hotly debated. Data on increased longevity with testosterone are as scarce as polar bears in Paraguay. And, at some point, maybe between 5 and 10 years after treatment, the testicles will never regain the glory of themselves if they decide to stop. Only you can decide if this is worth it.
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