Our Services

Testosterone Deficiency

Testosterone deficiency syndrome is a combination of clinical symptoms and a low serum testosterone level.  These symptoms can cause significant morbidity and a decrease in quality of life.  Signs of testosterone deficiency include low libido, sexual dysfunction, impaired fertility, loss of muscle mass, poor work-out recovery, fatigue, loss of body hair, hot flashes, gynecomastia, mood instability, increased abdominal fat deposition, reduced concentration, and low bone mineral density.  Treatment is directed at symptomatic improvement and health maintenance.  There are now many options available to replace testosterone including depot pellets that last 4-6 months.
 

 

What is the link between stress and testosterone?

Currently there are not many direct links between stress and a man’s testosterone level.  We do know that a woman’s hormone levels can be affected by stress, particularly physical stress on the body.  While there are not direct links, often if does seem as if stress may be a component in decreasing a man’s testosterone, at times through obesity (with those who eat to deal with stress), alcohol intake, or lack of physical exercise due to stress.
 

 

Stress and low testosterone seem to share some of the common symptoms. What are the most prevalent?

Men with low testosterone and those with stress exhibit decreased sex drive (decreased libido), low energy, poor sleep, decreased ability to concentrate and moodiness.  Stress can lead some men to have trouble attaining and maintaining an erection as well.  It can be difficult to determine the ultimate cause without a blood test and subsequent trial of testosterone if the level is low.  If a man does have low testosterone, correction of this may allow him to manage his stress level better.

Who is at risk for low testosterone?

 

Men who are older, obese, lack physical exercise, or have high alcohol intake have increased risk of low testosterone.  Certain medical conditions can also decrease testosterone levels.


How can managing stress can also help manage symptoms of low testosterone?

Managing stress can allow men to focus more on physical activity and maintaining a healthy diet.  The effects of stress and low testosterone can compound the resultant symptoms, like decreased sex drive or erectile dysfunction.  Therefore, improving stress levels can allow improved sexual function, decrease moodiness and allow men to sleep better.


What are some lifestyle changes that can help manage stress (ie, relaxation techniques, getting enough sleep, regular exercise, a healthy diet, etc.)?

Anything that helps men to relax can improve their overall quality of life.  Improved physical activity is the number one issue for most men.  Strength training combined with 20 minutes of aerobic activities like running or cycling can dramatically improve stress and indirectly improve testosterone.  A healthy diet is beneficial to maintain a healthy weight and sleep helps men to improve concentration and decrease fatigue.  At times, testing for sleep apnea may dramatically help in maintaining healthy stress and testosterone levels .


Testosterone options:

Low testosterone can be associated with metabolic syndrome, erectile dysfunction, coronary artery disease, diabetes, depression, osteoporosis, fatigue, low sex drive, poor sleep, high cholesterol, increased abdominal fat, muscle loss, irritability, hot flashes, and inability to concentrate. Treatment may increase risks of worsening urination and prostate size, rises in PSA (and concern/risk for prostate cancer), and polycythemia. There is an acne risk and breast tenderness may occur. Some men will retain fluid and there is a risk to worsen sleep apnea or heart failure as well. Finally, there are reports of testosterone causing heart attacks, strokes or even death.  Research has shown testosterone to increase plaque build up in the heart but not associated heart attacks.  These reports are debated and the literature is not entirely clear on the risk.

As for treatments- there are options of gels applied daily, injections every 1-2 weeks and pellets that last 4 months. There is a patch but the adhesive tends to cause a skin rash. The gels are placed on the chest, legs or underarms and take around 3 hours to absorb. It is best to place these on in the morning and to avoid contact of that area with others following application, plus to wash hands well after applying. The injections raise the testosterone quickly and we can teach you to give these to yourself.  This is generally the cheapest option.  The injection causes a peak of testosterone in 2-3 days and then it slowly drops over the next 2 weeks. The pellets are a slow release, long acting medication, but require an office procedure to put in place.  Additionally, if you get side effects due to this medication we cannot remove it to get a quick stop to those side effects.

There are also options that allow your body to make the testosterone.  The benefit of this option over the above mentioned options is that sperm production (spermatogenesis) will continue or improve.  Be sure to discuss these with Dr. Lowe if you are still interested in fertility. 


‚ÄčOTHER SPECIALTIES AT LOWE UROLOGY

Testosterone Options

Low testosterone can be associated with metabolic syndrome, erectile dysfunction, coronary artery disease, diabetes, depression, osteoporosis, fatigue, low sex drive, poor sleep, high cholesterol, increased abdominal fat, muscle loss, irritability, hot flashes, and inability to concentrate. Treatment may increase risks of worsening urination and prostate size, rises in PSA (and concern/risk for prostate cancer), and polycythemia. There is an acne risk and breast tenderness may occur. Some men will retain fluid and there is a risk to worsen sleep apnea or heart failure as well. Finally, there are reports of testosterone causing heart attacks, strokes or even death.  Research has shown testosterone to increase plaque build up in the heart but not associated heart attacks.  These reports are debated and the literature is not entirely clear on the risk.

As for treatments- there are options of gels applied daily, injections every 1-2 weeks and pellets that last 4 months. There is a patch but the adhesive tends to cause a skin rash. The gels are placed on the chest, legs or underarms and take around 3 hours to absorb. It is best to place these on in the morning and to avoid contact of that area with others following application, plus to wash hands well after applying. The injections raise the testosterone quickly and we can teach you to give these to yourself.  This is generally the cheapest option.  The injection causes a peak of testosterone in 2-3 days and then it slowly drops over the next 2 weeks. The pellets are a slow release, long acting medication, but require an office procedure to put in place.  Additionally, if you get side effects due to this medication we cannot remove it to get a quick stop to those side effects.

There are also options that allow your body to make the testosterone.  The benefit of this option over the above mentioned options is that sperm production (spermatogenesis) will continue or improve.  Be sure to discuss these with Dr. Lowe if you are still interested in fertility. 

Request An Appointment

Request An Appointment

We will attempt to make the appointment as close to your desired date as possible, but this submission is not a guarantee of an appointment at that time. If an urgent visit is needed to discuss sperm cryopreservation prior to cancer treatment, please call the office directly and be sure to notify the staff of this need.

*All green fields are required

OhioHealth Urology Physicians
OhioHealth Riverside Methodist Hospital
Bing Cancer Center
500 Thomas Lane, Suite 3G
Columbus, Ohio 43214

Phone: (614) 788-2870
Fax: (614) 533-0177
 
 

OhioHealth Urology Physicians
OhioHealth Riverside Methodist Hospital
Bing Cancer Center

500 Thomas Lane, Suite 3G
Columbus, Ohio 43214

Phone: (614) 788-2870
Fax: (614) 533-0177