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Androgen Deficiency (Low Testosterone)

What is Testosterone?

Testosterone is the most important male sex hormone in men and it is needed for normal reproductive and sexual function. Testosterone is plays a key role in masculine growth and development during puberty, and for the features typical of adult men such as facial and body hair.

What is Androgen Deficiency?

Androgen, or testosterone, deficiency is when the body is not able to make enough testosterone for the body to function normally. Although not a life-threatening problem, androgen deficiency can affect your quality of life.

What are the symptoms of Androgen Deficiency?

The effects of low testosterone depend on the cause and at what point in your life male hypogonadism occurs.

When it occurs in adult men, the signs and symptoms may include:

  • Erectile dysfunction
  • Infertility
  • Decrease in beard and body hair growth
  • Decrease in muscle mass
  • Development of breast tissue (gynaecomastia)
  • Loss of bone mass (osteoporosis)

Hypogonadism can also cause mental and emotional changes. As testosterone decreases, some men may experience symptoms similar to those of menopause in women. These may include:

  • Fatigue
  • Decreased sex drive
  • Difficulty concentrating
  • Hot flashes

How do you diagnose Androgen Deficiency?

The doctor will ask questions and perform a physical examination to assess for the symptoms and signs of low testosterone and work out what it may be caused by.

Two separate blood tests taken on different days are required to confirm low testosterone levels. A diagnosis of androgen deficiency is only confirmed when blood tests show a lower than normal testosterone level.

What are the treatment options?

Androgen deficiency is treated with testosterone replacement to give testosterone in doses that return the body testosterone levels to normal. Testosterone replacement is available in Australia in the form of injections, gels, sprays or patches;it works very well for men with confirmed androgen deficiency. Once started, testosterone therapy is usually continued for life and needs to be checked regularly by a doctor.

In Australia, there is PBS subsidy for men with serum testosterone levels <6nM. Some symptomatic men with testosterone levels higher than 6nM may still benefit from testosterone supplementation, but will have to pay for the full price of testosterone replacement without government subsidy.

What are the risks of testosterone supplementation?

Testosterone supplementation does carry some possible risks, including worsening sleep apnoea, stimulating benign prostatic hyperplasia, limiting sperm production, reduce testicular size, stimulating growth of existing prostate cancer and blood clots forming in the veins. Recent research also suggests testosterone therapy might increase your risk of a heart attack. Testosterone supplementation should be used for symptomatic people with documented low testosterone levels that warrant treatment.

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