Testosterone levels begin to decline in men starting around 30 years old and continue to decline for the rest of your life.  There typically is a shaper decline starting around 40 years old.  These levels can decline, on average, around 48% according to a study in the Journal of Clinical Endocrinology and Metabolism in 2002.  Testosterone replacement in men can provide many benefits.   

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Symptoms of low testosterone include:

• Fatigue, loss of energy

• Change in mood, especially depression or low mood

• Irritability, anger or bad temper (these can also occur when testosterone levels are too high)

• Decreased sex drive

• Decrease in memory or concentration

• Decrease in intensity of orgasms

• Weight gain

• Joint aches

• Bone loss (osteopenia)

• Decline in physical abilities

• Loss of fitness

• Erectile dysfunction

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Proper evaluation is essential in the management of low testosterone in men.  This includes blood testing and possible saliva or urinary testing as well to obtain results that are used in creating the right treatment plan. 

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Your history is vital when starting this process as Dr. Howard wants to understand the nature of the problem.  A complete physical examination must be performed and include examination of the prostate.  Every man who walks in does not necessarily need testosterone.  In fact, there are clinics that provide testosterone without a full evaluation and sometimes this leads to under or over treatment or inappropriate treatment for those who do not need testosterone.  Heart disease can actually present as erectile dysfunction as the smaller arteries in the penis are effected initially.  This means you need further cardiac evaluation BEFORE you get prescribed testosterone therapy. 

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Blood. saliva and/or urine testing are typically used to evaluate your levels.  If you have not had basic bloodwork such as checking your blood counts, electrolytes, liver/kidney function, thyroid, prostate cancer testing (Prostate specific antigen or PSA) cholesterol and other cardiovascular risk tests, then these need to be performed as well.  In addition, you would also get testosterone (free and bioavailable), sex hormone binding globulin and estradiol. Advanced testing may include (mainly in your saliva) dihydrotestosterone, which can cause hair loss DHEA and your cortisol levels (stress hormones).  

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Once these levels have been reviewed you can discuss your different options.  Options for men include:

• Topical gel or creams

• Injections into your muscles

• Pellet therapy.  This is a procedure that Dr. Howard performs to insert a long acting form of testosterone, typically into your buttocks.  This type of therapy usually lasts up to 3-6 months in most men.  You do need to have follow up blood work to determine your levels and to follow up on your blood count and PSA.

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Call the office today at to see if you are a candidate for testosterone therapy or to simply learn more about hormone therapy in men. 

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