Testosterone Optimization
While “testosterone replacement” is a well-known term and a service that many male health clinics offer — there are a few things you should know before seeking treatment. At Men’s Health, we ensure patients fully understand why your testosterone levels matter, what your treatment options are, and why testosterone optimization might be the best route forward.
Why Your Testosterone Levels Matter
Testosterone is the primary male sex hormone and it performs a number of vital functions in the body. Testosterone levels are at their peak in our 20’s and 30’s and gradually decrease by about 10% each decade thereafter. Low testosterone levels can lead to symptoms such as low sex drive, erectile dysfunction, fatigue, depression, obesity, and decreased muscle mass. It can also contribute to the development of diabetes, heart disease, decreased bone density, and ultimately an early death. This is why it is important for men to have their testosterone levels checked and to consider testosterone optimization if they experience these symptoms.
Where Do I Start?
The first step towards testosterone optimization is an initial consultation. Currently, we only offer testosterone optimization for members of Men’s Health, as we believe your primary care and testosterone optimization should be under the same provider, as they go hand-in-hand. At your initial visit, you will be asked about your symptoms and we will also order lab tests to check your blood levels. Once we have both pieces of information, we can discuss whether testosterone optimization is right for you.
Testosterone Optimization Versus Replacement
When most men think about doing something about their testosterone levels, they think of testosterone replacement. We prefer to talk about testosterone optimization because not every man needs to replace testosterone in his body, and there can even be some downsides to doing so. The testosterone levels in our blood are not the whole story. It is also important to consider how a man feels with the levels he has. Some men have what are considered “low testosterone blood levels,” yet don’t have symptoms of low testosterone. There may be no need to increase their levels if that is the case. Other men can have “normal” testosterone levels and yet still have symptoms of low testosterone. These are the men who may wish to consider raising their levels to see if the symptoms improve. At Men’s Health, we work with patients to identify the optimal level of testosterone for each man, one that improves symptoms of low testosterone without raising it so much that it causes adverse effects.
Methods to Increase Testosterone Levels
There are several methods available to optimize testosterone levels. The more commonly used method to increase testosterone levels is direct testosterone replacement, administered topically or by injection. There are various reasons to choose one method over another and we’ll discuss the benefits and risks of each before making a decision about which to use.
Risks of Increased Testosterone
Of course, as with any medical treatment, there are risks involved in raising testosterone levels. Men with prostate cancer should not take testosterone. Although the use of testosterone does not cause prostate cancer, it can make prostate cancer grow more quickly in men who do have it. This is the reason why we always check our patients’ Prostate-Specific Antigen (PSA) before starting testosterone optimization, and at least once a year thereafter.
High levels of testosterone can also increase production of red blood cells potentially leading to blood that is “too thick” to function properly. Testosterone use has also been associated with abnormal blood clotting, worsening of sleep apnea, and acne. Finally, a consequence of replacing testosterone that many men find distressing is that it turns off the body’s natural testosterone production (possibly permanently with long-term use) leading to shrinkage of the testicles.
Alternatives to Testosterone
There are alternatives to testosterone therapy, including certain oral supplements and medications. One particular medication often used is clomiphene. The use of clomiphene can increase a man’s natural production of testosterone and does not have many of the unwanted side effect, although as with any medication it can have side effects of its own. Clomiphene is often recommended under certain circumstances. Another alternative is not treating your low testosterone at all, but focusing more on treatment of symptoms. Depending on the patient and his symptoms, this may be the right choice.
What Does Testosterone Optimization Cost?
We offer testosterone optimization at Men’s Health with a low monthly add-on subscription to your primary care membership. We currently do not treat patients who do not have a Men’s Health primary care membership, as we think it is important for the provider treating you to know your full health status, and not just your hormone levels. As with all of our specialty treatments, we keep these costs significantly lower than those you will find elsewhere. The add-on subscription covers the direct supervision of your care, with regular lab testing, and unlimited access to your provider via telehealth or office visit.
If you are experiencing symptoms of low testosterone and would like to explore your options further, schedule a free consultation.