With 20 years of experience, Dr. Scumpia provides diagnosis, treatment and management of all types of hormonal and testosterone-related disorders.
LOW TESTOSTERONE (LOW T) is known as Androgen Deficiency. Its diagnosis requires the presence of clinical symptoms and the biochemical evidence that the level of the testosterone in blood is low. Guidelines for treatment with testosterone recently issued do not apply for the treatment of fatigue, improving athletic performance or physical appearance, or to prevent aging in the absence of a firm low testosterone. The medical community and the FDA have not approved treatment with testosterone if your level is normal.
- Low libido (sex drive)
- Erectile dysfunction (impotence)
- Lower sperm count or infertility
- Breast enlargement, breast discharge, or tenderness
- Reduced energy
- Increased irritability, inability to concentrate, depression
- Hot flushes
How is Low Testosterone Diagnosed?
- A careful history including puberty development, family history and recent changes
- Physical examination
- Laboratory measurements of the testosterone level, which should be done on three different occasions, preferably in the morning. The level of testosterone, like that of any other hormone, may vary greatly during the day, hence the wrong diagnosis can be made on only one level. One must be careful about other medications the patient might be using, presence of other illnesses, and/or obesity.
- A bone density measurement should be done to rule out osteoporosis, one of the major complications of LOW T
- For patients at risk, treatment should not start without a cardiac and vascular work up
Treatment of Low Testosterone
- There are many preparations including patches, gels, ointments, injections and pellets. All of them are recognized as good treatments; the best modality is up the patient and the physician
- The treatment has to be individualized for each patient, and can by gratifying to both patient and physician, since the symptoms rapidly disappear with a sense of well-being
Are all men good candidates for LOW-T treatment?
No, you should not be treated with testosterone if you have a history of breast or prostate cancer, or an undiagnosed prostate nodule and high PSA if you have polycythemia (high red cells in your blood stream), untreated sleep apnea, if you have severe problems passing the urine because of enlargement of the prostate or if you have poorly controlled congestive heart failure.
What are the complications of treatment?
Possible cause for prostate cancer, enlargement of the breasts, low sperm count, aggravation of sleep apnea, unknown whether it might increase the risk of heart attacks and strokes in men who already have heart problem or previous history of stroke.
True or false: If I take bioidentical testosterone hormone therapy, these complications will not occur.
FALSE: Any form of testosterone, regardless of origin or preparation, attaches to the same receptors and produces the same complications.