Testosterone for Men

Testosterone is a steroid hormone, also called an androgen, which is mainly produced by the testicles (testes) in men.

In men, testosterone controls:

• the growth of body hair
• penis growth during puberty
• sex drive and function
• deepening of the voice during puberty
• muscle development

Everybody has testosterone in their body. Women make testosterone in their ovaries, but their levels are around 1/10 of the male level.

The adrenal glands are also responsible for making testosterone in both men and women. This page will focus on testosterone in men.

The level of testosterone in the body is carefully controlled. There are two glands which help to control the amount of testosterone produced in the testicles – the hypothalamus and the pituitary gland.

Low testosterone levels can be caused by a number of different factors, which are categorised into:

• primary hypogonadism (caused by problems with your testes)
• secondary hypogonadism (problems with how your body regulates hormones)

Primary hypogonadism

In men, primary hypogonadism is typically due to a problem with the testicles. This can be caused by:

Ageing

Hypogonadism is common in ageing men as testosterone levels decrease in the ageing process.

Genetic causes

Syndromes like Klinefelter syndrome, experienced by men born with an extra X chromosome, or Congenital Hypogonadotrophic Hypogonadism (CHH) syndrome, a condition which stunts testosterone production due to incomplete pubertal development.

Injury

Damaging your testicle can impair testosterone production. This can happen at birth or at any other time in your life.

Inflammation or infection

Infections like Mumps orchitis can stunt the development of testosterone production.

Undescended testicles

In some people, the testicles are not in the usual place inside the scrotum, making it harder for them to produce testosterone.

Hemochromatosis

High levels of iron in the body can minimise the regular functioning of the gonads and cause low testosterone.

Cancer treatment

Chemotherapy can affect the Leydig cells which are in the testicles and are a part of the production of testosterone.

Secondary hypogonadism

In men, secondary hypogonadism is caused by a range of factors, such as:

• HIV – often causes damage to the testicles and pituitary gland
• obesity – can cause increased production of oestrogen, lowering testosterone levels
• Kallman syndrome – a genetic disorder which delays puberty, often resulting in lowered sex hormones
• Cushing’s syndrome – causes an excess exposure to cortisol which can impair sperm production and testicle function
• diabetes insipidus – makes you want to urinate more often, can affect the function of the pituitary gland, and the production of testosterone
• hypopituitarism – a form of hypogonadism, a condition where male testes produce little or no sex hormones
• empty sella syndrome (ESS) – a treatable condition where your pituitary gland becomes flattened, affecting the production of testosterone
• pituitary tumours – can affect the levels of testosterone being produced
• stress – prolonged exposure to stress can cause dysregulation of hormones
• excessive exercise – can lead to the development of low resting testosterone levels due to overexposure to fluctuating hormone levels
• trauma – can induce low levels of testosterone due to pituitary damage or high cortisol levels
• surgery – sometimes surgical stress or complications can lead to a lowered level of testosterone production

Our testosterone levels change as we age. A healthy testosterone level at age 19 will differ from one at age 50, as testosterone tends to decline once men are between 30 to 40.

Everyone’s testosterone levels are different, and they vary depending on a range of factors. If you are unsure about your testosterone levels or have concerns, speak with your doctor.

If a male’s testosterone level drops and is low, then symptoms occur. The most common consequences of low testosterone are:

• sexual dysfunction (erectile dysfunction, loss of morning erections, low sex drive)
• reduced muscle mass and strength
• anemia
• impaired cognitive function
• low mood
• reduced energy

Other risks associated with low testosterone levels even with no symptoms are:

• cardiovascular disease
• diabetes
• osteoporosis

If a male’s testosterone level is high, symptoms include:

• acne
• fluid retention
• reduced testicle size
• loss of body hair
• decreased sperm count
• swelling of the prostate gland
• enlargement of the breasts

Other risks associated with high testosterone levels even without symptoms are:

• testicular tumours
• too many red blood cells
• higher than normal risk of blood clots

We offer a home blood test to determine total testosterone levels.

The process is quick and easy – just follow these simple steps:

1. Place an order and get your kit delivered to your door, or collect from a local Post Office (delivery is free)
2. Collect a few drops of blood using a finger-prick test
3. Send your samples to our UK based, accredited partner laboratory (postage is free)
4. Once your results are available (in 2 to 3 days), our doctors will review your results
5. One of our doctors will contact you, via a secure and confidential message in your patient account, to let you know your results and give you advice and support on what to do next

In some cases, the doctor may need to ask for more information. They may contact you by phone, so make sure your telephone number is up to date in your online account.

You can also ask for a blood test from your doctor. In this case, it will be a full blood test, where a sample will be taken from a vein in your arm.

If your test shows that you have low testosterone, you will be recommended to repeat the test to confirm it before taking any other decision. If it is confirmed, you will need to have a complete check up with your doctor to assess the cause and to discuss starting TRT.

There are ways to boost your testosterone levels.

Exercise:

• High intensity workouts seem to be the most beneficial
• Exercise can help maintain testosterone levels, and increase them in some cases if they are low
• Stress training in the evening may have a big effect

Lifestyle choices:

• Drinking less alcohol or avoiding other substances like cannabis can help reduce the risk of low testosterone levels
• Eating a balanced diet can promote healthy testosterone levels
• Maintain a health weight as being overweight is linked to low testosterone levels

Treatment:

• You may be prescribed testosterone supplements by a specialist if your levels are low
• A doctor will assess whether supplements are the right treatment for you
• You can also get treatment for the consequences of low testosterone, e.g. medications like Viagra for erectile dysfunction

Other supplements

There are some other supplements which may help to boost your testosterone levels, including:

• vitamin D
• zinc
• magnesium
• DHEA

If you have low testosterone levels you may be referred to a specialist called an endocrinologist. You may be offered testosterone replacement therapy (TRT) which can be in the form of:

• tablets
• patches
• implants
• injections
• gel

If you’re currently taking TRT, you’re happy with it, and you meet our criteria for treatment, then you can reorder online with us.

We offer the following treatments:

• Tostran gel 2%
• Testogel sachets

Advantages of testosterone gel treatment:

• The main advantage of testosterone gels is that they provide a stable testosterone level for 24 hours with one application per day
• Testosterone gel is safe for most men, as long as it’s been prescribed by a doctor
• These gels can be a good option for improving quality of life for men who have a low testosterone level

How to apply testosterone gels:

• It is recommended to apply the gel about the same time each day (preferably in the morning), to clean, dry skin
• Depending on your treatment, the location where to apply the gel can vary (your doctor should give you instructions on this)
• Spread the gel gently until it is completely absorbed into your skin, then cover up where you applied the gel. Use loose clothing to avoid the gel spreading to other people

Thing to be aware of when using testosterone gels:

• Testosterone gel may give positive results in drug tests for work or sports
• Androgens (like TRT) should not be used for increasing your muscle mass, unless this is recommended by a doctor. They should also not be used to increase fitness or levels of physical activity
• Testosterone treatments can lower the amount of sperm that your body produces. So, it is important that if you plan to have children in the future you discuss this with your doctor before using testosterone gel

If you’re receiving testosterone treatment and you want to test your levels – ask your doctor what the best time of the day is to do it, as it can vary depending on the testosterone treatment you are taking.