Testosterone is a male sex hormone or androgen that is produced in the testes. Testosterone plays a vital role in development of male sexual characteristics such as increased muscle mass and growth of body hair. This hormone also regulates production of red blood cells and maintains muscle strength, bone density, libido and reproductive function.
Low level of testosterone can cause different problems and one of them is erectile dysfunction (ED). Erectile dysfunction can arise from several causes but if it is due to inadequate production of testosterone, it can be improved with testosterone replacement therapy.
Causes of Testosterone Deficiency
Testosterone deficiency occurs when the body fails to produce enough testosterone. Testosterone levels are normally affected by aging process and production of this hormone gradually decreases after the age of 30. However, testosterone deficiency can result out of many different causes. This includes:
- Damage to the testes due to infection or trauma
- Cancer treatment with chemotherapy or radiation therapy
- Genetic disorders such as Klinefelter’s syndrome
- Hemochromatosis (excess iron in the body)
- Disorders of the pituitary gland
- Use of certain medications
- Undescended testes
- Chronic illness
- Liver cirrhosis
- Chronic kidney failure
- Inflammatory disease like sarcoidosis
- Congenital abnormalities
Testosterone deficiency commonly causes decreased libido, low mood and irritability, depression, poor concentration, difficulty in remembering things, low energy and erectile dysfunction. Low testosterone level can also cause physical changes such as increased body fat and loss of muscle mass, changes in cholesterol metabolism, thinning of the bones (osteoporosis), reduced hair growth, decrease in red blood cells and anemia.
Diagnosis of Testosterone Deficiency
In order to diagnose testosterone deficiency, a doctor will order a blood test that measures the level of testosterone. Since testosterone levels tend to vary throughout the day, it is sometimes necessary to do several measurements of the hormone. Blood for testing is usually taken in the morning as levels of testosterone are highest at that time of day.
Testosterone Replacement Therapy
Testosterone replacement therapy comes in different forms. One of the options includes intramuscular testosterone injections that are usually given every two to three weeks. Testosterone patches are applied every day to the scrotum (scrotal patch) or to the buttocks, arms, back or abdomen (non-scrotal patch). Finally, there is a testosterone gel also known as Androgel that is applied to the shoulders, upper arms or abdomen once a day.
Each form of testosterone replacement therapy can effectively improve testosterone deficiency. However, every option has its negative effects, advantages and disadvantages. Testosterone injections can cause considerable fluctuations in hormone concentration resulting in change in mood, sex drive and energy level. Testosterone patches may cause skin irritation while the gel requires care in making sure that it is not unintentionally transferred to a partner or another person.