Low testosterone is relatively common in men especially as they become older. The condition is also known as Hypogonadism, the Male Menopause or Andropause. Low testosterone can cause a number of problems. The most obvious is of a sexual nature with low sex drive and erectile dysfunction. It also causes more non-specific problems such as fatigue, poor sleep patterns, memory loss, depression and anxiety. The ADAM questionnaire can be useful to document to document these symptoms. Testosterone has a beneficial effect on the way the body handles some fats and sugar with low testosterone recognised as one cause of early diabetes and high cholesterol.
The condition can be detected by measuring the blood level of testosterone. This is best measured in the morning as testosterone levels vary and are at their highest in the morning. If levels are low or borderline low, especially if there are symptoms such as erectile dysfunction or low sex drive, then testosterone replacement therapy can be beneficial.
Testosterone replacement therapy can be prescribed as a gel, which is rubbed onto the skin once daily, a patch, which is stuck to the skin, or a surgically implanted pellet that slowly releases testosterone over several months. Blood levels of testosterone should be monitored to ensure that the correct dose is being used. The commonest side effect of the gel and patch is skin irritation at the site of administration. High levels of testosterone can cause aggressiveness, and may make prostate cancer worse.