Testosterone Treatment Options

July 17, 2021

Testosterone is a big deal.

Low testosterone impacts quality of life dramatically. Men with low testosterone can experience low libido, fatigue, loss of energy, depression, mood changes, erectile dysfunction, infertility, difficulty with weight loss, decrease in muscle mass, lack of motivation, decrease in mental clarity and sleep disturbances, poor bone and cardiovascular health.

As men age, testosterone slowly declines. Levels typically decrease by 1% each year beginning at the age of 40. Testosterone may be low at ages younger than 40 as well. Additionally, testosterone may drop quickly due to medical illnesses such as stroke, trauma, diabetes, liver disease, kidney disease, obesity, heart attacks or medications.

Testosterone production is fairly complex involving a myriad of factors including the ability of the testes to produce sufficient amount of testosterone, correct brain signalizing and a proper amount of estrogen. Tests can help to determine potential causes of low testosterone prior to treatment. Regardless, low testosterone is treatable and there are multiple methods to do so. Depending on the approach, lifestyle modifications or medication can do the trick. Some medication may be used to stimulate the testicles into making more testosterone if able, blocking estrogen levels if too high. Some medication can also replace the body’s mechanism of making testosterone altogether. These are all well-studied approaches to treating low testosterone; it’s a matter of picking which one is right for you.

Everyone knows to do these simple things and yet they seem the most difficult to accomplish. Lifestyle modifications can boost testosterone production and help keep the relationship between testosterone and other hormones that influence it happy. A sedentary lifestyle, being overweight and indulging in unhealthy habits like excessive drinking and smoking are guaranteed testosterone killers.

Exercise and Lift Weights
Weight-lifting and resistance training along with cardiovascular exercise is the best combo to boost testosterone levels. 

Lose Weight
Obesity can actually decrease testosterone levels. Fat cells metabolize testosterone to estrogen, lowering testosterone levels.

Get Enough Sleep
Quality sleep plays an important role in testosterone. Generally seven to ten hours of sleep a night are needed for good health and to aid in healthy testosterone levels.

Decrease Stress
The stress hormone, cortisol, is often elevated when chronically stressed. Elevation in cortisol can reduce testosterone as cortisol and testosterone work in opposition to each other– as one goes up, the other comes down.

Eat Healthy
Eat proportioned whole foods daily, with a healthy balance of fat, protein and carbs. Avoid sugar, processed foods, fast food and fried foods. Restricting calories in dieting or overeating can disrupt hormone levels, including testosterone.

Kick the Habit
Alcohol, smoking, narcotics and opioids lower testosterone. There is some suspicion that chemicals also play a role in declining testosterone levels. BPA (bisphenol A) commonly found in plastic food and drink containers may have a link to lowering testosterone.

Take your Vitamins
Taking a daily multivitamin helps support the deficiencies in our diet. But double check your multivitamin to ensure it has key components to help naturally produce testosterone. Zinc, Vitamin D and Vitamin B are linked to testosterone production.

Reduce Estrogen Levels
Estrogen and testosterone are related. Both men and women have estrogen and testosterone, which are both are needed at certain levels. In men, if estrogen is too high, it plummets testosterone. A few simple lifestyle modifications include healthy eating and avoiding foods high in soy (soy has estrogen), maintaining a normal weight or losing weight, and engaging in regular exercise can help beat back unneeded estrogen. Additionally, vitamins such as vitamin C and zinc have been mildly linked to reducing estrogen levels.

Medications can be prescribed that help block estrogen as well. Medications are used when lifestyle modifications fail or the body abnormally makes too much estrogen.

Increase testicular output of testosterone
Clomid is used (off label) to help increase a man’s testosterone levels more “naturally.” Clomid is a different approach to increase testosterone in men. Originally it was used to increase ovulation and improve fertility in women. In men, Clomid works by stimulating the body’s own production of testosterone, effectively helping signal the testes to produce testosterone and thereby increasing testosterone levels (assuming the cause of the initial problem is not in the testes’ ability to make testosterone). For most men, Clomid is a good treatment option for low testosterone. Clomid must be prescribed and monitored by a doctor.

Testosterone Replacement Therapy
When all else fails, most men are eligible candidates for testosterone replacement therapy. It’s likely the most familiar treatment method as it is often advertised on television as gels, pellets, patches and injections. These treatments produce good results. Each method delivers testosterone as a medication to the body, basically “turning off” the body’s memo to make testosterone since it’s artificially provided by the medication.

If you are interested in evaluating your testosterone levels and discussing treatment options specifically tailored to you, contact Austin Urology Institute at 512.694.8888 and schedule a consultation with a provider.