Testosterone evaluation and TRT, done carefully.

What brings men in

Low testosterone, also called male hypogonadism, means the body is not making enough testosterone. Men are usually evaluated because of changes such as:

• Reduced sexual desire, or erectile difficulty
• Low energy or fatigue
• Less muscle mass or strength, and more body fat
• Low or irritable mood, or trouble concentrating

Less commonly, or when levels are very low, men may notice breast enlargement, testicular shrinkage, a lower sperm count or hot flashes.

These symptoms are common and not specific to testosterone. Sleep disorders, depression, thyroid problems, obesity, diabetes, some medications and heavy alcohol use can cause similar changes. That is why symptoms alone are not enough to diagnose low testosterone, and why evaluation matters.

How low testosterone is assessed

A diagnosis needs both symptoms and consistently low testosterone on blood tests. Because levels change through the day, clinical guidelines call for at least two early-morning tests, typically between 7 and 10 a.m. If levels are low, further testing helps show whether the cause lies in the testes or in the brain's hormone signals, and whether other conditions are involved.

Your clinician will also review your medical history, medications, sleep and weight, and may check other markers, such as blood counts and, where appropriate, prostate health.

We will confirm which tests we offer, and when results are available, before we open. We are not stating turnaround times until we can confirm them.

Potential benefits, and their limits

For men with an appropriately diagnosed testosterone deficiency, treatment may improve:

• Sexual desire and function
• Lean body mass
• Bone density

Energy, mood, focus and strength respond differently from man to man, and some men notice little change. We do not promise a guaranteed outcome or a fixed timeline.

Who may be suitable

Treatment may be considered for adult men who have symptoms, confirmed low testosterone, and no condition that would make treatment unsafe. It may not be appropriate, or may need extra caution, if you have prostate or breast cancer, an enlarged prostate with symptoms, untreated sleep apnea, a high red blood cell count, or if you want to have children now or in the future.

Your clinician decides, with you, after reviewing your results and history. For many men with similar symptoms, testosterone turns out to be normal and another cause is found.

Treatment options

If treatment is appropriate, your clinician will explain the available options and what each involves, including how and where it is given. We will list the options we offer here once they are confirmed, and we will not describe a treatment we are not yet able to provide.

Follow-up and monitoring

Testosterone therapy is not a one-time decision. Clinical guidelines call for regular visits and blood tests, so we plan follow-up around:

• How you feel and how you are responding
• Testosterone levels
• Blood counts, because treatment can raise red blood cells
• Blood pressure
• Prostate health, where appropriate

Treatment can be adjusted or stopped. It is usually long term, and if it is stopped, symptoms may return. We will publish our specific follow-up schedule once it is confirmed.

Risks and what to know

Every treatment has risks. Your clinician will review them with you before you decide. Important points include:

• Fertility. Testosterone treatment can reduce sperm production and may cause infertility. If you want children now or later, tell your clinician before starting.
• Blood counts. It can raise red blood cell counts, which may increase the risk of blood clots, so blood counts are monitored.
• Blood pressure. Testosterone products can raise blood pressure, and current FDA labeling carries warnings about this. Blood pressure is monitored, and men with high blood pressure need particular care.
• Heart health. Your clinician reviews your cardiovascular history and risk factors. FDA labeling has been updated to include results from a large safety trial.
• Prostate. Treatment is not appropriate for men with prostate cancer, and prostate health is monitored where appropriate.
• Other effects. These can include acne, breast tenderness or enlargement, fluid retention and worsening sleep apnea.

Further reading

• Endocrine Society: Hypogonadism (patient information)
• Endocrine Society: Testosterone therapy guideline
• FDA: Class-wide labeling changes for testosterone products

When to talk with a clinician