What is it?
Testosterone is the main sex hormone in men, although women have a small amount as well. In men it is the hormone that either directly or indirectly relates to libido (your interest in sexual activity), erectile function (your ability to get and maintain an erection), fertility (your sperm production), hair growth and distribution, muscle growth and the ratio of muscle to fat, bone density and strength, as well as mood and energy levels.
How do I know if I have it?
Probably 9 out of 10 people might say they are tired on any given day if asked, but a persistent depression or fatigue might be an indication of a low testosterone level. Lack of sexual interest with or without erectile dysfunction is often times a better indication than erectile dysfunction alone. Those who have used anabolic steroids in the past, even briefly, are at higher risk. With more severe deficiencies, one might also notice significant changes in facial and body hair distribution, small or shrinking testicles, and potentially development of abnormal breast tissue.
How can I get tested for it?
A simple blood test can show if your testosterone level is within the normal range. I don't think that every man should be concerned about this issue as the recent television commercials seem to indicate. I generally check the testosterone level in patients with chronic conditions such as diabetes, HIV, and liver disease, for the symptoms listed above, or if you have a particular concern that your level might be low. Two or more blood tests showing a low level would warrant treatment.
How can I be treated for it?
There are several ways to treat low testosterone. For most men I usually recommend a gel, which is applied to the skin daily. I feel that the gel gives the most stable and consistent level to mimic your body's natural rhythm and promote a sense of well being. There are other options though, mainly including patches and injections. If fertility is an issue, I may refer my patients to an Endocrinologist for a more involved treatment plan.