Men's Sexual Health | The Turek Clinic

Therapy for Low Testosterone

Improve Your Mood, Behavior, Sexual Health and More

Testosterone influences your appearance, behavior, mood, sexual health and much more. But your body’s production of testosterone declines with age. Testosterone levels decline by 1 percent yearly after the age of 40.


Low testosterone is a complex condition that requires the expertise of a trained and experienced specialist to properly treat. This is because testosterone is a “biomarker” of overall health and may reflect an underlying medical disorder, such as diabetes or thyroid issues. Dr. Paul Turek at The Turek Clinic has extensive experience with male hormone replacement therapy, helping him earn the title of one of the “Best Doctors in America” for nine years running. He will break down and explain testosterone levels in the context of your overall health and suggest a sensible course of action.

Treating low testosterone and balancing your hormone levels is life changing. It can help you look and feel youthful and energetic and improve your libido, muscle mass, cognition and more. Testosterone replacement therapy requires ongoing monitoring for optimal results, all of which Dr. Turek will manage.


Symptoms of Low Testosterone

The symptoms of low testosterone can include any of the following:

  • Decreased or low libido
  • Difficulty getting or keeping an erection
  • Changes in mood
  • Fatigue
  • Depression
  • Anger
  • Decreased memory or other cognitive functions
  • Reduced muscle strength
  • Increased abdominal girth
  • Hair thinning or balding
  • Increased facial wrinkling
  • Pale skin
  • Smaller or softer testicles
  • Low bone mineral density

The symptoms tend to develop gradually and can differ in severity. Some men only experience one or two symptoms. What is puzzling about the symptoms of low testosterone is that often they can be attributed to the consequences of the aging process. For this reason, Dr. Turek will examine other medical conditions that can also lead to low testosterone levels before engaging in treatment. Treating found medical issues often “cures” testosterone imbalance and means that men can avoid testosterone supplementation.


Diagnosing Low Testosterone

To diagnose low testosterone, Dr. Turek will take a complete history of your symptoms, both physical and psychological. He will order bloodwork to look at various forms of testosterone and pituitary hormones and evaluate the results in the context of your symptoms.

Although there is some disagreement as to what constitutes “normal” and “low” testosterone levels, below 300 ng/dL is considered low by national guidelines. However, testosterone levels above 300 ng/dL are can be low in men who previously showed much higher levels. Blood tests are repeated to confirm initial findings. Other tests, such as a DEXA bone density scan, may be ordered at Dr. Turek’s discretion.

Dr. Turek likes to distinguish between two types of low testosterone: that due to a testicle that is failing to produce enough testosterone for a healthy quality of life, and that due to inadequate brain delivery of luteinizing hormone (LH), which stimulates the testicle to make normal amounts of testosterone. In cases of low testosterone due to testis failure, testosterone must be given as a medication. However, in cases of low testosterone due to inadequate stimulation, naturally improving the stimulation to the testicle with pills can restore normal testosterone levels.


Low Testosterone Treatment Options

Dr. Turek’s goal is to normalize testosterone levels without causing significant side effects. Testosterone replacement can be administered through several different modalities, including a transdermal patch or gel, injectable or slow-release pellet. Testosterone is available in an oral pill in Europe but there is a high risk of liver problems and is not approved for use in the U.S.

In cases of low testosterone due to poor stimulation of the testicle, Dr. Turek uses a class of drugs called selective estrogen receptor modulators (SERMs), the most common of which is clomiphene citrate, to stimulate the testicle to make normal testosterone levels. Injections of luteinizing hormone (LH, hCG) is a more potent way to restore natural testosterone levels if SERMs are ineffective.

Dr. Turek will review the pros and cons of each approach with you and help you select the option that best suits your needs. He will monitor you regularly (more frequently during the first few months of treatment) to assess the effectiveness of the treatment and adjust the dose as needed.

Side effects can include water retention, worsening of existing sleep apnea, breast tenderness and possible worsening of detected or undetected prostate cancer. If you are at risk of prostate cancer, Dr. Turek will carefully monitor you while you are on testosterone therapy.


Testosterone and Fertility

If you are considering testosterone therapy, you should be informed of its effect on your fertility. Testosterone therapy leads to reduced sperm production. Within 10 weeks of starting therapy, 90 percent of patients have sperm counts of zero. It is normal to see sperm counts normalize 6 to 12 months after stopping testosterone therapy. Testosterone therapy in the setting of desired fertility is best approached using SERMs or hCG therapy instead of testosterone replacement therapy and Dr. Turek has ample experience treating this condition. He is also an expert at helping men who have been taking anabolic or high doses of testosterone for sports, training or bodybuilding purposes to get “back to normal” without experiencing dramatic falloffs in energy or quality of life.


Learn More about Testosterone Therapy

If you are experiencing symptoms of low testosterone and would like to discuss them with a trusted men’s sexual and reproductive health expert, please schedule a consultation at The Turek Clinic. Contact us today to request an appointment.