Are you a man who struggles with low energy? The issue could be low testosterone. Also known as male hypogonadism, low testosterone levels affect about 5 percent of men nationwide.

Unfortunately, there are many misconceptions about low testosterone and what to do about it. Amy Guise, MD, a urologist with Froedtert & the Medical College of Wisconsin health network, identifies the myths and shares the facts.

Myth #1: Low testosterone is a normal part of getting older.

Is low testosterone inevitable? According to Dr. Guise, that misconception keeps many men from getting the care they need. “Testosterone levels decrease to a certain extent with age, so as men get older, there is a normal decline,” she said. “However, in some men, testosterone drops well below the healthy range.”

Truly low testosterone is not normal, and it can cause several health problems. “Physical symptoms may include fatigue, loss of muscle mass and decreased exercise tolerance,” she said. “Men may also experience decreased interest in sex, difficulty concentrating, erectile dysfunction and, in some cases, depression.”

Myth #2: Only older men experience low testosterone.

Actually, this health problem does not discriminate by age. “Low testosterone can affect any man,” Dr. Guise said. “It is not just a disease of older men.”

How do you know if you have low testosterone? “The first priority is getting a diagnosis,” Dr. Guise said. “It’s important that your physician not only evaluate your symptoms, but also order blood tests to check various hormone levels.”

Myth #3: Testosterone replacement increases sperm count.

Increasing sperm count is one thing testosterone therapy will not do. “It’s a myth that testosterone replacement will increase your sperm count,” Dr. Guise said. “That’s not true. In fact, the medication will decrease your sperm count.”

Men with low testosterone can be treated with testosterone replacement therapy. Options include creams, gels, patches, pills and injections.

“Testosterone replacement therapy can decrease excess fatigue and increase your energy, mood and libido,” Dr. Guise said. “Other benefits include increased muscle strength and bone density.”

But the results are not instant. “Testosterone replacement will not make you feel amazing; it will just get you back to normal,” she said. “And it can take a long time.”

Myth #4: Testosterone replacement increases risk of heart disease and cancer.

“An early study suggested that replacement increases a man’s risk of heart attack, but more data has emerged since then,” Dr. Guise said. “The latest research shows testosterone supplementation decreases cardiovascular events.”

Concerns about cancer are also unfounded. “Testosterone replacement is controversial for patients with an existing diagnosis of prostate cancer,” she said. “However, the data shows that the medication does not cause prostate cancer.”

Myth #5: It’s safe to order testosterone supplementation online.

Testosterone medications are controlled substances that can only be prescribed by a physician. According to Dr. Guise, men who use testosterone without physician supervision run several risks.

“If you use testosterone in excessive amounts, your body may get to the point where it can’t make testosterone,” she said. “Excessive use can also lead to enlarged breasts. Very high levels of testosterone can increase your risk of blood clots and stroke.”

It’s important to get an appropriate diagnosis from a urologist or an endocrinologist. “That’s needed for ruling out other serious medical problems that could be causing your symptoms,” Dr. Guise said. “In addition, you need to be closely monitored to ensure your testosterone levels stay within the appropriate range.”

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About the Author

Amy Guise, MD is board certified in urology, and practices at Froedtert Hospital and Moorland Reserve Health Center.

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