When is testosterone Therapy Appropriate? What things should I consider before starting?
Like any other decision in medicine (or in life), this is really a question of how much potential benefit vs how much risk there may be.
The first question to be answered is “does the man have symptoms that may be attributed to declining testosterone levels and do they negatively impact his quality of life?” These symptoms can include fatigue, low energy, decreased sex drive, decreased muscle mass, depressed mood, or difficulty concentrating/brain fog. If the answer is no, there is really no reason to check a testosterone level.
However, if a man is affected by some of these symptoms, it is reasonable to look at his hormone levels, particularly at his free testosterone level. For a man with quality-of-life altering symptoms and a suboptimal testosterone level (generally in the lower part of the bell curve for his age range), it makes sense to consider the potential benefits of testosterone optimization and compare them to the potential risks of treatment. Only then can an informed decision be made.
When discussing risks, the patient’s age and medical history are some of the most critical considerations. Potential effects on fertility as well as other organ systems should be discussed. Understanding what may happen when therapy is stopped is important. This is why having the discussion with an experienced physician with formal training in testosterone therapy is always preferred.
Getting treatment online or from a non-qualified prescriber is not recommended. (Check out this article on Business Insider for why) On a related note, you don’t have to look too hard to find testosterone therapy clinics being operated by non-medical doctors and even chiropractors. As strange as it sounds, I have also seen testosterone replacement from men’s clinics run by former pediatricians and gynecologists. Yeah, that has always been a head scratcher to me. I would add that getting testosterone through non-medical means (such as a gym buddy) is clearly a bad idea with potentially serious consequences.
All of the above true, if done thoughtfully and responsibly for the right patient testosterone therapy can be life-changing with a very favorable risk-benefit ratio.
It can help many men live happier, healthier, and more productive lives.