Testosterone is the male sex hormone produced in the testes, although women also have testosterone production but at lower levels than men. Testosterone hormone levels are important for normal male sexual development and functioning.
During puberty, testosterone helps males develop masculine qualities, such as facial and body hair, deep voice and muscular strength, thus differentiating them from the female sex. Men need testosterone to produce sperm. Testosterone levels generally decrease with age, so men tend to have less testosterone as they age.
Low testosterone levels in men’s blood (low-T) is considered to be equivalent to having less than 300 nanograms per deciliter (ng/dL).
Frecuency:
It is estimated that 2 out of every 100 men suffer from it,1% of young men suffer from this deficit and 50% of men over the age of 80.This condition is more common in diabetic and overweight men.One study found that 30% of overweight men had low testosterone levels compared to 6.4% for men of normal weight.Another study found that 24.5% of diabetic men had testosterone deficiency compared to non-diabetic men who only 12.6% had testosterone deficiency.
Symptoms:
The symptoms of low testosterone levels can be divided into specific symptoms of this condition and nonspecific symptoms, which can also be seen in other situations or diseases and not only in testosterone deficiency.
Specific symptoms include decreased sexual desire, low fertility, lower semen volume, erectile sexual dysfunction, loss of body hair, loss of beard, of muscle and bone mass with osteosporosis (evidenced by repeated bone fractures with simple trauma), obesity, frequent fatigue, depression.
The non-specific ones are low levels of energy and strength to perform daily tasks, poor performance at work, loss of memory at different levels, low concentration, difficulty in choosing the right words to communicate. Some cases of anemia can be observed in testosterone deficiencies.
Anyone with two or more of these symptoms should talk to their doctor to assess testosterone levels.
Causes:
The development of testosterone deficiency is multicausal. From congenital diseases such as Klinefelter's syndrome and Noonan's syndrome to ambiguous genitalia, low testosterone levels are also observed in cases of testicular trauma, radiation and chemotherapy, removal of the testicles due to cancer, infections, pituitary gland diseases, autoimmune diseases (those in which the body develops defenses against itself). It also develops in obese people, with metabolic syndrome, advanced age, consumption of antidepressant drugs and painkillers, also decrease levels in patients with HIV or AIDS.
Diagnosis:
Diagnosis is made by patient questioning, physical examination and laboratory tests, including any history of brain trauma, history of central nervous system tumors, puberty, use of anabolic steroid medications, testicular trauma or infections, family history of low testosterone levels, chemotherapy or radiation. The physical examination is aimed at finding signs suggestive of low testosterone levels such as gynecomastia (increased male breast size), body mass index for nutritional assessment (underweight, normal weight, overweight and obese), pattern and amount of body hair and its distribution, presence of testicles and their size as well as prostate and abnormalities of the same. Among the laboratory tests that may be indicated depending on the findings of the interrogation and physical examination are: testosterone level, prolactin, luteinizing hormone and follicle stimulating hormone, hemoglobin, estradiol, glycosylated hemoglobin, karyotype, bone density tests, magnetic resonance imaging of the pituitary gland.
Treatment:
It is worth mentioning that not only men suffer from low testosterone levels, but also women. The so-called hot flashes in them may indicate a deficiency of this hormone. Treatment of low testosterone level in men should include frequent exercise and dietary modifications to achieve weight loss. All this will increase testosterone levels. There are also foods that enhance testosterone production such as: beef, oysters, fortified cereals, tuna, eggs, beans, shellfish, and milk enriched with vitamin D.
Although all these factors mentioned above comprise part of the treatment, in reality the replacement of the hormone is the main thing. This is achieved through topical treatment (of the skin) with testosterone such as patches and gels (they act for four days, it is better if the area of application is bandaged and hands must be washed thoroughly after applying it, needless to say, the skin must be healthy) in addition to tablets, microgranules that are inserted under the skin, weekly injections, every two weeks or once per month. The intranasal route is also described. Some of these medications will require a specific health follow-up to look for effectiveness and/or allergic reactions.