Dr Jeff Foster on Testosterone Deficiency
Testosterone deficiency is a common condition that many people don’t know exists. Whilst there is still a long way to go, awareness of the effects of hormonal changes many women experience around menopause is gradually improving. But men can also be significantly affected by hormonal changes – especially testosterone – and the effects can begin to be felt as early as the age of 30.
Testosterone deficiency is common in men over the age of 40, and affects up to 12% of men aged 50 and over. Affecting more than 790,000 men in the UK, this treatable condition can cause symptoms including tiredness, irritability, depression, low sex drive, loss of muscle and weight gain.
What are the signs and symptoms of testosterone deficiency?
Testosterone deficiency is associated with sexual, physical and mental symptoms that can affect your everyday life:
Your sex life
- Low sex drive
- Problems with erections
- Difficulty achieving orgasm
How you feel
- Low mood or irritability
- Reduced wellbeing
- Loss of concentration
- Hot flushes and sweats
How you look
- More body fat
- Male breasts
- Loss of muscle and strength
What is testosterone deficiency?
Testosterone plays an important role in physical and emotional wellbeing. Its roles include maintaining muscle and bone strength, sperm production, and the desire to have sex (libido). Testosterone deficiency is a failure of the body to produce enough testosterone to maintain healthy levels.
Who gets testosterone deficiency?
The reasons for having testosterone deficiency are not always clear. After the age of 30 our testosterone levels naturally begin to drop but in some cases they drop so far that it can cause the health and wellbeing of a man to suffer quite significantly. The chances of becoming testosterone deficient are higher in men who have certain other conditions, including:
- Diabetes (up to 50% of men with type 2 diabetes also have low testosterone levels)
- High blood pressure / raised cholesterol
- Heart disease
- Any chronic inflammatory condition (such as asthma or arthritis)
- Men who take medications (a large number of prescription drugs can also reduce testosterone levels)
- Men undergoing cancer treatment
What can you do to increase your testosterone levels naturally?
Improving your overall health can help to boost testosterone levels (as explained in the video on this page). Particularly good ways to increase your testosterone levels naturally include:
- Maintain a healthy weight. Losing weight can help increase testosterone levels. Aim for a healthy, balanced diet with plenty of vegetables and protein (and low in sugar, saturated fat and processed food)
- Stay active. Regular physical activity helps your brain send out testosterone-boosting signals.
- High intensity and weight-bearing exercise. Current evidence suggests it is the intensity that is most beneficial for health rather than the type of exercise. Short bursts of high impact/high intensity exercise appear to the produce the best results in metabolic stimulation and hormone production. Including a mix of high-intensity, weight-bearing, and aerobic exercise in your activities also keeps it interesting which means you’re more likely to stick with it.
- Reduce stress. While you might not always be able to remove or avoid the causes of stress, you can change your response to it. Being in good shape physically can help you to manage stress better and as can mindfulness or meditation, or simply talking about it (whether that’s to friends and family, or to a counsellor).
- Sleep tight. Try to get at least 7 hours good quality sleep a night. If you’re doing all of the above you’ll often find that your sleep improves; if you’re still struggling to get a good night’s sleep on a regular basis it’s worth speaking to your GP.
- Have more sex. Ironically, although testosterone deficiency can cause problems with sexual desire and performance, having sex can actually increase your testosterone production. If you are having sex very infrequently this is likely to reduce your testosterone levels.
How can testosterone deficiency be treated?
Testosterone deficiency can be diagnosed easily in most cases by listening to your symptoms and arranging some simple bloods tests. Based on the results of these tests, we can decide whether testosterone replacement therapy (TRT), is suitable for you. There is excellent evidence that, when used properly, TRT can help alleviate all of the symptoms listed above.
Recent good quality evidence suggests that safe use of TRT in men may be associated with a decreased risk of cardiovascular events, such as heart attacks and stroke.
There are different treatments for testosterone deficiency; the one that’s best for you can be discussed during your consultation. Options include:
- Gels applied to the skin each day
- Injections into the muscle (every 2-3 weeks or every 10–14 weeks)
Once you start treatment it is important to attend follow-up appointments so that we can make sure your treatment is working, and doing so in a safe manner.
Do you think you or your partner could have testosterone deficiency?
The ADAM questionnaire is a useful screening tool used by doctors to see if you might suffer with low testosterone. If you answer “yes” to questions 1 or 7, or three or more of the below questions, we suggest that you might need a testosterone blood test – you can contact us to book your consultation.
The ADAM questions
- Do you have a decrease in libido (sex drive)?
- Do you have a lack of energy?
- Do you have a decrease in strength and/or endurance?
- Have you lost height?
- Have you noticed a decreased “enjoyment of life”?
- Are you sad and/or grumpy?
- Are your erections less strong?
- Have you noticed a recent deterioration in your ability to play sports?
- Are you falling asleep after dinner?
- Has there been a recent deterioration in your work performance?
Above all remember: testosterone deficiency can be treated and you don’t have to (and shouldn’t) put up with the symptoms as a ‘natural’ part of ageing.
If you want further information or wish to make an appointment please contact Dr Foster or speak to our reception team on 01926 801111.
A final note on supplements, vitamins and minerals
- There is no medical evidence that any over-the-counter supplements (including tribulus, taurine, fenugreek, or ginger) will produce increases in testosterone levels.
- For healthy individuals on a balanced diet, additional vitamins and minerals will make no difference to testosterone production in men. However, there is some evidence that additional zinc or selenium can be linked to sperm quality, but not overall testosterone production.