Low Testosterone Treatment Low Testosterone in Men Low T As men age, testosterone levels typically decrease, but in some cases, men develop a testosterone deficiency called Testosterone Deficiency Syndrome (TD) or simply Low Testosterone (LT). The search yielded 15,217 references, 546 (enrolling approximately 350,000 men) of which were used to support guideline statements. Minimal data were found regarding outcomes of frailty, risk of venous thromboembolism, hyperestrogenemia, sleep apnea, prostate biopsy, recurrence of treated prostate cancer, and incidence of breast cancer. Randomized controlled trials (RCTs) were sought for effectiveness questions, whereas both randomized and non-randomized studies were sought for adverse events and questions of association and risk factors. Random effects meta-analyses were performed when deemed appropriate. Evidence tables (for included studies) and evidence profiles (showing estimates of effect for the outcomes of interest) were generated and presented to the Panel. Because of circadian variations in testosterone levels, serum testosterone measurement should occur in the morning, or within two hours of awakening in shift workers (Figure 19 ). The first testosterone measurement should be obtained two to four weeks after initial implant to determine if the number of inserted pellets needs to be increased or decreased to achieve the appropriate therapeutic level. Another way to raise your testosterone is through pills that you swallow. Instead they are other kinds of medicine that work well to raise testosterone levels. Low testosterone that causes symptoms usually is treated with testosterone hormone. You can get it in different ways, such as in a shot, through a patch or gel on the skin, or in a tablet you place between your cheek and gum. A blood test called a serum testosterone test is used to determine the level of circulating testosterone in a body. The test is usually performed in the morning, when T levels are highest. They can also affect sleep, mood, the size of the testicles, and more. In both males and females, low testosterone can lead to lower bone mass and reduced sex drive. The ASA guidelines recommend that a baseline evaluation be performed before therapy is started. After treatment has begun, the guidelines recommend additional evaluations after three, six, and twelve months, and then yearly thereafter. However, these guidelines were designed primarily for older men using exogenous testosterone replacement therapy, and these men generally are at much higher risk for problems such as prostate cancer and BPH. I therefore use the following guidelines for my generally younger fertility patients, but I recommend that you can get your medical provider’s opinion as well. Beyond the decrease in muscle mass, lower levels of testosterone can also cause brittle bones, which increases the risk of fractures. Another name for primary hypogonadism is hypergonadotropic hypogonadism. In this type, your pituitary gland produces more luteinizing hormone (LH) and follicle-stimulating hormone (FSH) (known as gonadotropins) in response to low testosterone levels. The high levels of these hormones would normally tell your testicles to produce more testosterone and sperm. However, if you have damaged (most commonly related to prior chemotherapy) or missing