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Testosterone deficiency

Testosterone deficiency, medically referred to as hypogonadism, is a condition in which a man's body does not produce enough testosterone – the hormone that plays a central role in the development and maintenance of male characteristics such as muscle mass, bone density, and libido. Testosterone deficiency can occur at any age but is more common in older men. It can have both physical and emotional effects and significantly impair quality of life.

Causes of Testosterone Deficiency

Testosterone deficiency can be caused by various factors, which are divided into two main categories:

 

Primary hypogonadism: The deficiency of testosterone is caused by a malfunction of the testes. This can be triggered by genetic disorders such as Klinefelter syndrome, injuries to the testes, radiation or chemotherapy, or diseases like mumps orchitis.

 

Secondary hypogonadism: Here, the problem is traced back to the hypothalamus or the pituitary gland – the brain regions that regulate testosterone production. Causes can include tumors, trauma, genetic disorders, or certain medications.

 

Age-related decline: In many men, testosterone levels gradually decrease with age, known as androgenic aging.

Symptoms of testosterone deficiency

- Reduced libido and erectile dysfunction

- Fatigue and lack of energy

- Loss of muscle mass and bone density

- Increase in body fat, especially in the abdominal area

- Depressive moods, irritability, and difficulty concentrating

- Gynecomastia (enlargement of breast glands)

- Decrease in body hair and reduced beard growth

Diagnosis of Testosterone Deficiency

The diagnosis of testosterone deficiency begins with a thorough medical history and physical examination. Specific tests include:

  • Blood tests: The testosterone level in the blood is measured to determine if it falls below the normal range. The tests should be conducted in the morning when testosterone levels are highest. In some cases, multiple blood tests are performed to confirm the diagnosis.
  • Hormone tests: Tests to check pituitary function and the hormones LH and FSH can help distinguish between primary and secondary hypogonadism.
  • Imaging procedures: If a tumor or pituitary dysfunction is suspected, an MRI of the brain may be necessary.

Treatment options for testosterone deficiency

  • Testosterone Replacement Therapy (TRT): The most common treatment method is testosterone replacement therapy, which can be administered in the form of injections, skin patches, gels, or tablets. This therapy aims to normalize testosterone levels and alleviate symptoms.
  • Treatment of Underlying Causes: If the testosterone deficiency is caused by other conditions, such as tumors or hormonal imbalances, the underlying cause is treated.
  • Lifestyle Changes: A healthy diet, regular physical activity, and sufficient sleep can help support testosterone levels naturally and alleviate symptoms.

Preventive measures for testosterone deficiency

There are no specific preventive measures to completely avoid testosterone deficiency. However, a healthy lifestyle with sufficient exercise, a healthy diet, and avoiding excessive alcohol consumption can help reduce the risk of age-related testosterone deficiency. Regular medical check-ups and early treatment of conditions that could lead to hypogonadism are also crucial.


Common Patient Questions About Testosterone Deficiency (Hypogonadism)

The most common therapy is testosterone replacement therapy (TRT), which can be administered in the form of injections, gels, patches, or tablets. Additionally, lifestyle changes such as regular physical activity, a healthy diet, and sufficient sleep can positively influence testosterone levels. 

Possible side effects of TRT include skin reactions at the application site, increased hematocrit levels, sleep apnea, and in rare cases, a worsening of existing prostate issues. It is important to conduct the therapy under regular medical supervision to minimize potential risks.

Yes, a low testosterone level can lead to reduced sperm production and thus impair fertility. In addition, improper testosterone replacement therapy can further reduce sperm production. Therefore, careful consideration and consultation with a specialist should be undertaken if there is a desire to have children. 

Yes, a healthy lifestyle can positively influence testosterone levels. This includes regular physical activity, especially strength training, a balanced diet, sufficient sleep, and stress reduction. Avoiding excessive alcohol and nicotine consumption can also be beneficial.

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