Hypogonadism, often called low testosterone or “Low T,” is a medical condition where the testes do not produce enough testosterone. This deficiency can lead to various physical and psychological changes that affect quality of life. Addressing potential low testosterone requires a productive and informed conversation with a healthcare provider. This guide offers a practical path for initiating that discussion and determining the need for further testing and potential treatment.
Preparing for the Appointment
A consultation regarding potential hormone deficiency requires detailed preparation to provide your doctor with a clear clinical picture. Start by meticulously tracking specific, persistent symptoms over several weeks or months, noting their severity and duration. Common indicators include persistent fatigue, decreased libido, mood changes like irritability or depression, and a loss of muscle mass or strength despite consistent exercise. Also document any episodes of erectile dysfunction or unexplained weight gain, particularly around the abdomen.
Gathering a comprehensive list of all current medications and supplements is equally important, as certain drugs can suppress testosterone production. These include opioid pain medications, some antidepressants (like SSRIs), statins, and specific blood pressure medications (such as beta-blockers). Be ready to discuss significant recent life changes, including chronic stress, major shifts in diet, or alterations in your exercise routine, as these factors also influence testosterone production. While your Primary Care Physician (PCP) can begin the initial workup, a Urologist or an Endocrinologist may be the most appropriate specialist for complex cases or long-term management.
Discussing Diagnosis and Testing
When speaking with your doctor, frame the discussion around your documented symptoms and your concern for hormone balance, rather than aggressively demanding a specific test or treatment. A constructive opening focuses on collaboration and medical investigation, such as stating, “I’ve been tracking these symptoms and am concerned about my hormone levels.” The initial step in diagnosis is a blood test to measure the level of circulating testosterone.
Ask your doctor about the standard testing procedure, which includes measuring total testosterone and often free testosterone (the unbound, biologically active fraction). Testosterone levels naturally peak in the morning, so blood draws for accurate diagnosis must be performed between 7:00 AM and 10:00 AM. If the initial result is low, a second morning test is typically required on a separate day for confirmation, as hormone levels fluctuate significantly. Additional tests, such as Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH), may be ordered to determine the cause of the deficiency.
A total testosterone level below 300 nanograms per deciliter (ng/dL) is the common threshold used by medical organizations to define low testosterone. Your doctor will interpret this number in the context of your symptoms, as the goal is to achieve an optimal level that alleviates symptoms, which may vary from the standard “normal range” printed on lab reports.
Understanding Treatment Paths and Monitoring
Once a diagnosis of hypogonadism is confirmed, the conversation shifts to treatment options, which primarily involve Testosterone Replacement Therapy (TRT). The delivery method should be a joint decision, considering your lifestyle and medical history. Available options include intramuscular injections (every one to two weeks), daily topical gels or patches, or small pellets implanted under the skin that release testosterone slowly. Each method creates a different release curve, affecting how consistently levels remain within the therapeutic range.
Testosterone therapy is a long-term commitment, requiring consistent medical supervision. Regular follow-up blood work is necessary, typically every three to six months, to ensure hormone levels are maintained safely and effectively. Monitoring includes checking total and free testosterone, along with other blood markers for potential side effects. Your physician will specifically monitor hematocrit levels to watch for erythrocytosis (blood thickening due to increased red blood cells), which poses a health risk.