How can hormone therapy help men with low testosterone?

For guys who have low testosterone (Low T), hormone therapy can help address symptoms such as fatigue and erectile dysfunction, but it's not the fountain of youth, and it shouldn’t be treated as an elixir for men looking to reclaim the vigor of their school years. Declining testosterone levels are a normal part of aging and don't always warrant treatment.

If you are tired, irritable, and/or disinterested in all the things that once brought you joy, including sex, and you suspect you have Low T, your doctor can order a blood test, but only after ruling out other causes, such as depression, says Robert Brannigan, a urologist at Northwestern Memorial Hospital and associate professor of urology at Northwestern University Feinberg School of Medicine. Many symptoms of Low T, such as fatigue and erectile dysfunction, mimic depression or present as a side effect of heart disease, obesity, or other health condition. It's important to figure out if an underlying medical condition, such as an autoimmune disorder, is causing your Low T.

According to Brannigan, testosterone levels vary widely from one man to the next. Healthy men can have testosterone levels between 270 and 1,070 ng/dL. "There are very few absolute indications for treating low testosterone," he says.

In other words, treating is optional. In his practice, Brannigan follows the Endocrine Society's recommendations: If a man doesn't have evidence of breast cancer or untreated prostate cancer; his testosterone levels are below 300; and he's bothered by symptoms of low testosterone, he's a candidate. While there's no doubt that treatment can improve the quality of life for men with low testosterone levels, there's no consensus on whether it's beneficial to men who aren't suffering from so-called "male menopause."

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