How can I help increase my testosterone levels?

First off, there are things a guy can do to raise his testosterone (T) levels naturally:

• Exercise regularly
• Eat a healthy diet
• Lose some weight (fat -- especially belly fat -- acts like a testosterone "sponge")
• Quit smoking

A guy with low T also has medical options, the most popular being a testosterone gel. These products, which are prescription only, are applied daily to the skin of the shoulders, upper arms, or abdomen. The testosterone in the gel is absorbed into the body through the skin. If used correctly, testosterone levels can return to normal and stay there. Testosterone can also be raised via injections or patches. Your doctor can advise you about which delivery route might be best for you.

Testosterone replacement isn't a cure-all, and it shouldn't be used unless a guy has true hypogonadism. But I've seen it work for many of my patients, who report having more energy and a renewed interest in sex.

If you think that your sex life could use a little boost and that increasing testosterone might be for you, here's what you and your doc need to do:

• Try old-fashioned options first. Being physically active (exercise can boost testosterone production), sleeping well, and engaging in sexual fantasies can all increase your testosterone in natural ways.
• Rule out other causes of low libido. Mood, medications, and relationship issues can also play a role in igniting or dousing passion. Mad at your spouse? Taking a new blood pressure med, antidepressant, or birth control pill? Feeling blue? Discuss these with your doc, who may refer you to a specialist.
• Be sure your testosterone blood test is accurate. Get it done in the a.m., when testosterone levels are naturally the highest, and expect to have the test repeated a few times since testosterone levels fluctuate. If you're only sent for one test, ask why.
• Know your treatment options. Men can choose between twice-a-month injections, twice-a-week abdominal-patch applications, or daily rub-ins of a gel or cream. There are no Food and Drug Administration (FDA)-approved versions for women, so your doctor will either prescribe one of the male products ("off label" use) and instruct you to use a much smaller amount (typically, about one-tenth the male dose) or will order a custom preparation made by a compounding pharmacy.
• Be patient. You won't begin to reap the rewards of treatment for 6 to 8 weeks, and not everyone sees benefits. If you don't within 6 months, stop.
• Get monitored. Men, your doc should schedule regular blood tests (about every 3 months) to check your testosterone levels, high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol, hemoglobin, and prostate-specific antigen (PSA) -- testosterone may not cause prostate cancer, but it can speed up a preexisting condition. Women, you also need regular blood tests, mainly to check your testosterone levels. Under-dosing won't help your libido (or muscles, bones, and brain). Overdosing can trigger side effects, such as acne or unwanted hair on the face, chest, or back. Don't worry -- adjusting the dose reverses these effects.
• Keep it up. The effects of testosterone only last as long as you take it.

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