While “testosterone replacement” is a well-known term and a service that many male health clinics offer — there are a few things you should know before seeking treatment. At The Prime Clinic, we ensure patients fully understand why your testosterone levels matter, what your treatment options are, and why testosterone optimization might be the best route forward.
Why Your Testosterone Levels Matter
Testosterone is the primary male sex hormone and it performs a number of vital functions in the body. Testosterone levels are at their peak in our 20’s and 30’s and gradually decrease by about 10% each decade thereafter. Low testosterone levels can lead to symptoms such as low sex drive, erectile dysfunction, fatigue, depression, obesity, and decreased muscle mass. It can also contribute to the development of diabetes, heart disease, decreased bone density, and ultimately an early death. This is why it is important for men to have their testosterone levels checked and to consider testosterone optimization if they experience these symptoms.
Where Do I Start?
The first step towards testosterone optimization is a consultation at The Prime Clinic, where you will be asked about your symptoms. I will also order lab tests to check your blood levels. Once I have both pieces of information, we can discuss whether testosterone optimization is right for you.
Testosterone Optimization Versus Replacement
When most men think about doing something about their testosterone levels, they think of testosterone replacement. I prefer to talk about testosterone optimization because not every man needs to replace testosterone in his body, and there can even be some downsides to doing so. The testosterone levels in our blood are not the whole story. It is also important to consider how a man feels with the levels he has. Some men have what are considered “low testosterone blood levels,” yet don’t have symptoms of low testosterone. There may be no need to increase their levels if that is the case. Other men can have “normal” testosterone levels and yet still have symptoms of low testosterone. These are the men who may wish to consider raising their levels to see if the symptoms improve. At The Prime Clinic, I work with patients to identify the optimal level of testosterone for each man, one that improves symptoms of low testosterone without raising it so much that it causes adverse effects.
Methods to Increase Testosterone Levels
There are several methods available to optimize testosterone levels. One that I am particularly excited about is an oral medication called clomiphene (Clomid). Clomiphene is a pill taken daily or every other day. Rather than raising testosterone levels directly, it works in the body to increase a man’s natural testosterone production. Clomiphene is generally very well tolerated, safe, and has few side effects.
The more commonly used method to increase testosterone levels is direct testosterone replacement, administered topically or by injection. There are various reasons to choose one method over another and I discuss the benefits and risks of each with my patients before we make a decision about which to use.
Risks of Increased Testosterone
Of course, as with any medical treatment, there are risks involved in raising testosterone levels. Men with prostate cancer should not take testosterone. Although the use of testosterone does not cause prostate cancer, it can make prostate cancer grow more quickly in men who do have it. This is the reason why I always check my patients’ Prostate-Specific Antigen (PSA) levels before starting testosterone optimization, and at least once a year thereafter.
High levels of testosterone can also increase production of red blood cells potentially leading to blood that is “too thick” to function properly. Testosterone use has also been associated with abnormal blood clotting, worsening of sleep apnea, and acne. Finally, a consequence of replacing testosterone that many men find distressing is that it turns off the body’s natural testosterone production (possibly permanently with long-term use) leading to shrinkage of the testicles. Nobody likes shrinkage! The use of clomiphene to raise testosterone levels, on the other hand, increases a man’s natural production of testosterone and does not have this unwanted side effect. This is one of the reasons I recommend Clomiphene to my patients when appropriate.
What Does Testosterone Optimization Cost?
I offer testosterone optimization at The Prime Clinic on a monthly subscription basis. There are two options depending on whether or not a patient has health insurance. For men who do not have health insurance coverage, I offer a plan that includes lab testing, all medications, medical supplies, and personalized management of their treatment for one monthly fee. For patients whose health insurance will cover the costs of labs, medications, and medical supplies, I offer a plan that includes the same personalized management at a lower cost.
If you are experiencing symptoms of low testosterone and would like to explore your options further, schedule a free consultation at the Prime Clinic. Our office is open by appointment only, with availability in the evenings and on weekends.