Low testosterone has been in the news with a significant number of patients asking for testosterone replacement. There is a large constellation of nonspecific symptoms associated with male hypogonadism (fatigue, decreased muscle strength, decreased libido, and decreased erections). On exam, you may find gynecomastia, diminished testicular volumes and absence of morning erections. If there’s not a presence of one of these, it’s highly unlikely that the patient has testosterone deficiency.
There are several tests your doctors need to go through to evaluate for low testosterone. There are many ways we can naturally increase our testosterone levels that you can do before considering replacement therapy.
- Sleep. The majority of testosterone is released during sleep. Fragmented sleep and obstructive sleep apnea can cause low testosterone
- Lose weight. Fat cells increases the conversion of testosterone to estrogen.
- Strength training. Build muscles with resistance training. More muscle mass is positively correlated with higher testosterone. Muscles also increases your androgen receptors making you more sensitive to testosterone.
- Chronic stress can lead to elevated cortisol levels which can decrease testosterone. How are you managing your stress throughout the day? We encourage our patients to get regular movement in with frequent walks outside as well as journaling, unplugging from social media.
- Hydration. Dehydration can cause elevated cortisol which causes decrease testosterone (notice a pattern?)