The decrease in sexual desire is just one of the signs of testosterone deficiency in men. Here you can find out when testosterone therapy should be used.

Testosterone is an androgen from the group of sex hormones. The hormone has a variety of functions in the body, such as Dr. Mario Pones, University Clinic for Urology at MedUni Vienna, reported on the MINI MED lecture “Testosterone – The Elixir of Men” in Vienna.

Causes of a testosterone deficiency

Testosterone deficiency can be congenital or acquired. If the problem arises from the testicles, one speaks of primary hypogonadism. On the other hand, if the function of the pituitary gland, which is involved in hormone production, is disturbed, one speaks of secondary hypogonadism. Other reasons for testosterone deficiency include B. burns, opioid abuse, cancer therapies or renal insufficiency.

Testosterone deficiency in old age

With the increasing life expectancy of the population, the spread of a form of androgen deficiency that only appears in later adulthood is becoming more common: late-onset hypogonadism. From the age of 40, the testosterone level in men decreases by about 1 – 2% per year. “Compared to female menopause, however, the decrease in testosterone levels and the associated symptoms are very different individually,” explained Dr. Pones.

Symptoms of a testosterone deficiency

The following symptoms indicate hypogonadism that begins before puberty:

• Small testicles
• male breast growth (gynecomastia)
• High pitched voice
• Sparse body / facial hair
• Decreased sexual desire
• Infertility
• Low bone mass
• Muscle loss

However, these are signs of late-onset hypogonadism:

• Libido loss
• Erectile dysfunction
• Depressed thoughts
• Exhaustion and loss of energy
• Low bone mass
• Muscle loss
• Hot flashes
• Loss of body hair

The path to diagnosis

“Unfortunately, there are no uniformly defined limit values ​​as to when one really speaks of a testosterone deficiency,” complained Dr. Pones. Testosterone levels should be measured early in the morning – a single measurement is not enough. However, the blood test only takes place if the man actually experiences symptoms that worsen his quality of life.

Testosterone therapy

The testosterone can in principle be administered in various ways, for example in the form of capsules, as a gel for application to the skin or as a depot syringe under the skin, in which the hormone is gradually released. “Sexual interest can increase after only three weeks, but in many cases, a plateau occurs after six weeks and there is no improvement,” said Dr. Pones. “Changes in erectile function and ejaculation can take up to half a year. Positive effects on the psyche can be achieved within a month, but sometimes it takes longer.”