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Over the last few decades men’s testosterone levels have been dropping by at least 1% per year.

Testosterone appears to decline naturally with aging but increased abdominal fat decreases it further.

Low testosterone levels can cause:

· Decreased sex drive, performance and fertility

· Increased fat mass with decreased muscle mass , strength and stamina

· Decreased bone density

· Tiredness, depression, irritability

· Hot flushes and sweats

· Reduced cognition and memory

The assessment of a man with low testosterone must include a thorough history: stress, sleep apnoea, alcohol and cigarettes, certain drugs (such as opiates, anti-fungals, and steroids), use of plastic containers, lack of exercise, weight gain, can all cause a decrease in the testosterone levels.

Dr Bitlan treats a lot of men with low testosterone levels with Male Hormone Replacement. These patients undergo a very thorough medical evaluation to assess their suitability for testosterone replacement therapy. In many instances testosterone levels improve as a result of correcting other health issues and making positive lifestyle changes.

Testosterone replacement therapy is reserved for people documented to have a low testosterone levels and symptoms of testosterone deficiency (Princeton III Recommendations).

There are several studies showing a reduction in mortality of all causes after testosterone replacement therapy in men with low testosterone.

Testosterone replacement therapy implies a very rigorous protocol of surveillance to ensure that there will not be any dangerous side effects.

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