Low Testosterone Treatment

Miami urologist Dr. Amy Pearlman specializes in the diagnosis, management, and treatment of testosterone deficiency in men of all ages.

What is Testosterone Therapy?

Testosterone is the main androgen found in people born male. Testosterone levels may start to decrease after 30 years of age by about 1% per year. Some men may even have low testosterone levels before 30.

What to expect with treatment

For many patients, testosterone therapy may lead to better erections, a higher sex drive, higher bone density, more lean body mass, improved depressive symptoms and improved energy and sense of well-being.

What are common symptoms of Low Testosterone?

Common symptoms of low testosterone include:

  • Reduced energy and fatigue
  • Reduced endurance
  • Diminished work and physical performance
  • Loss of body hair
  • Reduced beard growth
  • Reduced lean muscle mass
  • Obesity
  • Depressive symptoms
  • Cognitive dysfunction
  • Reduced motivation
  • Poor concentration
  • Poor memory
  • Irritability
  • Reduced sex drive
  • Reduced erectile function

What treatments are available?

There are many choices for testosterone treatment. 

  • Intramuscular: injected into muscle
  • Subcutaneous: injected into fat
  • Implanted into fat
  • Put on the skin with patches or gels
  • Taken orally

Treatment Benefits

  • Well-tolerated
  • Non-invasive
  • Minimal risk

FREQUENTLY ASKED QUESTIONS

Dr. Pearlman offers several treatment options tailored to individual needs, including:

  • Aromatase Inhibitors (Anastrozole):
    Used to lower estrogen levels and potentially increase testosterone. This helps maintain hormone balance and may aid in improving fertility.
  • Selective Estrogen Receptor Modulators (SERMs) like Clomiphene or Enclomiphene:
    These medications can raise luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels, increase testosterone, and/or improve sperm count. They are often chosen for their ability to stimulate natural testosterone production without compromising fertility.
  • Gonadotropins (Human Chorionic Gonadotropin, hCG):
    Often prescribed to stimulate testosterone production and enhance fertility. hCG mimics the action of LH, promoting natural testosterone synthesis and supporting sperm production.

These medications are carefully selected based on blood work and/or semen analysis results to create a personalized treatment plan that aligns with your specific health needs and fertility goals.

Enclomiphene is the trans isomer of clomiphene citrate. It is increasingly requested by men due to its potential to raise testosterone levels without negatively affecting fertility.

  • Why Use Enclomiphene?
    Enclomiphene specifically targets the increase of testosterone production while maintaining or enhancing fertility, making it an appealing option for those who wish to optimize hormone levels without compromising their reproductive capabilities.
  • Off-Label Use
    Although not traditionally used for this purpose, enclomiphene’s ability to improve testosterone levels while preserving fertility has led to its off-label use in appropriate candidates. Dr. Pearlman evaluates patients on an individual basis to determine if enclomiphene is a suitable option for their treatment plan.
  • Testicular injury/infection
  • Chemotherapy
  • Metabolic disorders 
  • Pituitary disorders
  • Medications (opioids, steroids)
  • Illness (acute/chronic)
  • Alcohol abuse (cirrhosis)
  • Chronic kidney disease
  • HIV/AIDs
  • Inflammatory conditions 
  • Obesity
  • Extreme weight loss
  • Diabetes
  • Sleep apnea
  • Aging
  • Prior anabolic steroids
  • Hypothyroidism
  • Head trauma
  • Brain radiation
  • Flushing
  • Edema or swelling
  • Breast enlargement
  • Injection site pain
  • Testicular shrinkage
  • Infertility
  • Acne
  • Scalp hair loss

Testosterone therapy can cause infertility. It is important to notify your healthcare provider if you are interested in current or future fertility as this will impact the treatment plan.

Human chorionic gonadotropin (hCG) may be used with testosterone therapy. It can help prevent the testicles from shrinking. 

Not necessarily. Men who start testosterone therapy who do not notice symptomatic benefit can stop at any time. Men who notice symptomatic improvement often stay on testosterone long-term.

There is no evidence to link testosterone therapy to prostate cancer. Many men with low testosterone and treated prostate cancer can safely use testosterone, as well.

CHOOSING THE RIGHT PROVIDER

Dr. Pearlman is fellowship-trained in men’s health, including testosterone deficiency. She believes in providing comprehensive care when it comes to the treatment of male hormonal concerns. As a result, she will discuss all treatment options with you prior to consideration of testosterone therapy so that she can help you come up with a treatment plan to best meet your quality of life goals. 

Focused Shockwave Therapy Package

6 sessions for $1,200 with Dr. Amy Pearlman, board-certified urologist. A non-surgical, drug-free option for erectile health.

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