Low Testosterone in Men: Causes, Symptoms, and Treatment Options

Q: Low Testosterone in Men: Causes, Symptoms, and Treatment Options

Ah Hua： Hello, in general, low male hormone levels should be assessed based on the actual situation, as currently only a few male hormone supplements are approved by the FDA. <br>In other words, the FDA considers that most of these formulations carry a risk of carcinogenicity. <b

Low testosterone levels in males?

My husband used to be able to maintain an erection for a long time when he was aroused, but now he becomes flaccid very quickly.
He seems to have a lack of interest in sex and doesn't want to engage in sexual activities or watch adult films.
Even when he does want to have sex, he struggles to maintain an erection and needs my assistance to achieve optimal firmness.
However, this only lasts for a short time, and even when he is erect, it is not firm enough for penetration.
If penetration does occur, he is unable to ejaculate.
We are trying to conceive, and I am at a loss as to why this is happening.
My husband does not smoke or drink and leads a normal lifestyle.
Could it be due to high levels of stress? He has seen a doctor who diagnosed him with low testosterone levels.
What should I do? I have heard that eating shellfish can help increase testosterone, but my husband has high uric acid levels.
Is it really advisable for him to consume shellfish? Are there other treatment options available?

A-Hua, 30~39 year old female. Ask Date: 2007/06/06

Dr. Xu Weikai reply Urology

Ah Hua: Hello, in general, low male hormone levels should be assessed based on the actual situation, as currently only a few male hormone supplements are approved by the FDA.
In other words, the FDA considers that most of these formulations carry a risk of carcinogenicity.
Often, male sexual dysfunction (let's call it that for now) is primarily caused by stress (economic, lifestyle, or even reluctance to have children, etc.).
I frequently encounter patients who experience anxiety related to job changes, economic instability, or pressure from parents to have grandchildren, which can easily lead to a fear of intimacy.
At this time, support from the female partner is crucial; appropriate stress relief methods such as taking baths, going on vacations, or getting massages can effectively alleviate stress and create a conducive atmosphere, which can significantly enhance interest.
From a Western medicine perspective, shellfish and mollusks, being rich in protein, zinc, and some trace elements, should provide some benefits for sexual function.
Some believe that supplementing with vitamins can help balance the body; generally, a multivitamin containing zinc (Zn) taken once or twice a week is sufficient.
This is a response from Dr.
Hsu Wei-Kai, Director of Urology at Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2007/06/06

More Info

Low testosterone, or hypogonadism, can significantly impact a man's quality of life, affecting various aspects such as sexual function, mood, energy levels, and overall health. In your husband's case, the symptoms you describe—difficulty maintaining an erection, decreased sexual desire, and challenges with ejaculation—are common indicators of low testosterone levels.

Causes of Low Testosterone
Low testosterone can stem from various factors, including:
1. Age: Testosterone levels naturally decline with age, typically starting around the age of 30.

2. Medical Conditions: Conditions such as obesity, diabetes, and metabolic syndrome can contribute to low testosterone levels.

3. Hormonal Disorders: Issues with the pituitary gland or hypothalamus can affect testosterone production.

4. Stress and Lifestyle Factors: Chronic stress, lack of sleep, and poor diet can also play a role.

5. Substance Use: While you mentioned your husband does not smoke or drink, other substances or medications can impact hormone levels.

Symptoms of Low Testosterone
The symptoms you mentioned—reduced libido, erectile dysfunction, fatigue, and mood changes—are classic signs of low testosterone. Additionally, men may experience:
- Decreased muscle mass and strength
- Increased body fat
- Mood swings or depression
- Difficulty concentrating

Diagnosis and Treatment Options
Since your husband has already been diagnosed with low testosterone, the next steps typically involve discussing treatment options with a healthcare provider. Here are some common approaches:
1. Testosterone Replacement Therapy (TRT): This is the most direct treatment for low testosterone. It can be administered through injections, patches, gels, or pellets. However, it's essential to monitor testosterone levels and overall health regularly, as TRT can have side effects, including potential impacts on fertility.

2. Lifestyle Changes: Encouraging your husband to adopt a healthier lifestyle can also help boost testosterone levels. This includes:
- Diet: A balanced diet rich in whole foods, healthy fats, and lean proteins can support hormone production. While shellfish are often recommended for their zinc content, if your husband has high uric acid levels, he should consult with a healthcare provider about dietary restrictions.

- Exercise: Regular physical activity, especially strength training, can help increase testosterone levels.

- Stress Management: Techniques such as mindfulness, meditation, or yoga can help reduce stress, which may positively influence testosterone levels.

3. Medications: In some cases, medications like Clomiphene citrate may be prescribed to stimulate the body's own testosterone production, especially if fertility is a concern.

4. Addressing Underlying Conditions: If your husband has conditions like obesity or diabetes, managing these can also help improve testosterone levels.

Consultation with a Healthcare Provider
It's crucial for your husband to have ongoing discussions with his healthcare provider about his symptoms and treatment options. If he is considering testosterone replacement therapy, he should also discuss the potential impact on fertility, especially since you are trying to conceive.
Additionally, if he has concerns about his uric acid levels and dietary choices, a consultation with a nutritionist or a specialist in metabolic health may be beneficial.

Conclusion
Low testosterone can be a complex issue, but with appropriate medical guidance and lifestyle adjustments, many men can see significant improvements in their symptoms. Encourage your husband to maintain open communication with his healthcare provider to find the best treatment plan tailored to his needs.

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