what causes high testosterone in females

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What is low testosterone?

Regaining fertility is not guaranteed, but it is possible for some patients depending on their age and duration of testosterone use. The first step is to end any testosterone therapy and get baseline lab tests to know where your levels truly are. Often, we find that the patient’s LH production has been suppressed. If you have low blood levels of testosterone AND symptoms that affect your daily life, your doctor may suggest taking supplemental testosterone. You may want to see a specialist to discuss the risks and possible benefits of treatment. Look for a urologist or an endocrinologist, a doctor who treats hormone problems. The body requires testosterone to develop the penis and testicles.

Fluid from the seminal vesicles and prostate gland combine with sperm to make semen. A better combination in terms of T production is combining anastrazole with either SERMs or HCG. Since anastrazole works in a completely different manner than SERMs or HCG, it can complement their effect on testosterone production while also keeping estradiol levels from getting too high.

Many people benefit from losing weight or getting a sleep study and using a CPAP machine, which delivers steady air through a hose connected to a mask or nosepiece to help you sleep. Often men will come to my office complaining that they have erectile dysfunction and are feeling excessively fatigued, weaker or depressed. Another major complaint is a marked decrease in their sexual desire. If your doctor diagnoses low testosterone, other tests may be considered before therapy. For example, low-t can speed bone loss, so your doctor may recommend a bone density test to see whether you also need treatment for osteoporosis. Low serum testosterone, also known as hypogonadism or andropause, affects many men — up to 40% — after the age of 45.

However, the cost of HCG along with the need for injections three times a week has limited the enthusiasm for long-term maintenance usage. SERMs and anastrazole are generally safe to take over the course of several years with proper monitoring. There are some concerns about taking these medications for decades as there really is just not good long-term safety on these medications for men. The data so far shows that clomiphene is safe to take for an intermediate length of time in a study of 400 men taking the medication for up to 7 years. Data beyond this time window for clomiphene is not currently available, as are studies on long term tamoxifen and anastrazole use. One potential concern is for men who have very low estradiol levels from taking anastrazole due to the potential risk of bone health and osteoporosis. HCG should be safe to take indefinitely with proper monitoring since it basically just mimics LH, the body’s natural pituitary hormone.

An enlarged prostate can block the flow of urine and cause symptoms such as a slow urinary stream and difficulty emptying the bladder. These symptoms are rare in young men but can occur in some circumstances. Assessment for symptoms of urinary obstruction can be performed in older men, or younger men with a history of benign prostatic hyperplasia (BPH, or enlarged prostate) or voiding problems. Standardized evaluations, such as the AUASS (American Urologic Association Symptom Score), can also be utilized. Congenital LH production problems are rare and can be treated with LH replacement (HCG injections). Lesions of the pituitary gland (such as a tumor or damage from trauma or radiation) can also result in decreased LH production.

Three to six months of testosterone shots can help start puberty. The testosterone can help increase muscle mass, beard and pubic hair growth, and growth of the penis. This treatment what is free t4 blood test given only if the bones have matured enough.

But the effects can be quite different from one man to the next. Sometimes in primary hypogonadism testosterone levels are within the normal range and gonadotropins are high. Your specialist will help you understand if you need treatment, even with normal testosterone levels.

If a man’s baseline estradiol is relatively high then I consider starting with anastrazole, since SERMs tends to increase estradiol levels in a significant percentage of men. Due to pituitary suppression, these men often do not respond well initially to SERMs or anastrazole, and going straight to HCG is sometimes the best choice. Men without a functional pituitary (e.g. prior pituitary surgery or radiation) are not going to respond to the use of SERMs either. Unfortunately, this seemingly basic concept is not as widely known as it should be within the medical community. I regularly see primary care physicians (and even some urologists) prescribing exogenous androgens to young male patients who are trying to have children. Hypogonadal men who are trying to have children (or who would like to have children in the future) should instead be treated with medications that increase their own endogenous testosterone production.