Hormone therapy for men
Fatigue, reduced motivation, increased body fat, irritability, brain fog, decreased strength, and changes in sexual function can occur with low testosterone, but they can also overlap with sleep problems, thyroid dysfunction, metabolic changes, medications, and other health conditions. That is why we evaluate the whole picture before recommending treatment.
What to know about testosterone therapy
Start with the key points. Details and supporting research follow.
- 01Fatigue, low libido, weight gain and irritability are the usual symptoms. Underlying medical conditions such as sleep apnea, low thyroid and weight gain can also contribute to low testosterone.
- 02Routine monitoring is a standard, built-in part of your treatment. We keep a close eye on your testosterone levels, blood counts and sleep.
- 03Sometimes other health conditions contribute to your symptoms, and we refer when appropriate.
- 04Our comprehensive lab panel checks testosterone, SHBG, thyroid function, nutrient deficiencies, insulin resistance and more.
- 05What you get: a clear treatment plan built around your results, your symptoms and your goals.
- 06Exogenous testosterone can affect fertility, so please tell us if you are trying to conceive.
What to expect at your visit
You meet with Elizabeth G. Bagan, APRN. Tell us what has changed: your energy, libido, sleep, sexual performance, strength. We review your health history, discuss testing, and explain what happens next.
We protect your health information and respect your privacy.
At your results visit, we discuss our findings and treatment recommendations. If testosterone replacement therapy is appropriate, we review the benefits, risks, and timing before scheduling treatment.
The symptoms are real and they are not specific
Low energy, reduced libido, erectile dysfunction, loss of muscle mass, increased body fat, poor sleep, irritability, and changes in mood are common symptoms of low testosterone.
Other factors such as sleep apnea, thyroid dysfunction, diabetes and metabolic changes, certain medications, alcohol use, and chronic sleep deprivation can also contribute to lower testosterone levels or intensify these symptoms.
Our evaluation looks beyond a testosterone number alone. We assess your symptoms, health history, and supporting lab work so we can identify what may be contributing and build a more complete treatment plan.
The treatment process
Comprehensive evaluation
We review your symptoms, when they started, your medical history, medications, sleep, and previous treatment.
Labs drawn in-house
In-house testing evaluates testosterone and other relevant health markers. We explain which tests you need and how to prepare.
Results review
We review your results alongside your symptoms and explain whether testosterone treatment or another next step is appropriate.
Personalized treatment and monitoring
If treatment is appropriate, we discuss your options, expected benefits, risks, and follow-up. We monitor your response and adjust the plan when needed.
Benefits, risks, alternatives and candidacy
Testosterone therapy is not one-size-fits-all. Before treatment, we review your symptoms, lab results, health history and goals to make sure treatment is appropriate for you. We also explain what testosterone may improve, what we monitor, and what you should know before getting started.
What testosterone therapy may improve
When testosterone is low and symptoms are present, treatment may help improve:
- Energy and motivation
- Libido and sexual function
- Strength and ability to maintain muscle
- Body composition
- Mood and sense of well-being
- Mental clarity and focus
Everyone responds differently. Our goal is not simply to raise a testosterone number. We follow how you feel, how your body responds and what your lab work shows, then adjust your treatment when needed.
Risks and side effects
Testosterone therapy is generally well tolerated when appropriately prescribed and monitored, but side effects can occur.
- Red blood cell changes: Testosterone can increase red blood cell production. We monitor your blood counts and address changes when appropriate.
- Prostate health: We review prostate history and monitor appropriate prostate markers as part of ongoing care.
- Skin changes: Acne or increased oil production can occur, particularly when treatment is first started or doses are adjusted.
- Fluid retention: Some men may notice temporary fluid retention or swelling.
- Mood or sleep changes: Changes in mood, irritability or sleep can occur and should be discussed with your provider.
- Fertility: Testosterone therapy can reduce sperm production. Tell us before treatment if you are planning to expand your family.
- Pellet placement: Risks include infection at the insertion site and a pellet extruding through the incision site.
- Other health conditions: Sleep apnea, metabolic disease, cardiovascular risk factors and other medical conditions are considered as part of your overall treatment plan rather than treated separately from your hormone health.
Monitoring and treatment options
- Your treatment is monitored. Starting testosterone is not the end of the process. We follow your symptoms, testosterone levels, and overall response to treatment over time. If another health issue is contributing to how you feel, we address that as part of the bigger picture.
- Treatment options. If treatment is appropriate, we review your options, choose the approach that best fits your needs, and explain how we will monitor your response and adjust treatment when needed.
- If another condition may be contributing to your symptoms, we discuss next steps and arrange a referral when appropriate.
Who may not be a candidate
- Some conditions, including elevated hematocrit, untreated severe sleep apnea, certain cancers, or uncontrolled heart failure, may need to be addressed before starting testosterone. We review your history and labs to make sure treatment is appropriate for you.
Answered before you ask
When will I notice a difference?
Most patients are getting relief from their symptoms, including improvement in fatigue and mood, by their six-week follow-up. Finding your best dose can take several rounds of pellets and up to a year.
Can the pellets be taken out?
Short answer: no. Trying to dig pellets out would cause more harm than leaving them in place. The pellets dissolve completely in about five to six months once placed, so there is nothing left to remove at the end of the pellet cycle.
How long do pellets last for men?
In this practice, typically five to six months, varying with metabolism, activity level and stressors on the body.
Where this information comes from
Primary sources only: regulator publications, specialty society patient guidance and manufacturer information. Not marketing pages.
- 01U.S. Food and Drug Administration, Compounding and the FDA: Questions and Answers
- 02Federal Trade Commission, Health Products Compliance Guidance
Start with a consultation.
Your first appointment is an evaluation. We will listen to what has changed, evaluate the clinical picture and explain the options that may be appropriate for you.