Hormone evaluation for men
No drive at work or at home. Belly fat that showed up and will not leave. Strength going the wrong way, foggy by mid afternoon. Two morning blood draws and the right supporting labs will tell us whether this is testosterone or something else, and either answer is useful.
The honest version, before the detail
Everything below expands on these points, with sources.
- 01Fatigue, low drive, weight gain and low mood are the usual symptoms, and they are also the symptoms of sleep apnoea, depression, thyroid disease and alcohol intake.
- 02Testosterone varies through the day, so a diagnosis needs more than one appropriately timed morning measurement.
- 03Testosterone therapy can reduce sperm production. If you may want children, tell us at the first appointment.
- 04It can raise red blood cell count and worsen untreated sleep apnoea, so monitoring is part of treatment rather than optional.
- 05If testing points at a cause other than testosterone, that is a useful result and we act on it.
- 06What we run: morning testosterone twice, plus the supporting labs needed to read it and to check the other causes.
- 07What you get: the numbers, what they mean, the plan, and how long it takes before you should feel different.
How this works, practically
You see Elizabeth G. Bagan, APRN, for 30 minutes. You talk, we test, and you leave knowing what happens next.
Nothing about your care is discussed with anyone else. Follow up happens by phone, text or in the office, whichever you prefer.
Most men come in because something measurable changed. You do not have to frame it as anything more than that.
The symptoms are real and they are not specific
Low energy, reduced libido, erectile difficulty, loss of muscle, increased body fat, poor sleep, irritability and low mood are the common presentation.
Sleep apnoea, depression, thyroid disease, diabetes, alcohol intake, medication effects and simple sleep debt all produce overlapping pictures. Testosterone is one candidate explanation, not the default one.
Testosterone also varies through the day, which is why the timing and the repetition of the test matter. A single convenient draw is not a sufficient basis for a diagnosis.
What we do before anything is prescribed
History
Symptoms and onset, sleep, alcohol, medications, weight history, cardiovascular and prostate history, and whether you may want children in future. That last question matters and is asked early.
Appropriate testing
Morning testosterone, repeated on a second day for confirmation, plus the related studies needed to read it properly and to check the other causes above. Guidelines are clear that one convenient draw is not a diagnosis.
Honest interpretation
We go through what the numbers support. If the picture points at sleep apnoea or another condition, that is the finding and we act on it.
Options and monitoring
If treatment is appropriate, we cover delivery methods, what monitoring is required, and the fertility implications before you decide.
Benefits, risks, alternatives and candidacy
This appears before the booking button on purpose. You should be able to decide with the risks in front of you.
What it may do
- Where testosterone is genuinely low and confirmed on repeat testing, treatment may improve libido, energy, mood and body composition.
- Response varies between individuals and some men notice little change. Monitoring exists to establish which applies to you rather than to assume.
Risks and side effects
- Testosterone therapy can reduce sperm production and can affect fertility. If you may want children, say so before starting, not after.
- It can raise red blood cell count, which requires monitoring, and it can worsen untreated sleep apnoea.
- Effects on the prostate require baseline assessment and ongoing monitoring.
- Acne, oily skin, fluid retention and mood changes can occur.
- Pellets are compounded medicines, made by an FDA registered 503B outsourcing facility and not covered by insurance. The dose is set for the months between visits, so follow up labs are scheduled to fine tune it.
Alternatives, including doing nothing
- Treating the actual cause, which is frequently sleep apnoea, alcohol intake, medication effects, thyroid disease or weight related.
- FDA approved testosterone products in gel, patch or injectable form.
- Structured sleep, resistance training and weight management, which measurably affect several of these symptoms.
- Referral to urology or endocrinology where that is the right level of care.
- Monitoring without treatment, which remains a legitimate choice.
Who may not be a candidate
- Untreated prostate or breast cancer, an unevaluated raised red cell count, untreated severe sleep apnoea, uncontrolled heart failure, and active plans for conception are among the situations that change or exclude this option.
Answered before you ask
Will this affect my fertility?
Why do you want to test twice?
How long do pellets last for men?
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
Request a hormone evaluation
The first appointment is an evaluation, not a prescription. If the cause turns out to be something other than testosterone, that is a useful result.