Symptoms of Low Testosterone

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Testosterone Replacement Therapy (TRT) is the gold-standard for treating men with hypogonadism (low-testosterone). We offer testosterone cream and injectable testosterone replacement.  Testosterone cream is well-absorbed and a common treatment method with fewer side effects and tends to mimic the peak and trough of natural testosterone in the body. The most effective replacement method is testosterone injections however most men experience more side effects with the weekly injections.  You can easily self-inject at home and we will teach you how.

Clomiphenem (Clomid) and Enclomiphene belong to a class of medications called Selective Estrogen Receptor Modulator (SERM).  These are alternative treatment options for men with hypogonadism or low testosterone that still desire fertility.  Testosterone cypionate injections are more effective at raising serum testosterone levels and improving symptoms, but will result in lower testicular volume which is associated with a decreased sperm production, therefore acting as a natural male contraceptive.  If you are younger than 40 years old and still desire fertility, we will discuss options using SERMs alone or in conjunction with testosterone cypionate to treat your suboptimal testosterone levels.

Aromatase inhibitors (AI) are medications used to lower estrogen levels by inhibiting the conversion of testosterone to estrogen.  Anastrazole is the most commonly used AI to decrease unwanted side effects of high estrogen such as nipple sensitivity, breast tenderness and gynecomastia while on TRT.  Anastrozole is best used as an adjunct therapy along with testosterone cypionate injections.

PDE5 inhibitors are prescribed for the treatment of erectile dysfunction (ED).  Roughly half of all males between the ages of 40 and 70 have some degree of ED.  ED is defined as the inability to achieve and maintain an adequate erection for satisfying sexual activity.  PDE5 inhibitors, like sildenafil (Viagra) and tadalafil (Cialis) can help males achieve and sustain an erection, especially if the underlying cause is physiological. PDE5 inhibitors are not appropriate for all males and should never be used with nitrate medications like nitroglycerine and Isosorbides.