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Testosterone 101: What Every Man Needs to Know

  • Writer: Esra Shermadou
    Esra Shermadou
  • 5 days ago
  • 4 min read

Have you been wondering if testosterone therapy might be right for you?

Maybe you’ve noticed it’s harder to build muscle, your energy is down, your sex drive isn’t what it used to be—or you’re struggling with erectile dysfunction.

These can all be signs of low testosterone, often referred to as low-T.


An image showing an overweight male.
An image showing an overweight male.

I’m Dr. Esra Shermadou, a board-certified Family Medicine physician, and in this post, I’ll walk you through the essentials of testosterone: what it is, what happens when it drops, and what you can do about it.


🔍 What Is Testosterone?


Testosterone is the primary male sex hormone. About 95% is produced by the Leydig cells in the testes, with the rest coming from the adrenal glands.

It plays a major role in male development during puberty—but its importance doesn’t stop there.


In adult men, testosterone supports:

  • Muscle mass and bone density

  • Sperm production

  • Sex drive

  • Energy and mood

  • Cognitive function


Normal testosterone levels typically range between 300–1000 ng/dL. Starting around age 40, testosterone levels naturally decline by about 1–2% per year. For some men, this drop leads to hypogonadism—a clinical term for low testosterone paired with symptoms.


⚠️ What Causes Low Testosterone?


The most common cause of acquired low-T is simply aging. But other factors play a role too:

  • Obesity

  • Chronic stress

  • Sleep apnea

  • Type 2 diabetes

  • Certain medications

  • Testicular injury or infection


In many cases, it's a combination of these that leads to low testosterone levels.


🚨 Common Symptoms of Low-T


Low testosterone can sneak up slowly—but its effects are real. Some of the most common signs include:

  • Low energy and motivation

  • Decreased sex drive and fewer spontaneous erections

  • Weight gain, especially around the midsection

  • Loss of muscle mass

  • Mood changes like irritability or depression

  • Brain fog or memory issues


If these symptoms sound familiar, it may be time to get checked.


🧪 How Is Low Testosterone Diagnosed?


Diagnosing low-T requires both symptoms and lab testing.

Because testosterone peaks in the morning—especially in men under 45—your levels should be tested early in the day, on two separate occasions.


In addition to total testosterone, your provider may check:

  • Free testosterone

  • Prostate-Specific Antigen (PSA)

  • Hematocrit (red blood cell concentration)

  • Cholesterol and lipid levels


These help determine if testosterone replacement therapy (TRT) is safe and appropriate.


💉 What Are the Treatment Options?


Before jumping into TRT, it’s essential to optimize the basics:

  • Sleep

  • Diet

  • Strength training

  • Stress management


These lifestyle changes can significantly improve testosterone levels.


If symptoms persist, your provider may discuss testosterone therapy, which comes in different forms:

  • Injections

  • Gels or creams

  • Patches

  • Pellets (implanted under the skin)


The best option depends on your lifestyle, preferences, and overall health.


⏱️ What to Expect From TRT: Benefits & Timeline


When medically indicated, TRT can bring powerful benefits:

  • Increased energy and stamina

  • Improved libido and sexual function

  • Lean muscle gain

  • Reduced belly fat

  • Better mood and focus


Some effects are noticeable within a few weeks, but full benefits can take several months. TRT is not a quick fix—it’s a long-term commitment often paired with lifestyle change.


⚠️ Risks & Side Effects of TRT


Like any treatment, testosterone therapy comes with potential risks:

  • Acne or oily skin

  • Water retention

  • Increased red blood cell count

  • Worsening of untreated sleep apnea

  • Reduced sperm production and fertility


TRT doesn’t cause prostate cancer, but because the prostate has testosterone receptors, PSA levels may rise initially. That’s why monitoring is critical.


🚫 Who Should NOT Use TRT?


TRT is not for everyone. You may not be a candidate if you have:

  • Uncontrolled heart failure or cardiovascular disease

  • Untreated sleep apnea

  • Active prostate cancer


In these cases, treating the underlying condition must come first. Once stable or cancer-free, TRT may be reconsidered under medical guidance.


🩺 Safety Monitoring: Why Follow-Up Matters


If you start TRT, ongoing follow-up is essential.


Your provider should check:

  • Testosterone levels

  • PSA

  • Hematocrit

  • Lipid and metabolic markers


These are usually monitored every 3 to 6 months to ensure your therapy stays safe and effective.


🧬 Alternatives to TRT


Not ready for direct testosterone therapy? Some men explore non-TRT options like:

  • Clomiphene citrate

  • hCG (human chorionic gonadotropin)


These medications can help your body increase natural testosterone production—especially useful if preserving fertility is a priority.


💬 Final Thoughts


Feeling “off” isn’t something to ignore. Whether it’s low-T or something else, getting answers matters.


Work with a provider who listens, investigates the root causes, and creates a personalized plan. Testosterone therapy may be one piece of your health puzzle, but it works best when paired with intentional lifestyle shifts.



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📩 Have questions? Leave a comment or reach out.

📺 Don’t forget to subscribe to my YouTube channel for more on men’s health, hormone therapy, and metabolic wellness.


🔗 References:


 
 
 
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