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Health education · Hormonal healthSaint‑Hyacinthe
Fatigue, low libido, reduced strength, erectile problems, mood changes or loss of energy? These symptoms can sometimes be associated with testosterone deficiency, but several other causes are possible.
At Clinique IPS du Palais in Saint-Hyacinthe, our team can help you take stock of your symptoms, assess possible causes and determine whether a hormonal workup is appropriate.
The word andropause is often used to describe certain hormonal changes that can occur in men with age. However, this term can be confusing.
Unlike menopause, men generally do not experience a sudden and universal halt in hormone production. Instead, testosterone may decrease gradually with age in some people.
When this decrease is large enough to cause symptoms and is confirmed by appropriate testing, the terms testosterone deficiency or male hypogonadism are more accurate.1
Testosterone production may decrease gradually with age, but this change varies greatly from one man to another.
A man can have a lower level without significant symptoms. Conversely, symptoms attributed to “low testosterone” can sometimes be related to something else.
That is why symptoms alone are not enough to conclude that there is a hormone deficiency.
Possible symptoms
Possible manifestations can affect sexuality, energy, the body and mood.1
An increase in body fat or a decrease in bone density are also possible in some situations. These symptoms are not specific to testosterone deficiency.
No.
Fatigue can be associated with, among other things, lack of sleep, sleep apnea, stress, depression or anxiety, anemia, thyroid disorders, diabetes, medications, alcohol use, a chronic illness or reduced physical fitness.
A comprehensive assessment is therefore preferable before attributing fatigue to testosterone.
Reduced sexual desire can be associated with testosterone deficiency, but it can also be influenced by stress, fatigue, sleep quality, the couple relationship, depression, anxiety, medications, alcohol use or other medical problems.
Context is therefore essential.
Sexual health
Erectile problems are not necessarily caused by a hormone deficiency.
Erectile problems can therefore be an opportunity for a more comprehensive check-up.
They can also be associated with:
Assessment
The assessment begins with symptoms and medical history. A physical examination and tests may then be indicated.1
The health professional may want to know, among other things:
Tests
Yes.
Testosterone deficiency should generally not be diagnosed based on symptoms alone. A testosterone level consistent with the diagnosis must be demonstrated in an appropriate clinical context.1
Testosterone levels vary depending on factors such as the time of day. For this reason, hormonal assessment is usually standardized, with a morning sample collection, and may require more than one measurement depending on the situation.1
Depending on the situation, the health professional may want to assess certain elements that can help understand the cause of a hormone deficiency or make any potential treatment safer. This may include certain hormonal and metabolic tests.
The tests chosen depend on symptoms, age, medical history and initial results.
Low testosterone is not always simply related to aging. It can be influenced by various factors, including:1
Management may therefore differ depending on the cause.
Weight, body composition and metabolic health can be associated with testosterone levels. A person with obesity, insulin resistance, diabetes or metabolic syndrome may have a different hormonal profile.
Men’s hormonal health is therefore best assessed from a broader perspective.
Poor sleep quality or sleep apnea can be associated with, among other things, fatigue, reduced energy, low libido and concentration problems.
These symptoms can resemble those of a hormone deficiency. A sleep assessment may therefore be relevant.
Overall health
Before considering treatment, it is relevant to assess overall health and cardiovascular risk factors.
Health Canada also lists diabetes and ischemic heart disease among the chronic diseases that affect men, which reinforces the value of a comprehensive approach to men’s health.4
This may include, among other things:
Hypogonadism is a condition in which the body does not produce enough testosterone because of a problem affecting the testicles or the hormonal mechanisms that control them.1
There are therefore different forms of hypogonadism. Determining the cause can influence testing and treatment.
Not automatically.
Testosterone is a medication used to treat certain situations of documented hormone deficiency. In Canada, testosterone replacement products are indicated for men with a condition associated with a deficiency or absence of endogenous testosterone.2
Treatment must therefore be based on an appropriate medical assessment.
Treatment
Hormone therapy may be discussed when the conditions shown here are met. The decision must be individualized.
Different testosterone preparations may be used depending on the situation. The choice depends on the product, the clinical profile, preferences and the follow-up required. Clinique IPS du Palais can discuss with you the options appropriate to your situation when treatment is indicated.
Yes.
Testosterone therapy requires clinical and laboratory follow-up.1 The goals include:
So it is not simply a matter of starting testosterone and continuing without monitoring.
This is a particularly important point.
Testosterone therapy can reduce sperm production.1 For a man who wishes to conceive a child now or in the future, fertility plans must therefore be discussed before starting treatment.
Some cases of hypogonadism associated with a desire to have children require other therapeutic approaches; INESSS also recognizes specific treatments to induce sperm production in men with hypogonadotropic hypogonadism who wish to have children.3
Not necessarily.
In a man who truly has testosterone deficiency, correcting this deficiency may improve some sexual symptoms. However, erectile dysfunction often has several causes and may require a different approach.1
No.
The goal of hormonal management is not to artificially maximize testosterone. The goal is to treat a deficiency when one truly exists and when treatment is indicated.
Excessive levels can cause adverse effects.
No.
Commercial products are sometimes sold with claims related to testosterone production. This does not mean that they are a treatment equivalent to medical hormone therapy or that they correct documented hypogonadism.
Prescribed hormone treatment is based on a clinical assessment, tests and follow-up.
A hormonal assessment can also be an opportunity to look at:
This approach avoids viewing testosterone as the sole explanation for symptoms that often have multiple causes.
Seeking care
A consultation may be appropriate if you persistently have any of the following.
Depending on your situation, our team can, among other things:
Clinique IPS du Palais offers a program dedicated to hormonal health and hormone therapy.
Frequently asked questions
The term is commonly used, but it does not correspond exactly to female menopause. In men, hormone production may decrease gradually and some men develop symptomatic testosterone deficiency.
There is no precise or universal age. Hormonal changes vary considerably from one person to another.
Not necessarily. Many factors can influence libido.
No. Fatigue can have many causes. An assessment is necessary before concluding there is a hormone deficiency.
The assessment is based on symptoms, the clinical context and appropriate blood tests.
Not always. The professional may request confirmation depending on the results and the context.
Yes, in certain situations where the deficiency is documented and treatment is appropriate.
Yes. Testosterone treatment can reduce sperm production. Any wish to have children must be discussed before treatment.
No. Erectile problems can have many causes.
Do not change a prescribed treatment without discussing it with the professional in charge of your follow-up.
This page provides general information and does not replace an individualized assessment by a health professional.
