Low Testosterone Evaluation and Treatment

Low energy, low sex drive and changes in mood have many possible causes, and low testosterone is one of them. We confirm the diagnosis with the right blood tests, look for the reason behind it, and talk through treatment options with you plainly.

Become a Patient

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Understanding Low Testosterone

Testosterone is the main male sex hormone. It supports sex drive, erections, muscle and bone strength, red blood cell production, energy and mood. Low testosterone, also called hypogonadism or testosterone deficiency, means the body is not making enough and the low level is causing symptoms. Levels drift down slowly with age, but a true deficiency is a medical diagnosis that needs both symptoms and consistently low blood tests, not just a single number or a sense of slowing down.

Causes fall into two groups. One is a problem in the testicles themselves, such as an injury, a past infection, chemotherapy or a genetic condition like Klinefelter syndrome. The other is a problem with the signals from the brain and pituitary gland, which can come from excess weight, type 2 diabetes, poor sleep or sleep apnea, opioid or steroid use, heavy alcohol use, serious illness or, less often, a pituitary condition. Some of these causes are reversible, so finding the reason matters as much as measuring the level.

Professional care matters because the symptoms of low testosterone overlap with depression, thyroid disease, anemia, sleep problems and medication side effects. Testosterone levels also change through the day and from day to day, so a single test, especially one drawn in the afternoon, can be misleading. A careful evaluation avoids treating the wrong problem, and when treatment is right for you, regular monitoring keeps it safe. Testosterone therapy can also lower sperm production, which matters a great deal if you hope to have children.

Signs & Symptoms of Low Testosterone

Low sex drive. Less interest in sex than is usual for you is one of the most common symptoms.
Erection changes. Fewer morning erections, or trouble getting or keeping an erection.
Fatigue and low energy. Feeling worn down in a way that rest does not fix.
Low mood or irritability. Feeling flat, down or short-tempered.
Loss of muscle and strength. Losing muscle or strength despite staying active, often with more body fat around the middle.
Less body hair. Slower beard growth or thinning body hair over time.
Breast tenderness or swelling. Enlarged or tender breast tissue can occur.
Bone loss. Thinning bones, sometimes found after a fracture from a minor fall.

What to Expect

A video visit to review symptoms, health history, medicines and goals, including whether you hope to have children
Fasting morning blood tests at a local lab, repeated on more than one day to confirm a low level
Follow-up labs to look for a cause, such as LH, FSH and prolactin, when the level is low
An honest talk about treatment options, benefits and risks, including the effect on fertility
Monitoring labs during treatment, including the testosterone level, red blood cell count and, when appropriate, PSA
Testosterone is a controlled medication, prescribed only when appropriate under the federal and Utah rules that apply

How We Evaluate and Treat Low Testosterone

Confirming the Diagnosis

We talk through your symptoms, sleep, weight, medicines, alcohol and supplement use, and whether you hope to have children. To confirm low testosterone, we order a fasting morning blood test at a local lab and repeat it on a different day, because levels vary. If the level is low, follow-up labs such as LH, FSH and prolactin help find the cause. A physical exam may be part of the evaluation, and when it is, we will help you arrange an in-person visit.

Treatment Options

Treatment depends on the cause and your goals. Weight loss, better sleep, treating sleep apnea and changing medicines that lower testosterone can raise levels on their own. When testosterone therapy is appropriate, options include gels, injections and other forms, and we go over the benefits and risks of each. If you choose injections and need hands-on teaching or an injection given in a clinic, we will help you arrange an in-person visit. For men hoping to have children, testosterone therapy is usually not the right choice, and we discuss other options or refer you to a specialist.

Monitoring and Follow-Up

Testosterone therapy needs regular monitoring. We check your testosterone level, red blood cell count and, when appropriate for your age and risk, PSA at a local lab, usually a few months after starting and then about once a year. We also ask about blood pressure, sleep, mood and side effects, and adjust or stop treatment if the risks outweigh the benefits.

Benefits

A Careful Diagnosis

We confirm low testosterone with repeat morning blood tests and look for the cause before starting any treatment.

Honest Options

You hear the benefits and the risks, including the effect on fertility, so you can decide with clear information.

Safe Monitoring

Regular labs at a local lab keep treatment safe and the dose on track.

Care From Home

Visits happen by video for patients physically located in Utah at the time of the visit, so you can talk openly from a private space.

Your Treatment Journey

First Visit (Week 1)

We review symptoms, history, medicines and goals by video and order fasting morning blood tests at a local lab.

Weeks 2 to 4

A repeat morning test confirms whether the level is truly low, and follow-up labs look for the cause. We then talk through options together.

Months 3 to 6

If you start testosterone therapy, we recheck your level, blood count and other labs, review how you feel, and adjust the dose.

Long-Term Care

We repeat monitoring labs about once a year, or more often if needed, review whether treatment is still helping, and keep up with heart, bone and prostate health.

Warning Signs That Need Prompt Care

Chest pain or trouble breathing. Call 911 or go to the nearest emergency room.

Signs of stroke. Sudden weakness or numbness on one side, trouble speaking or a drooping face need emergency care. Call 911.

Pain or swelling in one leg. This can signal a blood clot and needs prompt care.

Sudden severe pain in the testicles. This is an emergency. Call 911 or go to the nearest emergency room.

A lump or change in the testicles. Any new lump, swelling or ongoing pain should be checked promptly.

Severe headaches or vision changes. Along with low testosterone, these can rarely point to a pituitary problem and should be checked promptly.

Loud snoring or pauses in breathing during sleep. Sleep apnea can lower testosterone, and testosterone therapy can make it worse.

Urinary changes. A weak stream, trouble emptying the bladder or blood in the urine should be evaluated.

Thoughts of self-harm. Call or text 988, the Suicide and Crisis Lifeline, or call 911.

If you recognize these signs, help is available. Early treatment leads to better outcomes.

Testosterone and Fertility

Testosterone therapy signals the body to make less of its own testosterone and can sharply lower sperm production, sometimes to zero. For many men this improves after stopping, but it can take months and is not guaranteed. If you are trying to conceive now, or may want children in the future, tell us before starting treatment, because other options or a referral to a specialist may fit better.

Testosterone Is a Controlled Medication

Testosterone is a controlled medication. When it is appropriate, it is prescribed following the federal and Utah rules that apply, which may include an in-person visit, and we cannot promise that it will be prescribed by telehealth. Prescriptions go to your pharmacy. Our in-person clinic is being planned in Cache County, Utah. If an in-person visit is needed before it opens, we will talk through the options with you.

Evidence-Based Treatment

Guidelines recommend testosterone therapy only for men with consistent symptoms and repeat morning blood tests showing a low level. It is generally not recommended for men planning a pregnancy soon, or for men with breast or prostate cancer, a high red blood cell count, untreated severe sleep apnea, uncontrolled heart failure, or a recent heart attack or stroke, and it is used with care in other situations. Treating the cause, such as excess weight, sleep apnea or a medication side effect, can raise testosterone on its own. Anabolic steroids and testosterone taken without a prescription carry real risks and should be avoided.

Common Questions About Low Testosterone

Why do I need more than one blood test?

Testosterone is highest in the morning and varies from day to day, and illness, poor sleep and some medicines can lower it for a while. Guidelines recommend confirming a low result with a second fasting morning test on a different day before making the diagnosis.

Will testosterone therapy affect my fertility?

It can. Testosterone therapy can lower sperm production, sometimes to very low levels. If you are trying to have children now, or may want to in the future, tell us before starting, because other approaches or a referral to a specialist may be a better fit.

Can testosterone be prescribed by telehealth?

Testosterone is a controlled medication. When it is appropriate, it is prescribed following the federal and Utah rules that apply, which may include an in-person visit. We cannot promise that it will be prescribed by telehealth, and we will explain the options for your situation.

What monitoring is needed during treatment?

We check your testosterone level and red blood cell count and, when appropriate for your age and risk, PSA. These are usually checked a few months after starting and then about once a year at a local lab. Monitoring keeps the dose right and catches side effects early.

Is low testosterone just part of aging?

Levels drift down slowly with age, but many older men have normal levels, and symptoms such as fatigue or low sex drive have many possible causes. A diagnosis needs both symptoms and repeat low blood tests, and when levels are truly low, there is often a reason worth looking for.

Does insurance cover low testosterone treatment?

Sagebrooke Family Medicine is an insurance-based practice, and we are in the process of joining insurance plans. What you pay depends on your plan, including any copay, deductible or coinsurance. Contact the practice to check whether your plan is accepted, and check with your insurer about coverage for testosterone, monitoring labs and any specialist referrals.

Get Answers About Low Testosterone

Low energy and low sex drive deserve a careful look. Request a telehealth visit and we will start with the right blood tests.