Declining testosterone is a normal part of aging, but do not fear there is hope for replacement therapy, if it is appropriate for you. Deciding what is right for you is why we are here.

Here is what you need to know:

Many men look to testosterone replacement therapy to restore their hormone levels, give them that boost of energy and add that fire back to their sexual life.

Although there still remains controversy over the benefits and potential risks, it does not mean you should avoid testosterone replacement therapy. For some men, the therapy can be a viable option.

What is testosterone?

Testosterone is the hormone that gives men their manliness. Produced by the testicles, it is responsible for male characteristics. It also promotes the production of red blood cells and increases bone density. Normal levels are between 348 and 1,197 ng/dL (reference range may vary by laboratory). Low testosterone produces several symptoms, such as:

• Impotence or changes in sexual desire
• Depression and anxiety
• Fatigue
• Reduced muscle mass
• Weight gain
• Anemia
• Hot flashes
• Incomplete or delayed sexual development
• Infertility due to low sperm count

Who is a candidate?

You need to have both low levels of testosterone and be symptomatic to receive a prescription for testosterone replacement therapy. Although you may be symptomatic with a low testosterone level, coverage of the prescribed therapy depends on your insurance.

A simple blood test measures testosterone levels. Testosterone levels are more accurate when collected in the morning hours as levels can fluctuate daily and be influenced by medication, diet, and medical conditions. Weight gain is the number one contributor to falling testosterone levels. A five-point increase on the body mass index scale-for instance, going from 40-45-is like adding 10 years to your age in terms of testosterone levels.

What treatment is available?

Testosterone replacement therapy is often given by either gel application, injection or implantation. With the gel, you spread the dose daily over both upper arms, shoulders or thighs. Injections are typically given into the buttocks. Implantations are usually every four to six months.

Each method has its advantages and disadvantages. With gels, you have to be careful to avoid close skin contact for a few hours after the application with women and small children.

With injections, testosterone levels can rise to high levels for a few days after the injection and then slowly come down causing a roller coaster effect. You may feel a burst of energy within the next day or two and then it drops.

With the implant, the medication is slowly released over a period of time but over time you may have some scar tissue.

How long will I have to be treated?

Each patient will vary. Re-evaluation for need of therapy is performed routinely.

If you feel that you are experiencing any symptoms of low testosterone, schedule an appointment with your primary care provider to get evaluated.

Dr. Michael Lobos is a urologist with Vidant Urology of Washington located at 1202 Brown St., Washington, and can be reached 252-946-0136.