Testosterone gels like Tostran or Testogel are effective treatments for men with low testosterone (also called male hypogonadism). They are applied to the skin every day and help to improve low testosterone symptoms such as erectile dysfunction, low sex drive, and fatigue.

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What is low testosterone?

Testosterone is a hormone produced by the testes in men. It is vital for a number of functions in the body including:

• The production of red blood cells
• Maintenance of bone density
• Regulation of sex drive
• Maintenance of muscle mass

In some men, testosterone levels in the body can fall below the normal level and cause symptoms. Low testosterone in men is also known as male hypogonadism.

Causes of low testosterone

Testosterone levels in men steadily decline with age, beginning around the age of 30. Older men have lower levels of testosterone. This is a normal part of ageing. This decline is very slow and steady and men are unlikely to suffer symptoms from this natural fall in levels. 

The production of testosterone from the testes is regulated by the pituitary gland and the hypothalamus in the brain. Low testosterone can sometimes be caused by a problem or disease of the pituitary gland or hypothalamus.

Other causes include:

• Obesity
• Type 2 diabetes
• Removal of one or both testicles
• Injury to one or both testicles
• Chemotherapy
• Radiation therapy

Diagnosing low testosterone

Low testosterone is only diagnosed if a man shows signs and symptoms of low testosterone as well as having blood tests that show consistently low levels of testosterone in the body. 

To request Testosterone Replacement Therapy (TRT) from our website you will need to complete an online consultation form, as well as having a blood test to measure your testosterone levels. We can arrange for a test kit to be sent to your address or, if you have had a test performed elsewhere, you can send us the results of your test. Our doctors need to interpret these test results before prescribing TRT.

Symptoms of low testosterone

Low testosterone symptoms can be both physical and psychological. There are many possible symptoms:

• Decreased libido
• A reduction (or absence) in morning/night-time erections
• Erectile dysfunction
• Decreased body hair
• Gynaecomastia
• Reduction in muscle mass and strength
• Fatigue
• Sleep disturbances
• Mood changes (e.g depression, irritability, anxiety)
• Poor concentration and memory
• Long term low testosterone can lead to osteoporosis
  The most common symptoms are erectile dysfunction, low sexual desire and a reduction in morning/night-time erections.

Treatment

The treatment for low testosterone/hypogonadism is Testosterone Replacement Therapy (TRT). TRT consists of adding testosterone (through gels, tablets or injections) to the body to increase testosterone levels. This increases testosterone levels to a normal range and helps to correct any signs or symptoms that may be affecting a man’s quality of life.

The time it takes for symptoms to improve varies from patient to patient. Some symptoms will improve within 3 months. Other symptoms, like erectile dysfunction, may take longer to improve. The maximum effect of testosterone gel on symptoms is generally seen after a period of time of 6-12 months.

Treatments include:

• Testosterone gels applied to the skin every day
• Oral testosterone tablets taken every day
• Injections of testosterone every 10-14 weeks

Our doctors are able to prescribe Tostran gel and Testogel sachets, or Testogel pump. Our doctors are unable to prescribe injections or oral tablets of testosterone. We recommend discussing both of these options with your GP or endocrinologist.

Testosterone gels

When testosterone gels are applied to the skin, the testosterone is absorbed through the skin barrier and into the bloodstream. This increase in testosterone improves hypogonadism symptoms such as erectile dysfunction and decreased libido. 

The dose of testosterone gel depends on the dose you are prescribed. Tostran and Testogel pump are canisters that contain the gel. These have a pumping mechanism that delivers a certain dose with each pump. Your doctor will tell you how many pumps of gel to apply each day.

Testogel sachets are individual sachets that contain the gel. The usual recommended dose is one sachet worth applied to the skin daily, but your doctor may prescribe a different dose.

 

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