Testosterone Deficiency & Male Hormone Optimization

About This Condition

Testosterone deficiency (hypogonadism) affects an estimated 20–40% of men over 45, with prevalence rising substantially with age, obesity, and metabolic syndrome. Symptoms include reduced libido, erectile dysfunction, fatigue, loss of muscle mass, increased body fat (particularly visceral), cognitive fog, depression, and diminished motivation. Despite its prevalence and treatability, low testosterone is routinely missed in primary care — either because it's not tested or because total testosterone is checked alone without free testosterone, SHBG, and LH/FSH, leaving the full hormonal picture incomplete.

Our Approach

We run a complete male hormone panel: total and free testosterone, SHBG, LH, FSH, estradiol (sensitive assay), DHEA-S, prolactin, and PSA. This allows us to distinguish primary from secondary hypogonadism, identify estrogen excess driven by aromatase activity in visceral fat, and rule out pituitary pathology. Treatment options include testosterone replacement therapy (TRT) via intramuscular, subcutaneous, or topical routes with close monitoring, or — for men who wish to maintain fertility — clomiphene or HCG-based protocols to stimulate endogenous production. We monitor hematocrit, PSA, and estradiol on a structured schedule and adjust dosing to optimize symptoms and biomarkers, not just bring numbers into "reference range." iDXA scanning tracks the musculoskeletal and metabolic response to treatment over time.