Evaluation and Treatment Options for Low Testosterone

Low testosterone is diagnosed based on a patients reported symptoms and confirmed using a simple blood test. Dr. Fenig normally orders this test in the morning hours when testosterone levels are highest. During the day, levels can fall by as much as 13 percent. Normal total testosterone levels range from 300 - 1000 ng/dL, although treatment is often considered if levels fall below 300-350 ng/dl. Testosterone levels naturally decrease with age, so age-specific averages should be taken into consideration when discussing treatment. 

There are a number of treatment options for low testosterone in men including:

  • daily topical gels
  • testosterone injections every 1-2 weeks
  • testosterone pellets injected beneath the skin every 3-4 months
  • daily skin patches
  • buccal tablets (placed under the gums) twice daily

It’s important to note that oral testosterone is not approved in the United States because of its potential for serious liver damage. In the past, men who were at increased risk of developing prostate cancer were warned against testosterone therapy, but recent data have shown this to be controversial. Supplemental testosterone is also a male contraceptive that will decrease sperm counts, so if you are considering trying to have a child, talk to Dr. Fenig first about the risks and benefits of this option. 

Low Testosterone in Infertility Patients

Many infertile males are diagnosed with low testosterone in addition to abnormalities in sperm production. Dr. Fenig’s treatment of low testosterone in a male desiring fertility is different than that of an older patient not interested in fertility.  Testosterone, when given to a patient, is a male contraceptive resulting in a lack of sperm production.

While some patients have symptoms of low T such as decreased energy, libido, concentration, exercise capacity, or moodiness, many patients do not know that their testosterone is low.  Dr. Fenig will often perform a delicate hormonal manipulation with medications to boost a man’s own testosterone production.  This is a safe, natural way to increase testosterone. If you desire children, however, it’s important to see Dr. Fenig to discuss the hormonal effects of testosterone on sperm production.

In cases of male infertility and low testosterone, Dr. Fenig will often try to enhance your body’s own testosterone production so as to not interfere with sperm production. In fact, studies have demonstrated that improving one’s natural testosterone helps increase testosterone levels within the testicles and provide a more favorable environment for sperm of good quality to be produced in the testis.


You can find out if you are experiencing symptoms of low testosterone by filling out this simple questionnaire and bringing your responses back to Dr. Fenig for a comprehensive consultation and evaluation. Click here for the Low T questionnaire.