Low Testosterone (Hypogonadism)
A comprehensive, safety-first approach to diagnosing and treating Low T — focused on restoring energy, mood, sexual health, and long-term wellness.
Educational content only; therapy is individualized after medical evaluation and labs.
What we offer
- Guideline-based diagnosis
- All modern TRT options
- Close safety monitoring
Symptoms of Low Testosterone
- Fatigue, low daytime energy
- Decreased libido and weaker erections
- Reduced muscle mass/strength; increased abdominal fat
- Mood changes: irritability, low motivation, depression
- Brain fog, reduced concentration or memory
- Decreased body hair growth
- Low bone density/osteoporosis
- Sleep disturbances
- Hot flashes or night sweats
How We Diagnose Low T
- Two early-morning total testosterone tests on separate days (goal ≥ 300 ng/dL when treated in context of symptoms).
- Comprehensive assessment of symptoms and focused physical exam.
- Baseline labs to find causes and ensure safety: LH, FSH, prolactin, CBC/hematocrit, PSA, liver function, lipids, ± estradiol, thyroid, and fertility considerations.
We always correlate numbers with how you feel — and we address reversible causes first.
Common Causes
- Sleep apnea
- Obesity/metabolic syndrome
- Medications (opioids, steroids)
- Chronic illness or stress
- Pituitary disorders or testicular injury
- Natural aging
Benefits of Treatment (by System)
Brain & Mood
Improved mood and motivation; better focus and memory.
Sexual Health
Increased libido; improved erectile function and orgasm quality.
Musculoskeletal
More muscle mass/strength; reduced fat; stronger bones.
Metabolic
Better insulin sensitivity and lipid profile; weight support.
Energy & Sleep
Less fatigue; improved sleep quality and stamina.
Overall Well-Being
Enhanced confidence and quality of life.
Cardiovascular effects are an active research area; we individualize decisions based on your risk profile.
Before Starting Therapy
- Optimize diet, exercise, and sleep.
- Treat reversible causes (e.g., sleep apnea, medication effects).
- Clarify fertility goals — most testosterone therapies suppress sperm production.
Treatment Options & Costs
| Option | How It’s Used | Pros | Cons | Approx. Cost* |
|---|---|---|---|---|
| Topical Gel/Cream | Daily to clean, dry skin (shoulders/arms/abdomen) | Steady levels; needle-free; easy to adjust/stop | Transfer risk before dry; skin irritation; daily habit | ~$45/mo generic (GoodRx); brand $200–$500 |
| Clomiphene Citrate | Oral pill stimulates LH/FSH to boost own T | Preserves fertility; oral; affordable | Not for all; mood/vision side effects (rare) | $20–$60/mo |
| Short-Acting Injections | Self-inject weekly or twice weekly (cypionate/enanthate) | Lowest cost; flexible dosing; strong symptom relief | Peaks/troughs; injection discomfort; mood swings possible | $15–$40/mo + $5–$10 supplies |
| Testosterone Pellets | Implanted every 3–6 months | Set-and-forget; steady levels | Minor procedure; not adjustable between implants | $150–$400/mo equivalent |
| Oral TU (Undecanoate) | Twice daily with meals | Needle-free; stable with proper dosing | Expensive; must take with meals; may raise BP/lipids | $400–$900/mo |
*Prices are typical cash estimates and may be lower with insurance/coupons. We’ll help you find cost-effective options.
Risks & Safety Monitoring
Possible Side Effects
- Higher red blood cell count (hematocrit)
- Acne/oily skin or fluid retention
- Worsening sleep apnea
- Mood changes; breast tenderness/enlargement
- Prostate monitoring is essential
Ongoing Monitoring
- Baseline labs: testosterone, hematocrit, PSA, liver function, lipids
- Recheck at 6–8 weeks after starting/adjusting
- Then every 3–6 months once stable
- Targets: T 400–800 ng/dL, hematocrit <54%, symptom relief
We individualize decisions for cardiovascular risk, prostate health, fertility, and sleep apnea. Never start or stop therapy without medical guidance.
Our Recommendation
Topical gel with a savings card or GoodRx (often ~$45/month) balances convenience and stable levels for many men. If you prefer the lowest cost and are comfortable with self-injection, weekly injections are excellent. If preserving fertility is a priority, consider clomiphene citrate. We tailor therapy to your goals and medical profile — with close monitoring for safety.
Take the Next Step
At Advanced Urology, we personalize Low T care to restore vitality while protecting long-term health. Let’s review your symptoms, labs, and goals — then choose the best plan together.
Fertility plans, prostate history, and cardiovascular risk are discussed before starting therapy.