So, how does one ensure that testosterone levels remain in balance? Some doctors suggest that monitoring testosterone levels every five years, starting at age 35, is a reasonable strategy to follow. If the testosterone level falls too low or if the individual has the signs and symptoms of low testosterone levels described above, testosterone therapy can be considered. However, once testosterone therapy is initiated, testosterone levels should be closely monitored to make sure that the testosterone level does not become too high, as this may cause stress on the individual, and high testosterone levels may result in some of the negative problems (described previously) seen.
Primary hypogonadism (congenital or acquired): Testicular failure due to diseases and conditions in the body such as cryptorchidism, bilateral torsion, orchitis, vanishing testis syndrome, orchiectomy, Klinefelter Syndrome, chemotherapy, or toxic damage from alcohol or heavy metals; these men usually have low serum testosterone levels and gonadotropins (FSH, LH) above normal range Hypogonadotropic hypogonadism (congenital or acquired): Gonadotropin or luteinizing hormone-releasing hormone (LHRH) deficiency or pituitary-hypothalamic injury from tumors, trauma, or radiation; these men have low testosterone serum concentrations but have gonadotropins in the normal or low range.
Twenty-one men with erectile complaints who were found to have a low level of serum testosterone without a reciprocal elevation of the serum levels of luteinizing hormone were evaluated to identify whether the defect was of hypothalamic or of pituitary origin. Patients underwent a luteinizing hormone (LH)-follicle-stimulating hormone (FSH)-releasing hormone stimulation test that showed a normal but sluggish increase in LH and FSH levels, thus ruling out a pituitary defect and suggesting a suprapituitary abnormality. This was confirmed when, in response to clomiphene, patients had a normal increase in gonadotropin and testosterone levels. Although the basal as well as clomiphene and gonadotropin releasing hormone-stimulated levels of total testosterone and gonadotropins were identical in men less than and more than fifty years old, the elevation of free testosterone levels in response to clomiphene was higher in patients younger than fifty.