Men, be in the know: Low testosterone is a treatable disorder Testosterone is the important male hormone that prompts development before birth and causes typical male growth changes in adolescence. In adulthood, testosterone levels control the male sex drive and fertility. However, many men have abnormally low levels of testosterone. Testosterone levels naturally fall as a man ages, but to fall prematurely may leave many men with some debilitating effects. The lack of testosterone in males, as well as the lack of estrogen in females, is called "hypogonadism." "Hypogonadism affects about five in every 1,000 men," said Sarwat Takla, M.D., board certified in internal medicine at Kimball Medical Center, Lakewood. "Many men may not be aware of their low testosterone problem, or may be too embarrassed to get help. If you are suffering with the symptoms of low testosterone, there are treatments that may help you improve your quality of life." The symptoms of hypogonadism vary depending on the time period where the problem occurs. Before puberty, hypogonadism results in developmental problems. The changes that happen in a boy when he becomes a man may not take place, or may be delayed. This includes the growth of the male genitalia, increase in pubic and facial hair, increased musculature and deepening voice. Hypogonadism occurring before puberty may also manifest as disproportionately long arms and legs, and the development of breasts. Hypogonadism after puberty typically manifests in progressive loss of muscle mass and stamina, loss of libido, erectile dysfunction, development of breast tissue, increase in body fat, loss of bone mass, poor ability to concentrate, reduced facial hair and infertility. In addition, the sudden onset of hypogonadism may cause hot flashes similar to the onset of menopause as well as fatigue, irritability and depression. Low testosterone can also increase the risk of two diseases - osteoporosis and heart disease. "There is mixed evidence right now, but there seems to be a relationship between low testosterone and heart disease," Dr. Takla said. "Hypogonadal men are also at an increased risk of osteoporosis and related fractures." "Hypogonadism has several causes, including surgery, radiation, undescended testicles, injury, and some diseases and disorders," explained Dr. Takla. "Levels of hormones are controlled by the brain and the pituitary gland, so if there are defects in either of these organs, the patient will experience symptoms and impaired testicular function. Establishing the cause of hypogonadism is an important first step to getting appropriate treatment. See your doctor if you or your child has any of the signs or symptoms of low testosterone." Treatment of male hypogonadism depends on the cause and may involve testosterone replacement therapy (TRT). There are several preparations available, including gels, patches, injections, pills, and implants. The effects of TRT vary by the age of the patient. In boys, TRT can stimulate puberty and the development of sex characteristics, "which helps enormously if the child is having difficulty fitting in a social sense," notes Dr. Takla. In adult men, TRT can restore sexual function and muscle strength and prevent bone loss. "TRT often helps psychological and relationship problems that men may be experiencing. It also gives men an energy boost and increased sex drive and sense of well-being," he said. "Regular exercise and calcium supplements may also help prevent osteoporosis." For more information, call the Saint Barnabas Health Care Link at (888) SBHS-123 or call Dr. Takla's office directly at (609) 693-5006. Dr. Takla's office is located at 833 Lacey Road in Forked River.