Diagnosis
Doctors diagnose low testosterone based on a physical exam, a review of symptoms, and the results of multiple blood tests since levels can fluctuate daily.
If your doctor diagnoses low testosterone, other tests may be considered before therapy. For example, low-t can speed bone loss, so your doctor may recommend a bone density test to see whether you also need treatment for osteoporosis.
Prostate cancer is another concern, as testosterone can fuel its growth. As a result, the Endocrine Society recommends against testosterone supplementation for men in certain situations, including those who:
have prostate or breast cancer
have an elevated blood level of prostate-specific antigen (a blood test used to screen for prostate cancer)
have a prostate nodule that can be felt during a rectal exam.
Other circumstances in which testosterone supplementation is not recommended include:
a plan to become a father in the near-term
an elevated red blood cell count
severe, untreated sleep apnea
severe lower urinary tract symptoms
poorly controlled heart failure
heart attack or stroke within the last 6 months
a tendency to form blood clots (a condition called thrombophilia)
