If you suspect you have low testosterone, and after a thorough workup it’s determined you do in fact have low T, you may want to know what treatment options are available. After all, the benefits of treatment include an increased sex drive, reducing the symptoms of erectile dysfunction, more energy, improved mood, better bone health, and an increased sperm count.

For those who have low testosterone, the benefits of proper treatment often outweigh any potential risks. Millions of men use testosterone treatment to restore their low levels and feel more active in their lives. However, the treatment needed is not always straightforward. Treatment may be multifaceted depending on your specific circumstances. It’s part of our mission to ensure that you fully understand the treatments for low testosterone, any potential side effects, risks, and holistic approaches to complement medical treatment to optimize your overall wellness.

What is Testosterone?

Testosterone is a hormone that exists in males and females. However, its presence is in much greater levels in men and is essential for the male reproductive system.

At The Billups Center, we look at more than just your sexual health. A diagnosis of low testosterone levels means we also look at your overall physical health. This means our treatment plans include lifestyle recommendations and can include monitoring your nutrition and physical activity. We do in-depth evaluations of your health to create the best treatment plan for you which may include medications.

Lower Testosterone Levels are Normal with Aging

It’s completely normal for the male body to start producing lower amounts of testosterone as they get older. Almost 40% of men over the age of 45 will experience low testosterone levels. Some symptoms of low testosterone levels include a lower sex drive, the development of erectile dysfunction, and lower energy.

However, not all low testosterone is caused by aging. Other factors may include medications, chronic diseases, and obesity. These are important things to consider when deciding the best treatment plan for low testosterone levels.

If you would like to learn more about what causes low testosterone in men, then watch our video here. We go over why testosterone is important to men and what could potentially be the cause of low testosterone levels.

How is it Treated?

If you suspect you have low testosterone, scheduling an appointment with us for a test can confirm whether you need treatment. Many physicians and specialists in the Greater Nashville area refer their patients to us and trust us to look after their male patients’ sexual health needs, including low testosterone, because of our combined 50+ years of experience specializing in this area of health. We have a deep understanding and are able to determine what underlying factors may also be causing this problem. We don’t believe in “quick fixes”. Although we work with all of our patients to choose the best treatment plan which may include medications that replace testosterone or help the body boost its level, we focus on treating the core problem that causes the condition.

Lifestyle Recommendations

Dr. John La Puma once wrote in an op-ed for the New York Times, “Too many doctors are now writing testosterone prescriptions without even measuring the patient’s hormone levels, much less re-testing for confirmation and adjusting the dose after prescription. Up to a quarter of these prescriptions are dispensed without a blood test. From a psychological perspective, this isn’t helping men. From a medical perspective, it’s devastating.”

Although the testes may be to blame for your lowering testosterone levels, there can be secondary problems that are causing your testosterone levels to drop. These underlying issues can be treated and solve your low testosterone without needing testosterone replacement therapy.

Our treatment plans start by evaluating your nutritional and physical activity. An improvement in this area can lead to higher testosterone without needing replacement therapy. Not only will this help your hormones, but it will also increase your overall well-being and quality of life.

Weight loss is a great way to address low testosterone levels. High body fat, especially located around your waist, leads to lower production of necessary hormones including testosterone. Studies have shown that obesity is the number indicator of low testosterone and losing weight can increase the production of this hormone.

Chronic diseases such as type 2 diabetes, chronic obstructive pulmonary disease, HIV/AIDS, and renal failure can lead to lower production of testosterone. You may be able to treat low testosterone by first treating the chronic disease.

Other lifestyle issues like alcoholism, smoking, or medications may also be a contributing factor to the cause of your low testosterone. As always, it’s important to have a complete physical with your doctor and address all of your symptoms in order to find the right diagnosis and treatment for your specific needs.

Low Testosterone Treatment Options

We work with you to incorporate the lifestyle changes into your daily routines to help support any treatment plan we create together. In some instances, we’ll decide together to start with lifestyle changes but if after implementing these changes you’re not seeing a vast improvement, we may move forward with treating your low testosterone levels more directly. Some potential treatment options include:

Skin patch

A medicated patch may be put on your skin that will release testosterone into your bloodstream.


Similar to the skin patch option, a gel is put on your skin which absorbs the testosterone and releases into the bloodstream.

Mouth tablet

Tablets are inserted in the mouth twice a day and release testosterone.


This is a form of hormone replacement therapy that is implanted under the skin and is about the size of a grain of rice. It slowly releases testosterone over a period of time.


A shot of testosterone which is a common treatment option.

Testosterone Treatment and its Long-Term Effects

Although the short-term use of testosterone treatment can lead to an improvement in the overall well-being of the individual, there are some risks involved. One study showed no significant negative consequences for men undertaking testosterone replacement therapy during nearly eight years of follow-up monitoring with all of the men reporting feeling much better. However, every treatment carries a risk, and if you’re not the right candidate or your treatment isn’t tailored to your specific needs and monitored properly, there are adverse effects to consider.

Let’s go over the potential negative effects of long-term testosterone treatment.

Body Can Stop Producing Testosterone on its Own

Taking testosterone shots may create long-term dependence. It can trigger your body to stop making testosterone naturally. This could mean struggling with the symptoms of low testosterone for the rest of your life.

Infertility May Occur with Long-Term Use

Although testosterone treatment can help with fertility issues, it’s possible that long-term testosterone treatments or use of steroids may actually decrease your sperm count and ability to conceive. A 2016 study shows that young men may not be aware that testosterone could make them sterile and create complications for fertility in the future. It’s important for doctors to educate and inform patients of the risks involved with long-term testosterone treatment or steroid use. While it’s possible to reverse this, it’s a costly treatment that you may not be interested in.

A 2013 study reported that many physicians were unaware that testosterone replacement therapy affected sperm production which could greatly impact the lives of patients who may want children in the future. This same study suggests that some testosterone treatments are better for future fertility than others. Fortunately, some of the participants had their fertility return within one year of stopping the treatment.

Our decades of experience in this specialty means we’re educated on such matters and are able to help determine what treatment path is the best for you.

Address Obstructive Sleep Apnea Prior to Treatment to Avoid Increased Symptoms

Obstructive Sleep Apnea (OSA) may be a side effect of testosterone treatments. OSA is a serious sleep disorder that can affect the quality of your sleep and your overall well-being. Symptoms include loud snoring, pauses in breathing while sleeping, and feeling tired in the morning even if you slept all night. If left untreated, it can cause high blood pressure, heart disease, and other serious health conditions.

Men should be informed of all risks, and with studies indicating a link between TRT and OSA, it’s important to monitor for new symptoms such as loud snoring or fatigue while starting testosterone treatment. If you already have OSA, treatment may worsen symptoms. It’s important to discuss this issue with us and any physicians or specialists you’re working with, and that you’re aware of what may happen to your body once you begin treatment.

One study recommended that OSA should be treated before beginning testosterone treatments. Otherwise, it can exacerbate the symptoms and cause other significant health issues. Let us know if you have been diagnosed with or have concerns that you may be suffering from obstructive sleep apnea. If needed we can refer you to an accredited sleep center before treatment, or if your symptoms worsen.

Testosterone’s Controversial Link to Increased Risk of Cardiovascular Issues

Cardiovascular disease is a term that covers conditions that involve issues with the heart and can lead to a heart attack, chest pain, or stroke. There is also an increased chance of blood clots. These issues can be fatal, and it’s important to note any symptoms and discuss them with a doctor before starting any new treatment. It’s especially the case if you’re seeking treatment for low testosterone levels.

There is controversy surrounding issues of risk associated with TRT. Too few studies address this specific area of men’s health and the studies are conflicting. For example, a potential risk of heart failure has been reported, yet many long-term studies assessing the benefits for men with hypogonadism report improvement of cardiovascular disease. Hypogonadism is a condition in which the body doesn’t produce enough testosterone.

One study, published in 2017 in the Mayo Foundation for Medical Education and Research, pointed to decades of conflicting evidence surrounding the association of endogenous testosterone levels and cardiovascular disease events. The conflicting reports stimulated debate and caused confusion among individuals as well as health care providers. This led to the FDA releasing a warning statement about testosterone therapy and potential risk of it contributing to cardiovascular disease. Experts, such as the American Association of Clinical Endocrinologists, challenged the FDA’s statement citing a lack of scientific evidence and claiming many of the studies linking the two to be “critically flawed”.

More research is clearly needed and with studies like this one published in 2014 claiming that both younger and older men with pre-existing diagnosed heart disease, saw a substantially increased risk of myocardial infarction (MI) following the initiation of TT prescriptions suggest that you trust your health and any testosterone treatments to specialists in this field. Low T treatment is best accompanied by a comprehensive plan, proper care, and monitoring, to ensure minimizing all potential risks.

Prostate Cancer Growth Risks Can Be Avoided with Proper Screening

Traditional “shot clinics” (clinics that specialize in giving men testosterone shots) don’t always do complete workups. A full and comprehensive physical examination ensures that doctors aren’t missing secondary factors causing your low testosterone levels. One aspect of a complete workup they may not provide is screening for prostate cancer.

Some symptoms of prostate cancer include erectile dysfunction, urge to urinate frequently, and blood in the urine. Early stage prostate cancer can exhibit no signs or symptoms. Even if you feel fine, this is not a part of your health that you should ignore. It’s especially important if you are considering starting treatment for low testosterone.

Although low testosterone treatment doesn’t appear to cause prostate cancer, studies have shown that it can make cancer develop at a faster rate. This means if you have undiagnosed prostate cancer and start testosterone treatment, it could possibly make your cancer exponentially worse. Why? Testosterone has been shown to increase the growth of prostate cancer cells. This could potentially be fatal, or at the very least, cause your cancer to grow while undiagnosed making it more advanced and harder to treat.

Due to this potential risk, we believe in placing an emphasis on screening for prostate cancer before starting treatment for low testosterone levels. It’s not an unnecessary medical exam as it can affect your long-term health if not properly checked. This is especially important if you or a close family member has had prostate cancer. Our team at The Billups Center ensures that you are well taken care of and that you receive a full exam to find the underlying cause(s) of your low testosterone levels and also help prevent contributing to any further health risks.

Low Testosterone Therapy Benefits Outweigh Risks

A 2018 study determined that at the end of the day, the pros of testosterone treatment are undeniable, “The benefits of treatment of low testosterone levels with testosterone therapy in men and women substantially outweigh any risks, according to the current data.”

Receiving treatment for low testosterone is so much more than a simple prescription from your doctor or shot administered at a men’s clinic. It’s incredibly important to get an accurate assessment of your sexual health and other factors that may be causing low testosterone. Our comprehensive approach includes a team of physicians (Urologist), nurse practitioners, personal trainers, lab technicians, and a nutritionist to create the best treatment plan for your long-term health. We partner with you so that you are fully aware of the medical decisions you’re making.

When you make an appointment with us, you’re committing yourself to get the best and most comprehensive treatment in the Greater Nashville area, in Murfreesboro, TN. We complete thorough evaluations and questionnaires to get to know you and any potential issues or concerns and contact your medical provider(s) within 24 hours of meeting you to ensure open communication regarding your health. We are determined to get you the best care possible.

Contact us to request an appointment. We look forward to treating you.