Testosterone deficiency (hypogonadism): symptoms, tests and treatment in Tashkent

Other names: Дефицит тестостерона, андрогенный дефицит, возрастной гипогонадизм, низкий тестостерон

Hypogonadism is a condition in which the testicles do not produce enough testosterone. Its symptoms are nonspecific: fatigue, decreased desire, weight gain, irritability - and are easily attributed to stress or age. At the same time, today there is an opposite problem: testosterone is prescribed without proper reasons, which suppresses the hormone’s own production and deprives a man of fertility. Therefore, both diagnosis and treatment here require a strict approach.

🧾 МКБ-10: E29.1 🏥 Where it is treated: 3 Analysis strictly in the morningTwo measurements neededTherapy only when indicated

👨‍⚕️ Which doctor

Andrologist, endocrinologist

🔬 Diagnostics

Testosterone in the morning, LH, FSH, prolactin

💊 Treatment

Correction of causes, replacement therapy

📈 Prognosis

Good with the right treatment

⚠️ At risk

Obesity, diabetes, history of steroids

⏱ When to see a doctor

Scheduled appeal

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

Головные боли и нарушение зрения вместе со снижением либидо — возможна опухоль гипофиза
Увеличение грудных желёз и выделения of сосков
Резкое уменьшение объёма яичек
Отсутствие полового созревания у подростка
Внезапное развитие симптомов за короткий срок

What is hypogonadism and how does it happen?

Testosterone is produced in the testicles under the control of the pituitary gland, which secretes the hormones LH and FSH. The disruption can occur at the level of the testicles themselves or at the level of the control center - and these are fundamentally different conditions.

Primary hypogonadism is a problem in the testicles; testosterone is low and LH and FSH are high because the pituitary gland is trying to stimulate them
Secondary hypogonadism is a problem in the pituitary gland or hypothalamus; both testosterone and LH with FSH are reduced
Age-related decline is a gradual decrease in hormone levels over the years, which does not always reach a level requiring treatment
Functional hypogonadism - decrease due to obesity, diabetes, serious illnesses, stress, lack of sleep; reversible when the cause is eliminated

Различие между первичным и вторичным вариантом определяет всё: при вторичном возможна стимулирующая терапия с сохранением фертильности, при первичном — как правило, только заместительная.

Symptoms

Decreased sexual desire is the most characteristic symptom
Deterioration in erection quality, weakening of morning erections
Constant fatigue and decreased stamina
Decreased muscle mass and strength
Increased fat tissue, especially in the abdominal area
Irritability, low mood, difficulty concentrating
Sleep disorders
Hot flashes and sweating
Decrease in testicular volume
Reduction of hair on the face and body
Breast enlargement
Decreased bone density and increased risk of fractures with long-term deficiency
Deterioration of sperm parameters

None of these symptoms are specific: depression, sleep apnea, hypothyroidism, anemia, and chronic fatigue give the same thing. That is why the diagnosis is not made by symptoms and requires laboratory confirmation.

Reasons

Obesity - adipose tissue converts testosterone into estrogens and suppresses its production
Type 2 diabetes mellitus and metabolic syndrome
Previous use of anabolic steroids and testosterone drugs
Obstructive sleep apnea syndrome
Pituitary tumors, including prolactinoma
Klinefelter syndrome and other genetic conditions
Previous orchitis, including after mumps
Injuries and torsion of testicles, operations
Chemotherapy and radiation therapy
History of cryptorchidism
Chronic liver and kidney diseases
Long-term use of opioids and glucocorticoids
Chronic stress, lack of sleep, extreme physical activity combined with malnutrition

How to take the test correctly

Errors during testing are the most common cause of incorrect diagnosis in both directions: both a missed deficiency and treatment prescribed without reason.

Кровь сдают утром, обычно с 7 до 11 часов — именно тогда уровень максимален
Натощак
Не в период острого заболевания, лихорадки или сразу после тяжёлой физической нагрузки
При сниженном результате анализ повторяют — диагноз ставится минимум по двум измерениям в разные дни
Одновременно оценивают ЛГ, ФСГ, пролактин, а при пограничных значениях — свободный тестостерон и ГСПГ
Дополнительно исследуют глюкозу, липиды, ТТГ, общий анализ крови и ПСА у мужчин старшего возраста

Однократно сниженный тестостерон, измеренный днём или на фоне болезни, диагнозом не является. К сожалению, именно на основании такого анализа нередко начинают гормональную терапию, которая затем подавляет собственную выработку гормона.

Treatment: do not start with hormones

With functional hypogonadism, which is very common, eliminating the cause allows you to increase testosterone levels without any hormonal therapy.

Losing body weight is the most effective measure for obesity
Regular physical activity, including strength training
Compensation for diabetes mellitus
Sleep apnea treatment
Normalizing sleep and reducing chronic stress
Withdrawal of anabolic steroids followed by recovery
Reviewing testosterone-lowering medications with your doctor
Treatment of varicocele if present

Replacement therapy: for whom and with what precautions

Hormonal therapy is prescribed for confirmed deficiency in combination with clinical symptoms and after excluding reversible causes.

A prerequisite before starting is a PSA assessment and prostate examination in older men
Contraindicated in prostate cancer and breast cancer in men
Requires caution in severe heart failure, severe sleep apnea, high hematocrit
Suppresses own testosterone production and spermatogenesis - fundamentally important for men planning children
Men who want to preserve fertility are prescribed drugs that stimulate their own production of the hormone instead of testosterone.
Dynamic monitoring: testosterone, hematocrit, PSA, lipids - according to the schedule established by the doctor
Therapy is usually long-term; when it is discontinued, symptoms return

Главное предостережение: тестостерон — не средство «для тонуса и молодости». Назначенный без показаний, он подавляет работу яичек, уменьшает их объём и может привести к бесплодию, восстановление после которого занимает месяцы и не всегда бывает полным.

Where to get examined in Tashkent

Diagnostics requires a laboratory that performs hormonal tests and a doctor who correctly interprets the result, taking into account the time of blood sampling and associated conditions.

In Tashkent, examination and observation for testosterone deficiency is carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic, if necessary, together with an endocrinologist.

If you have already been prescribed testosterone, be sure to inform your doctor about this and take previous tests: the tactics in such a situation are significantly different. Clinic contacts are below on the page.

Services and prices for this diagnosis

Based on official price lists of Tashkent clinics. The exact cost is determined after examination.

🔬 Diagnostics

Первичный приём урологаfrom 200 000 Повторный приём урологаfrom 150 000

💊 Treatment

Микрохирургическая варикоцелэктомия (операция Мармара)from 5 150 000

Frequently asked questions: Hypogonadism (testosterone deficiency)

When is the right time to take testosterone?+

In the morning, usually from 7 to 11 o'clock, on an empty stomach, outside the period of acute illness and not immediately after heavy exercise. The level of the hormone fluctuates noticeably throughout the day, so a test taken during the day may show an underestimated result in a completely healthy man. If the value is reduced, the analysis must be repeated on another day.

Does low testosterone need to be treated with hormones?+

No. First, they find out the cause: very often the deficiency is functional in nature and is associated with obesity, diabetes, sleep apnea, lack of sleep or taking certain medications. When these factors are eliminated, the hormone level increases on its own. Replacement therapy is prescribed for confirmed deficiency with symptoms and after excluding reversible causes.

Does testosterone affect the ability to have children?+

Yes, and very significantly. Testosterone drugs suppress the production of pituitary hormones that stimulate spermatogenesis, which can lead to a sharp decrease in the number of sperm, even to their absence. Men planning children are prescribed drugs that stimulate their own production of the hormone instead of testosterone.

Is replacement therapy dangerous for the prostate?+

The therapy does not cause prostate cancer, but it can accelerate the growth of an existing undetected tumor, so before starting, be sure to evaluate PSA and conduct an examination, and then monitor the indicator over time. For established prostate cancer, such therapy is contraindicated.

Is it true that testosterone decreases with age?+

Yes, the level gradually decreases over the years, but this decrease is usually smooth and not everyone reaches values that require treatment. Obesity, diabetes and chronic diseases make much more significant contributions. Therefore, age in itself is not an indication for hormonal therapy.

Do dietary supplements and herbs help raise testosterone?+

There is no convincing evidence of the effectiveness of such drugs for true hypogonadism. A significantly greater and confirmed effect is achieved by weight loss, regular strength training, normalization of sleep and treatment of apnea. If a deficiency is confirmed, drug therapy prescribed by a doctor is required.

I took steroids at the gym, now is low testosterone permanent?+

Most often, no, but recovery takes time - from several months to a year or more, and sometimes requires special stimulating therapy. Be sure to tell your doctor about taking steroids, even if it was a long time ago: without this information, treatment tactics may be chosen incorrectly.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.

Where it is treated testosterone deficiency в Ташкенте

Диагноз дефицита тестостерона ставится только по правильно выполненным анализам, а лечение требует регулярного контроля, включая ПСА и показатели крови. В Ташкенте обследование и наблюдение при гипогонадизме проводят в медицинском центре UROLOGIC COMPLEX и в clinicsе Tashkent Medical Park.