1What is Testosterone Deficiency Syndrome (TDS)?

TDS occurs when the body is unable to produce enough testosterone. Although it can be caused by genetic or medical conditions, low testosterone is also caused by age. As men age their testosterone levels naturally decline.

2How common is TDS?

Low testosterone affects 1 in 10 men at the age of 50, increasing to 1 in 4 men over the age of 70.

3What medical conditions tend to be associated with TDS?

The likelihood of testosterone deficiency and associated symptoms is greater in patients with:

High blood pressure

Heart disease

Chronic obstructive
pulmonary disease





4What are the common signs and symptoms of TDS?

How you feel


Lack of energy



Loss of concentration

How you look

Loss of muscle mass

A loss of strength

Increased body fat

Weight gain

Loss of bone mineral density / bone strength

Male breasts

Loss of body hair

Changes in sexual function

Reduced sex drive

Problems with getting or keeping an erection

Difficulty in achieving orgasm

Some men with TDS have all of these symptoms, while others may only have a few, or even just one. None of these symptoms are specific to low testosterone so it is important to talk to a doctor to make sure that low testosterone is not confused with other medical conditions.

5How is TDS diagnosed and treated?

If the GP or specialist suspects low testosterone he should conduct a simple blood test to gage whether or not the patient’s testosterone levels lie within the normal range (300-1000ng/dL). If below normal, a TRT (testosterone replacement therapy) may be prescribed. In addition, the patient may benefit from making lifestyle changes, such as losing weight, reducing stress, maintaining a healthy diet , getting sufficient sleep and keeping active.

6What is Testosterone Replacement Therapy (TRT)?

1. TRT aims to replace the testosterone that is deficient and therefore restore testosterone levels to a normal range

2. TRT may be administered as a gel, injection, patch, or buccal table

3. Gels are self-administered on a daily basis

4. Alternatively, injections may be received from a healthcare professional on a monthly/two monthly basis

7How long will treatment be required?

TRT is a long term treatment and should be assessed 3, 6 and 12 months after the onset of treatment, and thereafter annually. Some men will require TRT indefinitely.

8How does low testosterone and TRT affect fertility?

The relationship between TRT and fertility is complicated. Both low testosterone and testosterone replacement therapy may cause a reduction in sperm production.

If infertility is an issue it should be discussed prior to treatment, as there are options available to address this.