Testosterone deficiency syndrome (TDS)

Making an appointment with Dr. Clavijo
Dr. Clavijo is fellowship trained in Andrology (having also completed a Urology residency) and strives to practice up-to-date evidence based medicine when treating patients with low testosterone.

Please call us at 916-734-2222 to inquire about appointments.

Testosterone deficiency syndrome (TDS) (AKA: low testosterone, hypogonadism) can be characterized by a serologic laboratory value, generally total testosterone, below a certain pre-defined cutoff and symptoms such as decrease or loss of muscle strength, libido, memory, vitality, alterations in mood, and erectile dysfunction (ED). One recent study helped define testosterone ranges in young men by measuring sample testosterone levels obtained during the conduction of several large studies in a central Centers for Disease Control and Prevention (CDC) lab¹. This study revealed that 303 ng/dL was the fifth percentile value among healthy non-obese patients between 19 and 39 years of age. Therefore, a cutoff of 300ng/dL is not unreasonable to use. One must also take in consideration that a lab value is not enough to diagnose TDS as symptoms are necessary to truly define this condition.

If you are diagnosed with testosterone deficiency syndrome, Dr. Clavijo can help you navigate the risks and benefits of testosterone replacement as well as testosterone replacement options.

1. Travison TG, Vesper HW, Orwoll E, Wu F, Kaufman JM, Wang Y, et al. Harmonized Reference Ranges for Circulating Testosterone Levels in Men of Four Cohort Studies in the United States and Europe. J Clin Endocrinol Metab. 2017 Apr 1;102(4):1161–73.

When synthesizing what has been written about testosterone replacement in medical journals it’s safe to say that most men will have improvement in sex drive/libido. Improvement in other areas such as mood, vitality, energy, strength, etc. are not as well defined or predictable. Erections may improve in some patients but there is rarely a drastic improvement although some studies suggest it may help medications like Viagra and Cialis work better².

2. Clavijo RI, Ramasamy R. Testosterone Replacement Should be Given to Men with Erectile Dysfunction: Pro. J Urol. 2017 Feb 1;197(2):284.

Testosterone, blood count and estrogen levels along with studies such as PSA levels, and other hormone levels (as needed) will be monitored with periodic blood tests.

There are several options available. We will usually go through your insurance first but if there is no coverage for the preferred replacement option Dr. Clavijo will help you with an affordable generic/compounding pharmacy option, if available.

• Intramuscular injections of testosterone enanthate or cypionate
• Patches
• Gels and creams
• Intranasal sprays
• Pellet implants (TESTOPEL)