Updated: Apr 27, 2020
What makes an expert testosterone clinic?
How to evaluate your testosterone therapy treatment?
How to evaluate your provider?
How to review a testosterone clinic website?
How to find the best testosterone clinic.
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Testosterone clinics are becoming more common place in countries around the world. Approximately 10-40% of men across the globe suffer from androgen deficiency and this may increase to 80% in men with several comorbidities. In 2011 over $1.8 billion dollars in testosterone prescriptions were administered, with the majority of prescriptions written for off-label indications. With an ever-increasing aging population more prescriptions for testosterone will undoubtably be written. The United States alone accounts for 80% of the global testosterone prescriptions. The increase in testosterone can be attributed to media presence, direct to consumer and social media advertisements.
In must be understood that testosterone is not a benign medication, it has both risks and benefits that must be monitored and managed by a trained physician.
Making the correct diagnosis of testosterone deficiency is just as important as the right treatment. Treating low-testosterone is about more than just measuring your testosterone levels alone. In fact, the majority of testosterone prescriptions today are written for off-label purposes and patients may not obtain the necessary monitoring every 3-6 months advocated by many professional medical societies. Having a low testosterone level does not make a man a necessary candidate for testosterone therapy. Vice versa, only having the symptoms of Low-T does not justify testosterone replacement therapy if hormone levels are normal. There any many other conditions that can mimic Low-T and understanding why a man has those symptoms is just as important as the right treatment.
The treatment of low-testosterone demands a physician’s expertise to confirm a more serious health condition is not the underlying cause for the symptoms.
When looking for a testosterone replacement physician or clinic, begin by asking the following set of principle question to help guide your health and treatment.
1. Reviewing Testosterone clinic websites
When reviewing a testosterone clinic website, it’s important to first look at the providers. Are the physicians managing your care properly trained? Review the bio if present. Some websites may not even list the providers, and this has been of much concern in the medical community. Observe the professional associations your doctor is participating and have membership. Professional medical and surgical associations such as the American Urologic Association (AUA) provide continued medical education to physicians to stay on the cutting edge of new research, therapies and announcements pertaining to men’s health. Physicians who are not members of such associations may not be and learning new insights or new risks associated with men’s therapies.
Next, observe if the physicians are board – certified. Board certification is an additional level of expert training and education a physician must procure to practice at the top of their profession. A Board-Certified Physician must continually undergo exams and continued learning to maintain this tittle. Most hospitals require that a physician be board certified to obtain privileges.
If a provider is board certified this is an excellent attribute to their practice and level training and patient can trust.
2. Will I see a doctor every time during my visit?
This is your body, and your health. Its common that testosterone clinics may not provide their patients with a physician visit every time or at all. It’s important to know if your care is being managed by an assistant or a physician. Finding the correct medication, monitoring, and optimizing your response to therapy should be done by a physician rather than a medical assistant or nurse. This is the best way to reach your goals and to be safe.
3. Does my provider have discretion to say that I am not a candidate for Testosterone replacement therapy?
If a man has his testosterone levels checked, and are within the normal range but still has the symptoms of testosterone deficiency, a more in-depth evaluation of symptoms should be undertaken. Being advised to start testosterone therapy despite a normal testosterone level without a detailed explanation should concern a patient and question the discretion of the provider. A man may suffer from other metabolic and hormone derangements that testosterone replacement cannot improve and this is important to protect your health and safety.
4. Is it convenient for my lifestyle?
Testosterone should be easy and convenient to apply and administer. The goal is improving quality of life among other performance and stamina factors. If a man has to make weekly visits to a clinic to get an injection this can be time consuming and tedious. Some clinics may charge for each individual injection, it’s important to ask. See if the clinic can teach you how to administer your own therapy , this is important and will save you time and expense. Also ask if a clinic provides alternative testosterone formulations such as a topical gel. This is important to note, that a clinic provides multiple types of therapy options. Testosterone therapy is not a one size fits all. A physician should be knowledge in all aspects of testosterone delivery and a patient should desire such expertise in their management.
5. Am I being thoroughly monitored?
Testosterone therapy should be monitored every 3-6 months with a complete panel of labs. Follow up visits should be with a physician. It is also important to know that testosterone testing and measurement should be done through a process called LCMS (Liquid Chromatography Mass Spectrometry). This is a blood test to measure testosterone and is the gold standard and provides the most accurate testosterone serum level result. Most clinic may test your blood in the clinic and provide an instant read of your level. This is often a less accurate method to testing your levels and may compromise your results.
6. Am I confident in the experts around me?
Is the place of business taking treatment seriously? Can the physicians answer all my questions about my health and am I content with the answers? Is the physician available to speak with me after hours? Do I feel I get personalized attention to my health? Is the clinic well maintained and clean? Asking some of these basic questions will help you know what feels right, and that you are in good hands. Physician availability is important and should be valued by every patient.
7. Am I being offered more than one testosterone delivery method?
Testosterone should be tailored to man’s lifestyle and be easy to apply or administer for the patient. There are a variety of testosterone delivery methods from injections, topical gels, and pellets to name a few. An expert in the field of testosterone replacement therapy (TRT) is knowledgeable in all aspects of testosterone delivery methods that are available to the patient.
8. Am I being offered other medications to improve my testosterone if I want to preserve fertility?
Most patients who desire to maintain reproductive potential or are actively trying to conceive should be offered alternatives to testosterone therapy. Testosterone is an infertility drug for men, and this should be explained in detail during a patient visit. Even when HCG is administered along with testosterone therapy, spermatogenesis can still be reduced. A patient should be explained about the reduced fertility potential that testosterone therapy can induce.
9. Did the physician providing me testosterone perform a full physical examination?
I advise patients that one objective measure to ensure your health is made a priority at a testosterone clinic is by observing the following: Did the provider perform a testicular examination for size, breast examination for gynecomastia and if a man is above 40 years of age, a prostate examination must be performed. A physical examination is paramount to confirming no other causes are present to cause testosterone deficiency. Finding a prostatic nodule on physical examination can preclude the administration of testosterone and may need further workup.
10. If I have low-T what is the cause?
There are a variety of causes for testosterone deficiency. These can be grouped into primary and secondary hypogonadism. A physician should partake in a full and comprehensive evaluation to understanding the etiology. A patient should be aware of the labs and steps a physician has undertaken to understand his causality for testosterone deficiency.
There is no doubt that low-t centers are just about everywhere you turn. But your body and your health should be treated with care and taken seriously.
Taking the steps to improve your health can have lasting impact. The key is doing it in the right way, at the right place, by the experts.