Low testosterone also decreases bone mass and may lead to osteoporosis which places these men at high risk for fracture of bones, especially of the hip and spine. Some patients have enlargement of the breast area, known as gynecomastia. Sometimes, symptoms of the underlying cause may also be present, such as patients with a pituitary tumor may experience visual disturbances especially in the visual field. Endocrinologists specialize in the treatment of low testosterone. Testosterone replacement has traditionally been done with intramuscular injections , usually every two weeks.
Intramuscular injections are inconvenient and also cause peak and trough levels of testosterone.
Testosterone skin patches became available a few years ago and work well for some patients, but others may develop local skin reaction. Testosterone gel has recently become available and appears promising in treating men with a low testosterone level. Most men after the age of 70 have low testosterone, decrease in muscle strength and decreased bone mass. This observation has lead some physicians to wonder if low testosterone level may, in part, be responsible for the process of aging and whether testosterone replacement can serve as anti-aging hormone therapy. At present, there is a lot of controversy on this issue.