Men's Health Center
The Miriam Hospital

Low Testosterone

What is low testosterone (hypogonadism)?

Low testosterone (hypogonadism) can be classified as either primary or secondary. Primary hypogonadism occurs when the testicles are injured by infection, medication or chemotherapy, or removed as part of treatment for testicular cancer. Inherited disorders like Klinefelter’s syndrome interfere with normal development of the testicles and also cause primary hypogonadism.

Appointments and Referrals

Call us at 401-793-4636 (4MEN)
for more information about our services, or to make an appointment, or refer a patient.

Monday to Friday
8 a.m. to 4:30 p.m.


The Men's Health Center
180 Corliss Street, Suite C
Providence, RI 02904

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What causes low testosterone?

Hypogonadism can be classified as either primary or secondary. Primary hypogonadism results from a problem within the testicles causing a deficiency in testosterone. This is also considered classic hypogonadism and occurs more frequently in younger men who might be suffering from Klinefelter’s syndrome, or in men who have had one or both testicles removed (from prostate or testicular cancer).

Secondary hypogonadism occurs when communication between the part of the brain that controls hormone production (hypothalamus and pituitary gland) and the testicles is disrupted. Common causes of secondary hypogonadism include obesity, metabolic syndrome, sedentary lifestyle, use of opiate pain medications and prior use of testosterone.

How do I get tested for low testosterone?

A blood sample taken before 10 am is used to measure testosterone levels. If the first sample is low, a second sample is taken to confirm the low level, and additional testing for causes of low testosterone is included. LH, FSH, prolactin, and iron studies are commonly included in the assessment.

What treatment options are available for low testosterone?

The Men’s Health Center offers a number of treatment options for low testosterone. Topical gels, creams, or patches may be prescribed and applied daily by the patient. Some patients opt for testosterone cypionate injections, which are self-administered at home. An in-office teaching session with the RN/NP would be scheduled to teach the patient or a responsible party appointed by the patient on how to self-inject. After completion of the teaching session, patients will self-administer injections either weekly or biweekly. Testopel, or testosterone pellets may also be implanted under the skin by way of a small incision. Testopel procedures are usually performed every three to four months. The latest addition to treatment options offered at the Men’s Health Center is AVEED (testosterone undecanoate). AVEED delivers long- acting testosterone therapy, which requires only five injections per year after the first month of therapy.

What are the advantages of AVEED over other medications?

AVEED is longer-acting testosterone therapy. The initial AVEED injection is administered on day one, with the next injection in four weeks, and then injections are administered every 10 weeks. Patients begin to notice the effects after the first injection. With AVEED, the patient does not have to worry about the daily application of a medication, transference of the medication to another person, or frequent injection appointments. With any testosterone replacement therapy, laboratory values, including bioavailable testosterone, hemoglobin and hematocrit, and PSA values will be monitored regularly.

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