Concerns about testosterone are common; testosterone affects our sense of self, our libido, and the sexual function in both men and women. It is essential for the proper completion of puberty, and the development and maintenance of the skeleton, and the management of testosterone problems is important as it can also affect fertility. 

Testicular failure – or hypogonadism – is characterised by low levels of testosterone and/or sperm production. If you are deficient in testosterone (or other androgens), a fast and accurate diagnosis is vital so that you can be monitored and/or given an appropriate treatment to restore your testosterone levels. This will always include a detailed clinical assessment, often including tests of blood or semen samples, and occasionally an MRI scan of the hypothalamus and pituitary gland.

One of the main functions of the testes is to produce healthy sperm. However, many endocrine conditions can affect the precise interplay of hormones necessary for this. We have experience in diagnosing these conditions and then treating them to restore sperm production. If the hormonal system is damaged by a tumour or inflammation in the hypothalamus or pituitary, we can replace the hormones to stimulate sperm production.

If the testes themselves are damaged – by tumour, inflammation, childhood trauma or injury, or by developmental defect – adjusting the hormones from the brain will have less effect. In these cases we may refer you to a very specialist male fertility doctor to see if any sperm retrieval can be performed directly.

In some men, hypogonadism occurs when there is an upset in their metabolism. This is usually because the body’s energy balance has been disturbed, either from weight loss, over-exercise (both cardiovascular and bulk) or by attempting to reduce body fat below a normal level. Other causes are psychological upset and mental health problems. In response, the hypothalamus suppresses testosterone production. Our experience in diagnosing such problems means we can work with you to find a route back to overall health – and more healthy sperm production.

Erectile dysfunction is a common problem, treated by many doctors and health practitioners, but it is not a symptom in isolation. We usually consider how it relates to your hormones, whether it might be a symptom of testosterone deficiency or a manifestation of cardiovascular disease, as well as looking at how it affects you and what we can do to improve it. We have extensive experience in finding the right treatment for erectile dysfunction and, if things are very difficult, work closely with experienced urologists to get specialist help.