Urologist or Endocrinologist for Testosterone Replacement Therapy?

@vincescs - I am 72 and have had my "T" tested for a dozen years. I follow the typical pattern of declining "T" with all the negatives associated with that decline. I go to a specialty clinic and they compound testosterone replacement pellets made up of bio-identical materials.

The process is simple. I have a blood draw to determine the current "T" level. I can usually tell when it's time for more pellets as I begin to feel lethargic, weaker, and my libido becomes noticeably less intense. A few days later I return to discuss my current "T" status followed by a brief compounding pause. The pellets are then inserted through a small one-stitch incision in my hip and away I go.

I apply cold compresses for the first day or two to reduce any pain associated with the insertion. In a matter of a week or two I feel great again - ready to take on the world.

That is what works for me...no guarantees it will work for you. I'm 12 years in to this process and am thrilled. Google "bioidentical therapy near me".

Good luck!

I'm happy with my current TRT approach with the topical gel. I just need a new doctor to prescribe and take care of insurance authorization

Endocrinologist that deals with testicular issues is usually the specialist who deals with TRT. I go to one and I'm monitered by her.

I have long suspected that I still am having low T symptoms. I'm 70 now and they started 25 years ago in my mid 40s. No doctor ever mentioned low T as a possible cause so it's always been anti-anxiety and depression medication. I recently heard that since total T readings are individual by nature that the current parameters used in the medical and insurance fields are not necessarily accurate. A guy can suffer from low T even though the readings are within what is currently considered as 'normal'. Does anyone have any knowledge or experience about this topic? Thanks in advance.

P.S. -- I have never in the past had a baseline T level done so I don't have a history to look back on as a reference.

The cynic in me feels that insurance guidelines for testosterone levels were created to allow them to deny claims. I feel good when my testosterone is around 500 ng/dL. This makes sense because The American Urological Association says 450 to 600 is the normal range for healthy males. They also say low testosterone is below 300 ng/dL but I think most men would have low T symptoms before that. I don't know if a baseline level from 25 years ago would be relevant for you. It really only matters what your level is now. Get a blood test (before 10 am) and see where you are.

My PCP prescribed it for me....Insurance would only cover gel which you have to be careful with around others.
I would have rather had injections myself.
I am about one month in of applying to my shoulder and starting to notice a little improvement.
I was right around the 200 range +- For 2 tests....can't remember the exact numbers... One was below 200 and one test just above 200.

I believe testosterone from the gel is fully absorbed in about two hours. After that you can wash your shoulder(s) if you're worried about contact exposure to others.

I went recently to three urologists who were all very uninterested in helping look at and treat/medicate me for low free-testosterone. I finally was authorized to see an endocrinologist who prescribed me to take 0.5 milliliters (100 mg) of testosterone cypionate, injected into my upper thigh once per week. It'll be a few weeks, into September before I can get a Free-T blood test check and see if that dosage is OK or not. The generic Androgel 1.62 made no difference whatsoever in terms or raising my free-T level, although it did increase my overall total testosterone. I've stopped applying it now. No feeling yet as to improved libido, that will hopefully come in 3 to 6 weeks after the T injections began per the internet. I'm 76 years old now. For at least 4 years now, my free-T has been substantially below the bottom of the range. Latest result was 3.8 in July versus a normalcy range of 6.6 to 18.1. I have zero libido and 100% ED.

I wasn't aware that injections might provide better levels of free T than topical gel administration, however, my urologist doesn't care about free T either - just total testosterone. Some scientific journals suggest there is clinical evidence to indicate that taking daily boron supplements can increase free T.

I have read a few things about various supplements helping increase total testosterone, including boron, DHEA, horny goat weed, fenugreek, and arginine. If I were to google it, I'd find more. But I've never read that any affect Free-T levels. Some websites say to avoid fenugreek. Who knows...I haven't found any sort of doctor who even wants to speak about supplements vs. testosterone, they just shove me out the office door when it comes up in conversation. Good luck to all of us with this....