Q: My testosterone level has dropped below 2. It has affected my libido and erection. My age is 52 years. What could be the reason? How do I increase my testosterone level?

A:It's very important that testosterone levels should be done at 9 am, otherwise interpretation of the test is difficult. Low testosterone or male hypogonadism can be due to Primary testicular failure or Secondary pituitary or hypothalamic dysfunction. This can be done by getting FSH and LH test done. In case it is primary, it is elevated but normal or low in case of secondary hypogonadism. Once we have the diagnosis, only then can the treatment be started. Testosterone treatment is available in India in the form of injection and gel. Levels should be assessed in standard labs. The potential side effects should be balanced before starting the treatment such as enlargement of prostrate, raised blood count, abnormal lipids levels and increase risk of sleep apnoea problem. An endocrinologist should be consulted before starting this treatment. I do not recommend till levels are below 200 ng/dL (6.9 nmol/L).