Male hypogonadism is a condition in which the body doesn't produce enough of the hormone that plays a key role in masculine growth and development during puberty (testosterone) or enough sperm or both. You can be born with male hypogonadism, or it can develop later in life, often from injury or infection. Some types of male hypogonadism can be treated with testosterone replacement therapy. In adult males, hypogonadism can alter certain masculine physical characteristics and impair normal reproductive function. Early signs and symptoms might include: decreased sex drive, decreased energy, and/or depression

Over time, men with hypogonadism can develop:

• Erectile dysfunction

• Infertility

• Decrease in hair growth on the face and body

• Decrease in muscle mass

• Development of breast tissue (gynecomastia)

• Loss of bone mass (osteoporosis)

Hypogonadism affects an estimated 4 to 5 million men in the United States, and although it may occur in men at any age, low testosterone levels are especially common in older males. More than 60% of men over age 65 have free testosterone levels below the normal values of men aged 30 to 35. Studies suggest that hypogonadism in adult men is often underdiagnosed and undertreated. This may be because the symptoms are easily attributed to aging or other medical causes, or ignored by patients and physicians. In fact, only about 5% of hypogonadal men receive testosterone replacement. 

Erectile dysfunction (ED) is when a man has trouble getting or keeping an erection firm enough for sex. It’s a common issue, especially as men get older, and can be caused by things like stress, medical conditions such as diabetes or heart disease, or lifestyle factors like smoking or alcohol use. While it can feel embarrassing to talk about, ED is treatable, and many options are available to help improve sexual health and confidence.

Hair loss is a common issue that can affect both men and women, often leading to thinning hair, bald spots, or a receding hairline. It can be caused by genetics, aging, stress, hormonal changes, or medical conditions like alopecia. Hair loss can be temporary or permanent, depending on the cause, but there are treatments available to help slow it down or promote regrowth. Taking early steps and consulting a professional can make a big difference in managing hair loss.

The only way to know if your hormones are in balance is to test them. You can either have your hormone levels tested at your next office visit or order an at-home test. We recommend having the following hormone levels tested: 

• Total Testosterone

• Free Testosterone

• DHEA-S

• Estradiol

• PSA

Different Testing Methodologies

Serum Testing is a broadly accepted method for measuring hormones and other analytes that circulate in the bloodstream.

Suitable for:

• · Assessing total circulating endogenous hormone levels (free plus protein-bound)

• · Monitoring hormone replacement therapy (sublingual, patch, pellet)

• · Assessing thyroid health

• · Assessing analytes that cannot be determined in dried blood spot, e.g., ferritin

Not suitable for:

• · Monitoring topical hormone replacement therapy (underestimates tissue uptake)

Dried Blood Spot Testing is ideal for measuring hormones and other analytes such as insulin, blood lipids, Vitamin D, thyroid hormones, and elements like lead and magnesium. Blood spot testing gives results equivalent to serum but with distinct advantages over serum testing for monitoring topical and vaginal hormone supplementation.

Suitable for:

• · Assessing total circulating hormone levels (free plus protein-bound)

• · Patients with dry mouth and/or children who may have difficulty collecting saliva

• · Monitoring hormone replacement therapy (oral, sublingual, pellet)

• · Assessing thyroid health, fertility parameters, and cardiometabolic risk factors

• · Self-collection of sample at home at a time convenient to the patient and avoiding a trip to the phlebotomist

Saliva Testing identifies bioavailable hormone levels – the active quantity that's free to move into body tissue. 

Suitable for:

• · Assessing “free” (unbound to carrier proteins) hormone levels

• · Monitoring hormone replacement given orally, topically, vaginally or via pellets

• · Collecting multiple samples during a day, e.g., determining diurnal cortisol levels for adrenal stress assessment

Not suitable for:

• · Monitoring sublingual/troche hormone replacement

• · Patients with dry mouth, e.g., due to Sjögren’s Syndrome

One size doesn’t fit all and every patient is unique. Drug compounding is the process of combining, mixing, or altering ingredients to create a medication tailored to the needs of a patient by a pharmacist as the result of a practitioner’s prescription drug order. While compounded medications are not FDA-approved, they serve an important patient need—especially when FDA-approved medication is not available for treatment. Our formulations are made to order in small batches to ensure freshness. The specific ingredients in your compounded formula will depend on your specific concerns and goals. It should be understood that your personal healthcare practitioner will make the final decision.

Yes! All of our compounded formulations, regardless of ingredients, are eligible for Flexible Spending Accounts (FSA) and Health Saving Accounts (HSA). 

• Ferri FF. Hypogonadism, male. In: Ferri's Clinical Advisor 2020. Elsevier; 2020. https://www.clinicalkey.com. Accessed Aug. 13, 2019.

• Snyder PJ. Clinical features and diagnosis of male hypogonadism. https://www.uptodate.com/contents/search. Accessed Aug. 13, 2019.

• AskMayoExpert. Male hypogonadism (adult). Mayo Clinic; 2018.

• Snyder PJ. Testosterone treatment of male hypogonadism. https://www.uptodate.com/contents/search. Accessed Aug. 13, 2019.

• AskMayoExpert. Delayed male puberty (child). Mayo Clinic; 2019.

• Sargis RM, et al. Evaluation and treatment of male hypogonadism. Journal of the American Medical Association. 2018; doi:10.1001/jama.2018.3182.

• Gardner DG, et al., eds. Testes. In: Greenspan's Basic and Clinical Endocrinology. 10th ed. McGraw-Hill Education; 2018. https://accessmedicine.mhmedical.com. Accessed Aug. 13, 2019.

• Male hypogonadism. Merck Manual Professional Version. https://www.merckmanuals.com/professional/genitourinary-disorders/male-reproductive-endocrinology-and-related-disorders/male-hypogonadism#. Accessed Aug. 13, 2019.

• FDA approves new oral testosterone capsule for treatment of men with certain forms of hypogonadism. U.S. Food & Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-approves-new-oral-testosterone-capsule-treatment-men-certain-forms-hypogonadism. Accessed Sept. 26, 2019.

• Bhasin S, et al. Testosterone therapy in men with hypogonadism: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology and Metabolism. 2018;103:1715.

All prescription medications require a valid and complete online consultation prior to approval and final pricing is determined. All compounded medications in the U.S. are considered off-label use. Licensed healthcare practitioners have the ability to prescribe compounds for off-label treatment, if they believe that it is an appropriate course of treatment.

The drug and medical information provided on this website is not meant to cover all adverse effects, drug interactions, warnings, medical uses, directions and precautions. The information provided is a medical resource and the judgment of your physician and/or healthcare practitioner should not be substituted. Premier Pharmacy has made every effort to ensure the information on the website is accurate and current based on present medical literature. 

Premier Pharmacy does not make any guarantees regarding the drug and medical information, and does not assume responsibility regarding the content. The drug safety and drug information contained on the website may be time sensitive and should not be utilized as a medical reference beyond the date hereof. The deficiency of a warning for prescription medications and vitamins provided on this website in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. 

If you have questions or concerns about your medications, please do not hesitate to contact us and/or your medical practitioner, including your pharmacist. Compound prescription products have not been tested or approved by the FDA for their intended use. No claims are made as to the safety, efficacy or use of this compound.