Testosterone therapy, diagnosed properly.

Is it really low testosterone?

Low testosterone, clinically known as hypogonadism, can cause real symptoms that significantly impact quality of life. But here’s what many men don’t realize: the symptoms commonly attributed to “Low T” can also be caused by other conditions entirely.

Fatigue, decreased energy, reduced libido, difficulty concentrating, mood changes — these symptoms overlap with thyroid disorders, sleep apnea, depression, diabetes, and other medical conditions. Starting testosterone without proper evaluation might mean missing the real cause of your symptoms.

That’s why we don’t prescribe testosterone based on symptoms alone.

Common symptoms of low testosterone

• Persistent fatigue and decreased energy
• Reduced sex drive (libido)
• Erectile dysfunction
• Loss of muscle mass or strength
• Increased body fat
• Mood changes, irritability, or depression
• Difficulty concentrating
• Decreased bone density

These symptoms warrant evaluation. They don’t automatically mean you need testosterone.

Thorough evaluation before treatment

Testosterone therapy is a medical treatment with real benefits, but also potential risks. Proper diagnosis requires more than a quick questionnaire or a single lab test.

Our evaluation process

1. Comprehensive medical history. We discuss your symptoms in detail, review your medical history, and identify any factors that might be contributing to how you feel. Many men are surprised to learn that lifestyle factors, medications, or other health conditions can significantly affect testosterone levels.
2. Physical examination. A thorough exam helps identify signs of low testosterone as well as other conditions that might explain your symptoms or affect treatment decisions.
3. Laboratory testing. We order comprehensive lab work, not just a testosterone level. This typically includes total testosterone (measured in the morning), free testosterone, LH and FSH, complete blood count, metabolic panel, PSA, and additional tests as clinically indicated.
4. Clinical correlation. Low testosterone is defined by both symptoms AND consistently low lab values. A single low reading doesn’t necessarily mean you need treatment. We confirm the diagnosis before discussing therapy.
5. Treatment discussion. Only after completing a thorough evaluation do we discuss whether testosterone therapy is appropriate, and if so, which option best fits your situation, lifestyle, and preferences.

Honest assessment: is TRT right for you?

Not everyone who walks into a clinic expecting testosterone actually needs it. Part of our commitment to evidence-based care is being honest about who benefits from TRT, and who might be better served by addressing other issues first.

TRT may be appropriate if:

• You have symptoms consistent with low testosterone
• Lab testing confirms consistently low testosterone levels
• There’s no reversible cause that should be addressed first
• You understand the commitment to ongoing treatment and monitoring
• The potential benefits outweigh the risks in your individual situation

TRT may NOT be the answer if:

• Your symptoms are better explained by another condition
• Your testosterone levels are actually normal
• You have a reversible cause (medication effects, obesity, sleep apnea) that should be addressed first
• You’re primarily seeking performance enhancement rather than treatment of a medical condition
• You have contraindications to testosterone therapy

We’d rather help you find the real cause of your symptoms than start a treatment you don’t actually need. If TRT is appropriate, we’ll provide excellent care. If it’s not, we’ll help you understand why and what alternatives might help.

FDA-approved testosterone treatments

When testosterone therapy is indicated, we offer multiple FDA-approved formulations. The best choice depends on your preferences, lifestyle, and medical factors.

All formulations come from regulated pharmacies. We do not prescribe compounded testosterone or products from unregulated sources.

Ongoing monitoring is essential

Prescribing testosterone is just the beginning. Safe, effective TRT requires ongoing monitoring to ensure the treatment is working and to watch for potential side effects.

Our monitoring protocol

Initial follow-up (6 to 12 weeks)

• Review of symptom response
• Testosterone level check (to ensure adequate dosing)
• Complete blood count (testosterone can increase red blood cell production)
• Adjustment of dose if needed

Ongoing monitoring

• Regular lab work (typically every 6 to 12 months once stable)
• PSA monitoring
• Symptom assessment
• Side effect evaluation
• Dose adjustments as needed

What we monitor for

Elevated red blood cell count (polycythemia), changes in cholesterol or lipid levels, prostate effects (PSA and exam), skin reactions (with topical formulations), mood or behavioral changes, and effects on fertility (testosterone suppresses sperm production).

Testosterone therapy without proper monitoring is not safe medicine. We track your response to treatment and adjust as needed to optimize benefits while minimizing risks.

Why choose Sterling Urology for TRT

We start with diagnosis, not sales. We’re not here to sell you testosterone. We’re here to determine if you actually need it, and if you do, to provide excellent care.

Urological expertise. As a board-certified urologist, Dr. Greene has specialized training in male hormonal health and the conditions that can mimic or coexist with low testosterone.

FDA-approved treatments only. No supplements, no “proprietary blends,” no unproven therapies.

Comprehensive monitoring. We don’t prescribe and forget. Ongoing monitoring ensures your treatment remains safe and effective over time.

Insurance-friendly. We work with most major PPO insurance plans and Medicare. Testosterone therapy doesn’t have to be a cash-pay expense.