Q&A: What every man should know about testosterone, ED and prostate health

From understanding testosterone levels to male infertility, it’s normal to have questions about your health and what to do when your body doesn't feel right.

Our team is here to help. The Men's Wellness Clinic at the University of Chicago Medicine has multidisciplinary specialists who offer a wide range of services across the span of men's health, and we have primary care physicians available across the Chicagoland area.

Here are some of the most common questions we receive about hormones, sexual health and fertility so you can be better informed and in control of your health at any age.

What’s included in a men’s health checkup?

During a routine checkup, your physician will likely conduct several standard examinations and assessments, as well as recommend specific tests based on your age and health. Most visits include:

• Physical exam to evaluate your vital signs (such as weight, blood pressure and heart rate)

• Blood tests to determine your cholesterol and blood sugar levels

• Questions about your mental and emotional well-being

• Making sure your vaccinations are up to date

• Starting at age 40 — and based on shared doctor-patient decision making and risk factors like family history — discussing a digital rectal exam (DRE) and/or a prostate-specific antigen (PSA) test, as well as a colonoscopy, to detect prostate cancer.

Every month at home, you should also check your scrotum and testicles for changes or irregularities and examine your skin for unusual growths, moles or spots.

Hormones and men’s health

What is testosterone?

Testosterone is a sex hormone naturally present in both men and women; in males, it’s produced in the testes and adrenal glands.

What does testosterone do?

Testosterone plays an important role in whether an embryo develops male or female reproductive structures, and it also influences a person’s sex drive, bone growth, cardiovascular health and overall energy level. Testosterone is involved in male puberty, including making sperm, deepening the voice and growing hair.

What are healthy testosterone levels by age?

Testosterone levels vary by person and are influenced by age and health. Males over the age of 18 should have a testosterone level between 300 to 800 nanograms in every deciliter of blood. Testosterone levels steadily decrease as you age, however. Research shows that up to 20% of men above the age of 70 have what's called low T.

What are signs of high testosterone in men?

A testosterone level above 800 ng/dL is considered high. However, the symptoms that we tend to associate with high levels of testosterone — such as irritability, acne and hair loss — are usually due to a person taking testosterone as an anabolic steroid and having anywhere from 1,000 to 2,000 ng/dL of testosterone in their blood.

What are signs of low testosterone?

Low testosterone, or “low T,” is generally considered to be below 300 ng/dL, but every man has a different baseline. Symptoms of low T include decreased sex drive, low energy levels and problems having an erection.

As you age, your testosterone production declines. UChicago Medicine offers several effective types of testosterone replacement therapy (TRT), including gels, creams, injections and oral pills, as well as medicines that promote testosterone production. Your doctor can assess your testosterone levels and guide you on available treatments.

Prostate health

What is a prostate?

The prostate is a small, walnut-sized gland found only in men and situated below the bladder and around the urethra.

What does the prostate do?

The prostate contributes the fluid that makes up most of your ejaculate volume and helps transport semen. That fluid also nourishes your sperm.

What are symptoms of prostate problems?

The most common problems are related to having an enlarged prostate (benign prostatic hyperplasia, or BPH). Most men will develop some degree of BPH as they age.

Think of the prostate as a stop valve — it sits right below the bladder and as it gets bigger, it makes it harder to pee and causes bladder dysfunction. This can make you strain to urinate or finish urinating, feel as if you still have to pee after urinating, consistently dribble, wake up frequently at night to urinate, or have bloody urine or repeated urinary tract infections.

The symptoms of prostate cancer are similar, but you can also feel pain in your bones with the latter.

What is a prostate exam?

Prostate cancer is the second-most common cancer and the second-leading cause of cancer death in men. Your doctor can check your prostate for lumps or anything unusual by conducting a digital rectal exam. Using their finger, they’ll feel the back surface of your prostate, a common location for tumors. The test usually takes less than 10 seconds, and it isn’t painful.

Men's sexual health and fertility

What is erectile dysfunction?

It’s the consistent inability to have and maintain an erection that’s sufficient for penetration.

Can diet cause erectile dysfunction?

Yes. High-fat diets can lead to high levels of cholesterol in the blood, diabetes and heart disease. All of these illnesses feed into erectile dysfunction and increase your risk of having ED.

When are men most fertile?

You’re at your most fertile before the age of 40; after that, your fertility significantly drops. Once you reach what we call advanced paternal age, both the quantity and quality of your sperm begins to decline.

What is considered a low sperm count?

Below 15 million sperm cells per cubic centimeter — that’s about the size of a small drop of semen — is considered low. There’s really no way to know if you have a low count until you see a reproductive urologist for a semen analysis. There are now also mail-in semen analysis kits, so you don't even need to see a doctor.

How can you tell if a man is infertile?

The only way to find out if you’re infertile is by seeing a doctor like a urologist and having a semen analysis. If you’re concerned about your fertility or sexual health, evaluation is key.