An endocrinologist or urologist can diagnose and treat low testosterone. For most people, a primary care doctor is the best first step because they can order initial tests and refer you to the right specialist.
The American Urological Association uses a total testosterone level below 300 ng/dL as a reasonable cutoff that supports a diagnosis. A single low result does not confirm testosterone deficiency.
Which Doctor Should You See for Low Testosterone?
The right doctor depends on your symptoms, test results, medical history and fertility plans.
| Doctor | Best choice when you have... | What the doctor may do |
|---|---|---|
| Primary care doctor | Symptoms but no confirmed diagnosis | Review your health history, order testosterone tests, look for common causes and provide a referral |
| Endocrinologist | Possible hormone, pituitary or testicular problems | Investigate hormone disorders and identify where testosterone production may be affected |
| Urologist | Erectile dysfunction, testicular concerns, prostate issues or fertility concerns | Evaluate male reproductive health and discuss treatment options |
| Reproductive urologist | Low testosterone and plans to have children | Assess fertility and consider treatments that preserve sperm production |
An endocrinologist specializes in hormone disorders. A urologist specializes in the urinary system and male reproductive organs. Either doctor may treat testosterone deficiency.
Which Specialist Is Best for You?
An endocrinologist may be the better choice if you have:
- Abnormal thyroid, pituitary or other hormone results
- A history of head injury, pituitary disease or brain surgery
- Unexplained low testosterone
- Several endocrine or metabolic conditions
- Symptoms that suggest a broader hormone disorder
A urologist may be the better choice if you have:
- Erectile dysfunction or reduced sexual function
- Testicular pain, injury or shrinkage
- Male infertility
- Prostate concerns
- Questions about testosterone treatment and sperm production
If you are unsure where to start, make an appointment with your primary care doctor.
How Is Low Testosterone Diagnosed?
Low testosterone is diagnosed using symptoms, repeated blood tests and an evaluation for the underlying cause.
Diagnosis generally involves:
- Symptoms or signs that fit testosterone deficiency.
- Two separate early-morning testosterone blood tests.
- Additional tests when needed to identify the cause.
Testosterone levels are usually checked in the morning because they change throughout the day. A doctor may also order tests for luteinizing hormone, follicle-stimulating hormone, prolactin, blood count and other conditions that can affect testosterone levels.
Can a Doctor Prescribe Testosterone Replacement Therapy?
Yes. An endocrinologist, urologist or qualified primary care doctor may prescribe testosterone replacement therapy when testing confirms testosterone deficiency and treatment is appropriate.
Treatment may include:
- Injections
- Gels
- Patches
- Tablets that dissolve in the mouth
- Nasal gel
- Pellets
The choice depends on the cause of low testosterone, your medical history, cost, preferences and fertility plans. Testosterone treatment also requires follow-up appointments and blood tests.
Tell the doctor if you want to have children. Testosterone replacement can reduce sperm production. A reproductive urologist or endocrinologist may recommend another treatment approach.
What If the Patient Is a Woman?
For a woman with possible low testosterone, the usual starting points are a primary care doctor, gynecologist or endocrinologist.
Low testosterone is harder to define in women because symptoms such as fatigue and low libido can have many causes. Routine testosterone treatment is not appropriate for everyone.
What Should You Do Next?
Start with a primary care doctor if you have symptoms but have not been tested. Ask for an evaluation instead of requesting testosterone based only on fatigue, low mood or reduced sex drive.
If your testosterone remains low on repeat testing, ask whether an endocrinologist or urologist makes more sense for your symptoms, fertility plans and suspected cause.