Is Hormone Therapy Right for Me?

By Stephanie DeRouin, APRN

Hormonal and metabolic changes are a natural part of aging but, unfortunately, not a positive change. Scientists have clearly documented the adverse effects of hormonal and metabolic decline as the primary contributors to the chronic diseases that impact our heart, brain, and bone health as we age. 1

That’s why hormone replacement therapies continue to be widely and carefully studied today – to see if they are the solution for a better quality of life as we age.

What are hormones?

Hormones are chemical substances secreted by various body organs that control the function of cells and tissues – everything from metabolism to behavior.2

We are most familiar with our sex hormones, which are responsible for puberty, menstruation, sex drive, pregnancy, sperm production, and menopause. These include estrogen, testosterone, and progesterone. These aren’t our only hormones. Human growth hormones, thyroid hormones, cortisol, and insulin also are critical to our health.

However, since urologists receive the most extensive training available in physiology, anatomy, and treatments associated with sexual issues, we are focusing on the sex hormones in this article.

Why is estrogen necessary?

Both men and women make estrogen, but it is most impactful to women. Its presence controls body composition and ovulation and keeps the vulva and urethra healthy.

Estrogen levels start to dip up to 10 years before menopause (the cessation of periods). On average, menopause occurs around age 50, so starting as early as age 40, women may begin to experience symptoms like lack of energy and fatigue, decreased sexual desire, weight gain, and hot flashes. As estrogen levels decline, pain or discomfort with intercourse can occur.

Estrogen is not only crucial for sexual function, though. It also affects women’s cholesterol, blood sugar, bone and muscle mass, brain function, and circulation.

Why is testosterone important?

Both men and women also make testosterone. While testosterone is most talked about for men, as it is the primary male sex hormone, there is a growing body of evidence that shows testosterone plays critical roles in women’s health as well – from sexual function to osteoporosis prevention to brain and breast protection.3

Testosterone for men is critical in triggering the development of male internal and external reproductive organs during fetal development. Like estrogen in women, testosterone plays a crucial role in body composition, the production of sperm, sex drive, and a sense of well-being. And, like estrogen in women, it starts to dip in a man’s third and fourth decades of life.

The first complaints from most men with low testosterone are tiredness and decreased libido. But low testosterone levels also contribute to an increased risk of obesity, an increased risk for type 2 diabetes, high blood pressure, high triglycerides, and reduced muscle mass, strength, and bone density.

How can hormone therapy help?

Suppose you have a hormone imbalance of estrogen or testosterone (which can be diagnosed with a simple blood test). In that case, hormone therapy may help alleviate the symptoms associated with that hormonal decline. This can include:

  • Increased energy
  • Improved sleep
  • A more balanced mood
  • Better ability to control your weight
  • Increased mental clarity
  • Restored libido

At AUI, we use bioidentical hormone replacement therapy pellets to treat hormone imbalances from Biote® and TESTOPEL®. These hormone pellets contain compounded testosterone or estrogen identical in structure to your body’s natural hormones.

The pellets are placed under the skin in a simple, in-office procedure that takes no more than 15 minutes. No pills. No shots. And the pellets are ultimately absorbed by your body, leaving nothing behind.

This type of therapy delivers a steady stream of hormones to patients for several months. Most patients report feeling symptom relief after the first round of pellets. However, it may take up to two pellet insertions.

Are there risks?

Like all therapies, hormone replacement must be tailored to the individual. Your family and personal health history of cancer, heart disease, stroke, blood clots, and liver disease will determine if hormone therapy is right for you.

Everything from your dosage and treatment length to establishing regular reevaluation intervals will be determined with your physician.

Hormone therapy is not suitable for everyone and can lead to increased risks for some individuals.

Hormone Therapy at AUI

At Advanced Urology Institute, we know that hormones and health go hand in hand, so we are passionate about offering hormone therapy through a disciplined approach in a clinical setting under the careful watch of our extensively trained physicians and staff.

Learn more about our approach to optimize your hormones and enhance your well-being as you age.




Do You Need Testosterone Therapy? Learn How Urologists Like Dr. Edward King Treat Low Testosterone


  • Testosterone is vital for maintaining bone density, muscle mass, and libido; low testosterone can lead to various adverse side effects.
  • Consultation with endocrinologists or urologists, like Dr. Edward King, is crucial for the proper diagnosis and treatment of low testosterone.
  • Testosterone therapy requires careful monitoring by a specialist to ensure patient safety and optimal results.

Understanding Testosterone and Its Importance

Testosterone, a naturally occurring anabolic steroid, is produced by the testicles and plays a vital role in the human body. According to Dr. Edward D. King, a renowned urologist in Oxford, FL, testosterone is responsible for increasing bone density and muscle mass. It also influences libido, or sex drive, and contributes to overall well-being.

Recognizing the Signs of Low Testosterone

Low testosterone levels can result in several adverse side effects. Dr. King explains that diminished libido, weakness, fatigue, loss of muscle mass, and an increase in weight gain (specifically fat instead of lean muscle mass) can all be indicators of low testosterone.

Seeking Professional Help for Low Testosterone

When faced with symptoms of low testosterone, it is crucial to consult with specialists such as endocrinologists or urologists. Dr. King emphasizes the importance of seeking care from professionals like himself who specialize in managing diminished libido, erectile dysfunction, and hypogonadism (the medical term for low testosterone).

Testosterone Therapy: Close Monitoring is Key

Testosterone therapy can be an effective treatment for low testosterone, but it requires careful monitoring by a qualified specialist. Dr. King highlights the potential risks associated with testosterone therapy, such as polycythemia (a significant rise in red blood cell count), which can lead to stroke if not closely monitored. Testosterone therapy can also cause an elevation in liver enzymes, necessitating regular liver function tests. It is essential to ensure that the patient’s testosterone level remains within the normal range – not too low and not too high.

Advanced Urology Institute: Leading the Way in Urological Care

The Advanced Urology Institute, the largest urology practice in Florida, is committed to providing exceptional care for patients with urological conditions, including low testosterone. Dr. Edward King and his team of expert urologists offer state-of-the-art treatments to help patients regain their quality of life and enjoy improved overall well-being.


My name is Dr. Edward King, I’m a urologist at the Advanced Urology Institute.

Testosterone is an anabolic steroid, so it occurs naturally in the body, it’s produced by the testicles, and it’s involved in increasing bone density and also muscle mass. When your testosterone is low, some of the side effects can include diminished libido or sex drive, weakness, fatigue, also loss in muscle mass, and increase in weight gain, that is fat as opposed to lean muscle mass.

Low testosterone should be managed by specialists such as endocrinologists or urologists, because we are the specialists in dealing with diminished libido erectile dysfunction and low testosterone, or the medical term is hypogonadism.

Testosterone therapy should be monitored closely because it can cause a pretty significant rise in the red blood cell count, that’s a condition called polycythemia, and it can lead to stroke, if not monitored closely.

It can also cause an elevation in liver enzymes too, so those need to be checked as well. And plus, we need to ensure that the patient’s testosterone level remains within the normal range, that is not too low, and certainly not too high.


Is Testosterone Therapy Right for You? Dr. Karavadia Explains How to Diagnose Low Levels


  • Testosterone is a crucial hormone for men, affecting their daily energy levels, sexuality, and overall health.
  • Low testosterone can cause various symptoms, including fatigue, hot flashes, gynecomastia, and low libido.
  • Treatment options for low testosterone include patches, gels, injections, and long-term pellet therapy.


Testosterone is a vital hormone for men, impacting their daily energy levels, sexuality, and overall health. Dr. Saumil Karavadia, a renowned urologist in Ocala, FL, provides insight into the symptoms of low testosterone, the importance of proper evaluation, and the available treatment options. Read on to learn more about testosterone therapy and how it could potentially benefit you.

The Importance of Testosterone for Men’s Health

According to Dr. Saumil Karavadia, MD, testosterone is a key hormone needed for men to maintain their health. Low testosterone levels can lead to numerous issues such as osteoporosis, decreased energy levels, and fatigue. Some individuals may experience symptoms similar to male menopause, including hot flashes, gynecomastia (enlarged breast tissue), low libido, and persistent fatigue.

Diagnosing Low Testosterone: Seeking Evaluation

If you suspect you may have low testosterone, Dr. Karavadia recommends seeking a professional evaluation to determine the cause. In many cases, low testosterone levels result from primary testicular failure, where the testicles do not produce enough of the hormone. This condition often requires testosterone therapy for treatment.

Testosterone Therapy Options

There are several treatment options available for low testosterone, including patches, gels, injections, and long-term pellet options. Dr. Karavadia highlights the convenience of pellet therapy, as it allows patients to receive treatment every three to four months, reducing the need for frequent visits to the clinic.

The Benefits of Testosterone Therapy

Patients who undergo testosterone therapy often experience a significant increase in their energy levels, allowing them to be more active and enjoy their daily lives. Additionally, testosterone therapy can improve libido, overall well-being, and alleviate feelings of fatigue or depression that can occur with age.

Advanced Urology Institute: Expertise You Can Trust

Dr. Saumil Karavadia is a dedicated urologist at the Advanced Urology Institute, the largest urology practice in Florida. Their commitment to providing exceptional care ensures that patients receive the best possible treatment for low testosterone and other urological concerns. Trust the experts at Advanced Urology Institute to guide you on your journey to improved health and well-being.


My name is Saumil Karavadia, I’m with Advanced Urology Specialists.

Testosterone is a male hormone that certainly has a big impact on a male’s sexuality as well as the daily energy that a person goes through from a day-to-day basis. Testosterone is one of the key hormones that’s needed to actually be healthy.

If you have low testosterone, it can certainly lead to osteoporosis, worsening energy levels, being tired. The majority of the symptoms are having like a male menopause. Hot flashes, gynecomastia, low libido, low fatigue. Those are all very common symptoms of having low testosterone. 

First thing is you’ll want to get evaluated. You’ll want to get checked out for the most common causes for this. And majority of the time it’s primary testicular failure where the testicles itself, they don’t produce any testosterone. When that happens, you need to supplement with testosterone therapy. And that’s one of the most common ways to treat it. There are several treatment options including patches, gels, injections, as well as long-term pellet options which are great for people who want to come in every three or four months and just get one treatment.

Once you start testosterone therapy, the patients have a significant increase in their energy. They’re sleeping not throughout the day. They’re being active and enjoying their lifestyle. They also have an increase in libido. They have an increase in their well-being. They don’t have that tired or fatigued feeling which is a big cause for being depressed almost as you get older.


What Causes Erectile Dysfunction and How Can It Be Treated? Dr. Dinesh S. Rao Explains


  • Erectile dysfunction is a common issue, affecting half of all men over the age of 40.
  • Various factors can contribute to erectile dysfunction, including aging, low hormone levels, smoking, alcohol use, and vascular disease.
  • A wide range of treatment options is available, from oral medications to surgical interventions, and the Advanced Urology Institute offers comprehensive care for patients with erectile dysfunction.

The Prevalence of Erectile Dysfunction

Dr. Dinesh S. Rao, a respected urologist in Ocala, FL, explains that erectile dysfunction (ED) is a common issue faced by many men, particularly those over the age of 40. In fact, half of all men over 40 experience some degree of erectile dysfunction. Despite its prevalence, many patients feel hesitant or embarrassed to discuss the issue with their healthcare providers.

Causes of Erectile Dysfunction

Erectile dysfunction can be caused by various factors. Some well-known causes include smoking and alcohol use. However, other factors, such as aging, low hormone levels, and vascular disease, can also contribute to ED. Dr. Rao emphasizes that heart disease and high cholesterol can have a profound effect on erections, further highlighting the importance of addressing underlying health issues.

Treatment Options for Erectile Dysfunction

When treating erectile dysfunction, Dr. Rao and his team at the Advanced Urology Institute screen for basic causes and attempt to reverse them where possible. They also offer a wide range of treatment options to suit each patient’s unique needs. These include:

  • Oral medications: Common medications, such as Viagra, Levitra, and Cialis, are often the first line of treatment for erectile dysfunction.
  • Mechanical devices: Vacuum erection aids can help those who do not tolerate oral medications.
  • Injectable therapies: Available at local pharmacies, these treatments are another option for those who cannot take oral medications. Dr. Rao’s team teaches patients how to administer injectable therapies safely and effectively.
  • Surgical interventions: Penile implantations are an option for patients who have not found success with other treatments.

Advanced Urology Institute: Comprehensive Care for Erectile Dysfunction

The Advanced Urology Institute, the largest urology practice in Florida, is dedicated to providing comprehensive care for patients with erectile dysfunction. Dr. Dinesh S. Rao and his team of skilled urologists work closely with each patient to determine the most effective treatment options, ensuring the best possible outcomes.


Many of my patients have erectile dysfunction and many of them are afraid to bring it up. There’s always some hesitation or embarrassment involved. There’s a feeling that it’s just me or there’s something wrong with me. The interesting thing is, and many people don’t know, that half of all men over the age of 40 have erectile dysfunction. So it’s extremely common, not uncommon. And there’s many, many different causes. 

Some of the things I think a lot of people are aware of, things like smoking and alcohol use, but also just aging, low hormone levels, and vascular disease apply to erectile dysfunction. If you have some element of heart disease or high cholesterol, it can make a profound effect on erections. When people come in with that problem, we screen for the basic causes and see if we can reverse some of those things, but there’s also many different types of treatments available. So we certainly have all of the different available here in our practice. Some of the most basic things include medicines, medications that people have probably heard of, things like Viagra or Levitra or Cialis. There’s also mechanical devices like vacuum erection aids that can help in people who don’t tolerate those types of medicines. We have injectable therapies that are also available and they’re available to local pharmacies and we teach people how to use them. And we even do surgeries, things like penile implantations for people who don’t succeed with other options.