Men’s Health

Testosterone Therapy for Low T in Cleveland, OH

Hypogonadism, also known as low testosterone or “low T,” can lead to symptoms of decreased energy and libido, decreased erections, moodiness, difficulty concentrating, and even loss of muscle mass and bone density. Men who are symptomatic and demonstrate low testosterone on a morning blood draw could benefit from testosterone therapy. There are many options, each with its benefits and disadvantages. If the desired effects are not achieved with your initial choice, a different option can be tried. Dr. Thirumavalavan is a board-certified urologist highly experienced in treating low T with testosterone therapy.  Call (216) 285-5036 to schedule an appointment today!

Topical Gels

Men can apply these gels themselves once a day, at home. Advantages include more constant levels with daily dosing and avoidance of needles. Disadvantages include increased cost compared to injectables, the potential for transference of the gel to others (e.g., spouses and young children) through contact with your skin or clothes, messiness of gel application, and potential skin irritation.

Office Injectable Testosterone

This testosterone formulation requires 2 injections in the office, 4 weeks apart. After that, you receive an injection every 10 weeks, in the office. Advantages include having everything performed in the office, so there is no need to inject at home.

Home Injectable Testosterone

You will be taught how to inject testosterone at home, usually about once a week. Advantages include convenience, the ability to change dose easily, and higher testosterone levels reached overall, but there may be more fluctuations in testosterone levels.

Implantable Testosterone Pellets

During a short office procedure that takes about 10 minutes, small testosterone pellets are implanted underneath the skin by your hip. The pellets slowly dissolve to release testosterone, and will be re-implanted every 3 to 6 months. Benefits are convenience and not having to do anything at home, but risks with the procedure include small risk of bleeding or infection.

Nasal Testosterone: This testosterone gel is placed in the nose 2-3 times a day. Advantages include being non-invasive, and it could preserve sperm production. Disadvantages include frequency of dosing.

Follow Up on Testosterone Therapy

Regardless of the type of testosterone replacement therapy chosen, you will need to be seen and evaluated by Dr. Thirumavalavan at regular intervals (usually every 3-6 months) both to confirm good control of your hypogonadal symptoms and to ensure that there are no potentially dangerous side effects. The follow-up regimen usually consists of the following:

  • Physical examination.
  • Routine bloodwork for testosterone levels and other hormones (every 3-6 months).
  • Routine blood work for lipids, hemoglobin and hematocrit, and PSA (prostate-specific antigen) (every 6 months).

Other medications that may be combined with your testosterone replacement therapy:

Anastrozole (Arimidex)

This is an oral medication that decreases the conversion of testosterone to estrogen, and may be used when estrogen levels are high. This can help reduce breast tissue growth and fluid retention.

Tamoxifen (Nolvadex)

This is an oral medication that blocks the effects of estrogen in the body without decreasing the level of estrogen in the blood. It can help reduce breast tissue growth and breast sensitivity.


This is a subcutaneous injection that can be used to preserve testicular size or function. It stimulates the production of testosterone within the testicles and helps maintain sperm production.

Clomiphene citrate (Clomid)

This is an oral medication that increases the production of testosterone as well as sperm production within the testicles. It can help enhance and preserve testicular function.

Schedule an Appointment

Dr. Thirumavalavan is a board-certified urologist highly experienced in treating low T with testosterone therapy.  Call (216) 285-5036 to schedule an appointment today!


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