Men’s Hormone Care • Board-Certified Internal Medicine
Comprehensive evaluation and individualized treatment for men with symptoms and repeatedly low testosterone levels. Care is directed by David Nazarian, M.D., with attention to possible underlying causes, fertility goals, treatment alternatives, potential benefits, risks, and ongoing monitoring.
Symptoms such as reduced sexual interest, erectile concerns, fatigue, depressed mood, reduced strength, changes in body composition, difficulty concentrating, or reduced motivation may occur with testosterone deficiency—but these symptoms are not specific to low testosterone.
A diagnosis generally requires compatible symptoms together with consistently low testosterone measurements obtained under appropriate conditions. Results should be interpreted in context rather than treated as an isolated number.
Review of sexual symptoms, energy, mood, sleep, exercise, weight changes, medical conditions, medications, prior hormone use, family history, and treatment goals.
Testing may include repeat morning total testosterone measurements and, when clinically useful, free testosterone or related studies. Timing and interpretation matter.
Evaluation may consider pituitary or testicular causes, obesity, sleep apnea, diabetes, acute illness, medications, fertility goals, prostate health, blood counts, and cardiovascular risk.
Prior injury, infection, surgery, chemotherapy, radiation, genetic conditions, or other disorders affecting testicular function.
Conditions affecting signaling from the brain to the testes, sometimes requiring additional hormone testing or imaging.
Obesity, sleep apnea, poorly controlled chronic illness, certain medications, substance use, severe stress, inadequate sleep, or recent illness.
Treating a contributing condition may improve symptoms or testosterone levels and may sometimes be more appropriate than beginning testosterone therapy.
Testosterone therapy may be considered for appropriately evaluated men with compatible symptoms and confirmed biochemical deficiency when expected benefits reasonably outweigh potential risks. The decision should include discussion of alternatives, fertility, prostate and cardiovascular considerations, and the monitoring plan.
Goals may include improvement in specific deficiency-related symptoms, sexual function, anemia, bone health, or body composition in appropriately selected patients. Individual response varies and no outcome is guaranteed.
Testosterone is not a general anti-aging treatment, a shortcut for bodybuilding, or an appropriate response to fatigue without diagnostic evaluation. It should not be prescribed solely to optimize a number.
Depending on the patient and clinical circumstances, treatment may involve injections, transdermal gels, patches, or other prescribed formulations. Each route has different practical considerations, absorption patterns, dosing schedules, and potential adverse effects.
Dose and frequency should be adjusted according to clinical response and safety monitoring—not simply increased to pursue supraphysiologic testosterone levels.
Exogenous testosterone can suppress sperm production and may reduce fertility. Men who are trying to conceive now or may want biological children in the future should discuss this before starting therapy.
Depending on the clinical situation, evaluation of reproductive goals and alternatives to exogenous testosterone may be appropriate. Referral to a fertility or urology specialist may also be recommended.
Baseline assessment may include blood count, prostate-related evaluation appropriate to age and risk, cardiovascular review, sleep-apnea assessment, medication review, and other testing based on the patient’s history.
Possible concerns include elevated hematocrit, acne or oily skin, breast symptoms, fluid retention, reduced sperm production, testicular shrinkage, worsening of untreated severe sleep apnea, and other treatment-specific effects.
Monitoring may include symptom response, testosterone levels, blood counts, blood pressure, prostate-related assessment, adverse effects, treatment adherence, and changes in cardiovascular or general medical health.
New chest pain, sudden shortness of breath, neurologic symptoms, severe headache, leg swelling, urinary obstruction, or another concerning change requires timely medical evaluation.
Board-Certified in Internal Medicine
Dr. Nazarian evaluates testosterone concerns within the broader context of metabolic health, cardiovascular risk, sleep, medications, weight, fertility, prostate health, and other possible causes of symptoms.
The goal is to determine whether testosterone deficiency is present, identify reasonable contributing factors, and select a medically responsible plan with appropriate follow-up.
Discuss symptoms, health history, medications, sleep, fertility goals, prior treatment, and concerns.
Confirm testosterone status and evaluate relevant contributing causes and baseline safety factors.
Review treatment and non-treatment options, limitations, risks, practical considerations, and goals.
Track response and safety, adjust treatment when appropriate, and reassess the continued indication.
Written by: David Nazarian, M.D.
Medically reviewed by: David Nazarian, M.D.
Medical review date: September 17, 2026
David Nazarian, M.D., is Board-Certified in Internal Medicine and has extensive experience evaluating and treating women and men with hormonal concerns. His approach emphasizes comprehensive assessment, evidence-informed decision-making, patient education, individualized treatment, safety, and ongoing follow-up.
Meet with David Nazarian, M.D., to discuss your symptoms, laboratory testing, health history, fertility goals, treatment alternatives, and whether testosterone therapy may be appropriate.
David Nazarian, M.D., is Board-Certified in Internal Medicine and provides physician-led hormone evaluation and individualized care for women and men. His approach emphasizes comprehensive assessment, patient education, individualized treatment, safety, and ongoing follow-up. Dr. Nazarian specializes in bio-identical hormone replacement therapy in men & women. He has extensive training and knowledge in treating andropause and testosterone replacement therapy in men and menopause and estrogen replacement therapy in women. Supported by his experienced medical team, Dr. Nazarian treats men and women with hormone deficiencies and imbalances and enjoys the one-on-one relationship between patient and doctor.
HRT LA provides physician-led hormone evaluation and individualized care in Beverly Hills and Los Angeles with David Nazarian, M.D.
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