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Robert Jansen, MD, discusses evaluation of candidates for testosterone therapy
Jansen stresses that testosterone is not a cure-all and often requires adjunct evaluation and management of other conditions such as sleep apnea or thyroid disorders.
Jansen stresses that testosterone is not a cure-all and often requires adjunct evaluation and management of other conditions such as sleep apnea or thyroid disorders.
In this video, Robert Jansen, MD, a urologist with Atlantic Urology Specialists in South Carolina, outlines his approach to evaluating candidates for testosterone replacement therapy (TRT). He emphasizes that although lab values are important, his primary focus is on a patient’s symptoms. Many men with low testosterone may feel fine and not require treatment, whereas others with symptoms such as fatigue, depression, sexual dysfunction, and low motivation may benefit from therapy. Jansen begins by taking a comprehensive medical history to identify other conditions or medications that might affect testosterone levels. He ensures low testosterone is documented, and if levels are borderline or normal but symptoms persist, he checks free testosterone. Additional labs include a pituitary panel (FSH, LH, prolactin), vitamin D, and fasting insulin for those at risk for prediabetes. This information guides a personalized treatment plan.
Jansen also addresses common misconceptions about TRT. He stresses that testosterone is not a cure-all and often requires adjunct evaluation and management of other conditions such as sleep apnea or thyroid disorders. Erectile dysfunction, for instance, may not resolve with TRT alone and may need separate treatment. He educates patients that without lifestyle changes, TRT may not be effective long-term. Some patients also fear TRT may cause cancer or heart problems. Jansen reassures them, citing literature showing no link to increased cancer risk—especially prostate cancer—and that cardiovascular risks are minimal or even questionable. Overall, patient counseling, symptom assessment, and a comprehensive evaluation are key to successful TRT management.
