Andropause Therapy:
What really helps with testosterone deficiency?

Diagnosis - what now?

The diagnosis is in: Your testosterone is too low, the symptoms match. What now? The good news: There is a broad spectrum of effective treatment options — from targeted lifestyle changes and individualized nutritional supplements to infusion therapies and modern stem cell treatments, all the way to hormone therapy accompanied by a specialist.

Which combination is the right one depends on your values, your situation, and your goals.

This page explains all therapy options in an understandable way — without promises, but with clear facts. So that you can go into your conversation with the specialist well informed.

Diagnosis in hand – now discuss therapy

Individual therapy plan based on your lab values.
By a specialist, discreet, nationwide via telemedicine.

Book a consultation now

Five therapy pillars —
individually combined

The AndroKlinik treats andropause holistically.
Instead of a one-size-fits-all solution, we combine five therapy approaches that build on one another — tailored to your lab values, your lifestyle, and your symptom profile.

The five therapy pillars of the AndroKlinik for andropause

1. Lifestyle &
Lifestyle Optimization

The foundation. Always first and accompanying.
2. Individualized Nutritional Supplementation

Targeted micronutrient supply based on lab values.
3. Infusion Therapy

Intravenous supply of vital substances for fast, noticeable effect.
4. Stem Cell Therapy of the Erectile Bodies (P-Shot)

Tissue regeneration with the body's own PRP.
5. Shockwave Treatment (ESWT)

Neovascularization and improved blood circulation.

All therapy decisions are made together with you — based on your complete lab panel, after a thorough conversation, and with regular follow-up checks.

Pillar 1: Lifestyle — the foundation of every therapy

Before further measures are taken, the question arises: What can your body achieve on its own — if you give it the right conditions? A targeted lifestyle change is not a consolation prize. With mild testosterone deficiency, it can address the cause directly — measurably and sustainably.

At the same time: Lifestyle change is always an accompanying therapy, not a replacement in cases of pronounced clinical deficiency. The specialist assesses together with you what is sufficient on its own and what should be supplemented.

Measure	Effect on Testosterone	Practical Tip
Strength Training	Stimulates testosterone production directly — effect measurable after 6–12 weeks	3x per week compound exercises (squats, deadlifts, bench press) — more effect than endurance training alone
Sleep (7–9 hrs.)	80% of daily testosterone is produced during sleep — sleep deprivation lowers it acutely	Fixed sleep window, no screen 60 min. before sleeping, room temperature 17–19 °C
Weight Reduction	Fat tissue converts testosterone into estrogen — every kilo less counts	Moderate calorie deficit — an extreme deficit lowers testosterone as well
Stress Management	Cortisol blocks testosterone production directly	Breathing exercises, meditation, clear work boundaries — even small measures help
Reduce Alcohol	Alcohol inhibits testosterone production and increases estrogen	More than 14 units/week are clinically relevant — every reduction counts
Treat Sleep Apnea	Sleep apnea drastically lowers testosterone through chronic sleep deprivation	Snoring + daytime fatigue = sleep lab recommended — often TRT is only started here after treating the apnea

Lifestyle measures take time. After 3 months of consistent implementation, the lab test should be repeated — only then can the actual effect be assessed.

Pillar 2: Individualized Nutritional Supplementation

Testosterone is not produced out of nothing — it needs building blocks. Many men with andropause have measurable micronutrient deficiencies that directly slow down hormone synthesis. Targeted nutritional supplementation can close these gaps.

Crucial: The supplementation should be based on your lab values — not on generic recipes from the internet. What works depends on what you are actually lacking. The AndroKlinik creates your individual supplementation plan based on the hormone and micronutrient panel.

Nutrient	Effect	Sources / Dosage	Especially with
Zinc	Direct involvement in testosterone synthesis — deficiency measurably lowers levels	Food: pumpkin seeds, meat, oysters · Supplement: 15–25 mg/day	Nutrient-poor diet, increased need due to exercise
Vitamin D	Acts like a hormone — receptors in the Leydig cells of the testicles	Sun (20–30 min./day) · Supplement: 2,000–4,000 IU/day depending on level	Northern Germany, office work, dark skin color
Magnesium	Lowers SHBG → more free testosterone available	Food: nuts, seeds, legumes · Supplement: 300–400 mg/day	Exercise, sleep disorders, chronic stress
Omega-3	Supports hormone synthesis via cholesterol metabolism · anti-inflammatory	Fatty fish 2–3x/week · Fish oil 2–3 g EPA+DHA/day	Inflammatory comorbidities, metabolic syndrome
Ashwagandha	Adaptogen — lowers cortisol, measurably increases testosterone in studies	Root extract: 300–600 mg/day over at least 8 weeks	Stress-related andropause, loss of libido
Vitamin B6/B12	Cofactors in hormone metabolism, energy production, nervous system	Supplement: depending on level · especially B12 with a vegan diet	Exhaustion, concentration problems, vegan diet

Important: Supplement ≠ Therapy

Nutritional supplements can compensate for deficiencies — they do not replace medical diagnostics or hormone therapy in cases of clinically relevant deficiency. High-dose single preparations (e.g. zinc > 40 mg/day) can be harmful if overdosed. The AndroKlinik creates your supplementation plan individually — based on your lab values, not off the shelf.

Pillar 3: Infusion Therapy

While oral nutritional supplements take the detour through the digestive tract, micronutrients delivered by infusion enter the blood directly — with significantly higher bioavailability and immediate effectiveness. Intravenous vital substance therapy is particularly effective when fast and noticeable results are desired or when oral absorption is limited.

Contents of an Andropause Infusion

The composition is individually tailored to your lab values and your symptom profile.

Typical components:

High-dose Vitamin C — antioxidant, supports hormone synthesis and immune system
Zinc, magnesium, selenium — direct building blocks of testosterone production
B vitamins (B1, B6, B12) — energy metabolism, nervous system, breakdown of stress hormones
Glutathione — strong antioxidant, promotes cell regeneration and vitality
Amino acids (e.g. L-arginine, L-carnitine) — promotion of blood circulation, energy provision

Procedure and Frequency

An infusion usually lasts 30–60 minutes and is performed on an outpatient basis at the clinic.

Depending on the therapy goal, the doctor recommends a single or series treatment — often 4–6 sessions at intervals of one to two weeks, followed by maintenance infusions as needed.

For many patients, the effect is already noticeable after the second or third infusion.

Pillar 4: Stem Cell Therapy of the Erectile Bodies (P-Shot)

The P-Shot (Priapus Shot) is a minimally invasive treatment with the body's own platelet-rich plasma — PRP (Platelet-Rich Plasma) for short, which is converted into a P-Shot in a dedicated process.

The P-Shot contains a highly concentrated amount of growth factors and mesenchymal stem cells from your own blood, which, when injected precisely into the erectile tissue of the penis, trigger tissue regeneration and neovascularization.

How does the P-Shot work?

From a small blood sample, the P-Shot is obtained in a centrifuged preparation process developed by Dr. Spanholtz (AndroKlinik) — a plasma with up to 5 times the platelet concentration compared to normal blood. This is then injected precisely into the erectile bodies and specific areas of the penis. The growth factors contained (PDGF, VEGF, TGF-β) stimulate there:

The formation of new blood vessels (neovascularization) — improved blood circulation
The regeneration of erectile tissue — more natural, firmer erections
The activation of dormant stem cells in the tissue
The improvement of nerve sensitivity

For whom is the P-Shot suitable?

Men with andropause and accompanying erectile dysfunction
Erection problems with a vascular cause (poor blood circulation of the erectile bodies)
Men who do not tolerate medications (PDE-5 inhibitors) or whose effect is diminishing
Accompanying TRT — for synergistic effect on erection quality and libido
Early stage of Peyronie's disease (penile curvature)

Procedure, Results, and Repetition

The P-Shot is an outpatient procedure that lasts about 30–45 minutes under local anesthesia. Many patients report the first improvements after 4–6 weeks — a full effect develops over 3–6 months. Depending on the response, a second treatment is recommended after 3–6 months. Since it involves the body's own material, allergic reactions are practically excluded.

The P-Shot Pro –
the big brother of the P-Shot

A particularly intensive form of the P-Shot! Especially recommended for more pronounced erection problems or when the standard P-Shot is to be optimized. The P-Shot Pro combines the PRP stem cell treatment with additional growth factors for more intensive tissue regeneration.

More information about the P-Shot and P-Shot Pro

Pillar 5: Shockwave Treatment (ESWT)

Extracorporeal shockwave therapy (ESWT) uses low-energy sound waves that are introduced from the outside through the skin into the erectile tissue — without an incision, without anesthesia, without downtime. Originally known from orthopedics, ESWT has established itself in recent years as an evidence-based method for treating vascular erectile dysfunction.

How does shockwave therapy work?

The sound waves produce several therapeutic effects at the cellular level:

Neovascularization — stimulation of the formation of new small blood vessels (capillaries) in the erectile body
Activation of stem cells in the penile tissue
Breakdown of microcalcifications and fibrotic plaques (relevant in Peyronie's disease)
Improvement of nitric oxide production — an important mediator of erection

Who particularly benefits?

Men with vascular erectile dysfunction in the context of andropause
Men in whom PDE-5 inhibitors (Viagra, Cialis) do not work sufficiently
As a preparatory measure before a P-Shot — for optimal tissue blood circulation
Early stage of Peyronie's disease (penile curvature)

Procedure of a Treatment Series

A treatment session lasts about 20–30 minutes and is almost painless. Usually 6–12 sessions over 6–12 weeks are recommended. The effect usually sets in after the third to fourth session and continues to improve over months after completion of the series — since the biological regeneration processes take time.

ESWT + P-Shot: The combination that mutually reinforces each other

Shockwave prepares the tissue — the P-Shot delivers the growth factors. Many andrologists recommend the combination: first an ESWT series, then a P-Shot.
At the AndroKlinik, the optimal sequence is planned individually with the specialist.

More information about Shockwave

Additionally: Testosterone Replacement Therapy (TRT)

When lifestyle change, nutritional supplementation, and the biological treatments alone are not sufficient, or when the testosterone deficiency is clinically confirmed and pronounced, a testosterone replacement therapy (TRT) can be considered. It is a prescription medication with a clear indication — not a lifestyle product.

Safety & Monitoring with TRT

After 6–8 weeks: Testosterone, free testosterone, hematocrit
After 3 months: Complete panel incl. PSA, blood count, estradiol
Every six months: Overall health assessment, dose adjustment if necessary

Contraindications: Prostate cancer · Breast cancer · Untreated severe sleep apnea · Active desire to have children (In case of a desire to have children: Alternative HCG therapy possible — please raise this in the initial consultation)

Therapy Form	Details & Application	Particularly suitable for
Testosterone Gel	Daily on shoulder, upper arm, or abdomen · even level · fast-acting	Flexible, easily dosable option · not suitable in case of close skin contact with a partner or children
Testosterone Injection	Every 10–14 weeks (depot) · no daily effort · stable long-term level	Men without a daily routine · suitable for long-term, stable therapy
Testosterone Patch	Change daily · even release · discreet	Sensitive skin or desire for non-visible application
Capsule (oral)	Twice daily with a meal · newer dosage form · no contact risk	Oral preference · not yet prescribed everywhere

Which therapy pillars are right for you?

That is decided by your lab values and your symptom profile — together with the specialist.

Book a consultation now

This is how your therapy support at the AndroKlinik works

From diagnosis to long-term support — structured, seamless, and without unnecessary trips:

Medical history form in advance via link — you prepare at your leisure, the doctor already knows your situation at the first conversation
Video consultation (30–45 min.) — initial consultation, lab order, first therapy considerations
Blood draw close to home — partner lab near you, no long trip
Findings evaluation within 48 hours — video conversation with an individual therapy plan
E-prescription issued directly — if medication is indicated, digitally to your pharmacy
Follow-up check after 6–8 weeks — first effectiveness review and safety check
Quarterly lab checks — dose adjustment, therapy conversation via video
Escalation path to the on-site clinic — when a personal examination or intervention becomes necessary

Frequently Asked Questions about Andropause Therapy

How quickly do the various therapies work?

This is individual. Infusions often have a noticeable effect as early as the second or third session. The P-Shot shows first effects after 4–6 weeks, the shockwave after 3–4 treatments. Lifestyle change and nutritional supplementation need 6–12 weeks for measurable lab changes. TRT shows first effects (energy, mood) after 3–6 weeks, full effect on libido and muscles after several months.

Can I use several therapy pillars at the same time?

Yes — and this is often sensible. Many treatments work synergistically: Shockwave prepares the tissue, the P-Shot delivers the growth factors. TRT increases the hormone level, nutritional supplementation secures the building blocks. The specialist plans the optimal combination and sequence individually for you.

Do I have to take TRT for life?

Not necessarily. For some men, one therapy phase with subsequent lifestyle optimization is sufficient. For others, the need exists long-term. The specialist assesses this regularly — a therapy can be adjusted or ended in a controlled manner at any time.

Is the P-Shot painful?

The procedure is performed under a local anesthetic cream and is well tolerated by most patients. A slight feeling of pressure during the injection is normal. Significant pain or downtime does not usually occur.

Do I get the prescription after the online consultation?

A private prescription can be issued after a telemedicine consultation — if the specialist assesses the indication as given based on your lab values. The e-prescription is transmitted directly digitally and can be redeemed at any German pharmacy. There is no prescription without prior medical examination.

What does the therapy support cost?

Our services are aimed at self-payers and are billed according to the GOÄ (German scale of medical fees). Guideline prices for the packages can be found on our services page. Medication costs are added separately depending on the preparation.

Take the next step now

You have all the information — now all that's missing is the conversation. Book your initial consultation at the AndroKlinik.

About the Author

Dr. med. Timo A. Spanholtz
Specialist in Plastic and Aesthetic Surgery - Specialist for Men's Health and Intimate Surgery

Dr. Spanholtz is the founder and chief physician of the AndroKlinik. With many years of clinical experience in men's health, andrology, and reconstructive urology, he supports patients from the entire German-speaking region.