I’m 58 years old and in my 20th year as a T7 complete paraplegic. Over the past few years it seems I’m always tired, have difficulty focusing on tasks and have lost enthusiasm for going out and doing my usual sports of handcycling and swimming. It is a struggle to get out the door and do them.

I’ve read that people with SCI have a higher incidence of low testosterone and that testosterone replacement can help improve energy, muscle mass, and concentration. Have you heard of this? And if so, how do I find out about it?
— Scott

A. Scott, you bring up a good question — a Web search of “chronic spinal cord injury and low testosterone” brings up page after page of articles and studies that conclude that low testosterone occurs in a higher percentage of men with SCI than the general public.

According to the Mayo Clinic (2015 online), in the general population testosterone levels peak in adolescence or early adulthood, then decline about 1 percent per year after 30 or 40. However, a study published in a 2014 issue of the Journal of Spinal Cord Medicine states: “Persons with SCI appear to have a higher prevalence of low T concentration for each decade of life than