Testosterone Therapy

The procedure

When the body no longer produces sufficient amounts of testosterone, replacement therapy is an option. TRT can help men with low testosterone regain sexual function, support overall health and energy levels, as well as mood and mental function.

Testosterone levels generally peak during adolescence and early adulthood. As you get older, your testosterone level gradually declines — typically about 1 percent a year after age 30 or 40. It is important to determine in older men if a low testosterone level is simply due to the decline of normal aging or if it is due to a disease (hypogonadism).

Hypogonadism is a disease in which the body is unable to produce normal amounts of testosterone due to a problem with the testicles or with the pituitary gland that controls the testicles. Testosterone replacement therapy can improve the signs and symptoms of low testosterone in these men. Doctors may prescribe testosterone as injections, pellets, patches or gels.

How low testosterone is treated

The testosterone replacement is achieved by absorption through the skin (transdermal or topical) or direct injection (subcutaneous) into the muscle mass or under the skin.

Testosterone replacement therapy is available in several forms. All can improve testosterone levels:

• Skin patch (transdermal): A skin patch is similar to a nicotine patch. It’s worn on the arm or upper body, and is changed every day. The patch continually distributes testosterone in a controlled release through the day.
• Gels (topical): There are several brands of gels that may have different application methods. Testosterone is absorbed directly through the skin by applying the clear gel on your skin once a day, either the body or in the nose. Gels can also be applied using a pump that that dispenses testosterone in the amount prescribed by your doctor.
• Injections and implants (Subcutaneous): Testosterone can also be injected directly into the muscles, or implanted as pellets under the skin. The pellets slowly dissolve releasing the hormone into the bloodstream.

Benefits

The ideal outcome from TRT is to regain sexual function, energy and clarity of mind. Some men experience a strong change. Others get limited benefits.

• Many men report improvement in energy level, sex drive, and quality of erections.
• Testosterone also increases bone density, muscle mass, and insulin sensitivity in some men.
• Men often report an improvement in mood from testosterone replacement.
• Men also may be able to focus better, and see improvements in memory and cognitive skills.

Risks

• Uncommon side effects include sleep apnea, acne, and breast enlargement. All such side effects go away if treatment is stopped.
• Men who use a testosterone gel should wash their hands thoroughly after applying a dose and make sure that no one else touches the spots where they medicate. If a woman or child comes into contact with testosterone gels, it can cause side effects in them – although this is a very rare occurrence.
• To continue to benefit, a man with low testosterone must remain on it, and this poses some risk because the very long-term impacts are not fully known. Research over the past few decades has shown little evidence of a link between testosterone replacement therapy and prostate cancer. However, the question has not been entirely laid to rest.
• There is a debate about the effect of testosterone therapy on cardiac disease, stroke and the formation of blood clots in the veins.
• Testosterone supplementation can cause male infertility however there are treatments that exists that can spear this side effect.

FAQ