TESTOSTERONE REPLACEMENT THERAPY
Hypogonadism (Total Testosterone < 400) is a term medical professionals and endocrinologists use for the condition of low testosterone in men and is often overlooked because the onset of men’s menopause is gradual.
Women go through menopause when their production of female hormones drops off dramatically over a short period of time.
Usually during middle age men go through Andropause when their production of the primary male sex hormone, Testosterone, begins to decline gradually over the coming decades.
WHAT IS ANDROPAUSE?
Andropause (Male Menopause) are symptoms caused by declining hormones in men. Like the menopause in women, it is caused by a decline in hormones – primarily testosterone, growth hormone (HGH) and DHEA. Replacing these hormones to optimal levels can and will reverse the effects of Andropause.
TESTOSTERONE LOSS AND DEFICIENCY?
Hormones start to decline in mid to late twenties and that is when the aging process sets in. We maintain fairly healthy hormone levels until age 35 to 40 and that is about how long we could be expected to live until about 100 years ago. The effects of declining hormones have only been a problem since we started living longer. Declining hormones, coupled with poor lifestyle, diet, exercise and high stress are largely responsible for health problems and frailties of later years.
TESTOSTERONE, SEXUAL FUNCTION AND MALE PERFORMANCE?
It seems that men, after forty-five, often have a hard time rising to the occasion, getting or maintaining an erection (ED – Erectile Dysfunction) and dealing with the challenge of daily stresses. Sometimes a lack of desire and sex drive can take a toll on a man’s relationship. This is what is known as Andropause or Male Menopause. So why do most men not know anything about Andropause, the male form of menopause?
It has only been recently that Andropause has received attention and recognition, but why the holdup? There are many reasons behind the stifling of its discovery along with many frames of mind that are still hindering its cure.
Testosterone is a principal androgen, or male sex hormone. Even though testosterone is a “male sex hormone” and one of the group of compounds known as anabolic steroids, testosterone is secreted by the testes but is also synthesized in small quantities in the ovaries, cortices of the adrenal glands, and placenta, usually from cholesterol.
Testosterone begins to decline in men at about age 30 – 40. Low testosterone has a number of negative effects on mental, sexual and physical health. The most common type of treatment for testosterone deficiency is known as TRT – Testosterone Replacement Therapy and it is prescribed to treat symptoms and problems associated with Hypogonadism – the medical term for low levels of natural testosterone. Also known as Andropause, this hormonal condition in men results in the steady reduction of the hormone testosterone or ‘Low T’ –> less than normal levels of natural testosterone in a man’s body.
SIGNS AND SYMPTOMS OF LOW TESTOSTERONE OR HYPOGONADISM?
- Decreased mental sharpness
- Decreased energy and strength
- Decreased muscle and increased fat
- Decreased sex drive (loss of libido)
- Decreased sensitivity to stimulation
- Decreased strength of orgasm
- Decreased erectile function (ED / Erectile Dysfunction)
- Depression and/or loss of eagerness and enthusiasm
- Irritability (20-35% of men – heard of “grumpy old men”)
- Osteoporosis (loss of bone density and bone mass)
- Insomnia, night sweats, hot flashes and profuse sweating
- Increased risk of cancer or Alzheimer’s (low testosterone levels increase risk)
- Increased risk of Cardiovascular disease
- Low Sperm Count and Infertility
- Hair Loss and Increased Skin Wrinkling
- Decreased Muscle Mass or Muscle Loss
- Depression, Irritability and Mood Swings
- Extreme Fatigue, Exhaustion and Insomnia
WHO IS A CANDIDATE FOR TESTOSTERONE REPLACEMENT THERAPY (TRT)?
- Do you tire more easily or feel fatigued?
- Is it more difficult to get and stay in shape?
- Not getting the results from your exercise routine?
- Is there less desire to exercise and the time to recover after exercise is longer?
- Have you lost some of the zest for life or lost interest in sex?
- Is your body getting soft, weak and losing muscle tone?
- Are you eating the same or less and putting on weight?
- Have you lost some of your mental quickness and reaction time has slowed?
- Is the fire going out of your sex drive or feel a loss of desire?
- Are you having trouble getting or maintaining an erection?
- Is getting a good night’s sleep becoming impossible?
HOW CAN I START MY TESTOSTERONE THERAPY?
After been evaluated by a doctor, lab work is required to assess levels of free and total testosterone as well as other labs. In a man older than 40 years old or family history of prostate cancer, a rectal exam is recommended before starting the therapy. The progress of the therapy is evaluated by resolution of symptoms and blood workup every 3 to 6 months.
Does TRT increase the risk of prostate cancer or BPH?
There is currently a heated debate about the theoretical association between TRT and the initiation, progression, and aggressiveness of prostate cancer; however, this link has not been uniformly studied, and any results have been contradictory and nonconclusive. Although no clear evidence links TRT to prostate cancer, the possibility of increasing the risk of a clinical manifestation of a latent pre-existing malignancy can influence the decision about TRT use. Current recommendations are to exclude prostate cancer before initiating TRT in men over age 40 and to closely monitor men in the first year of testosterone replacement, followed by observation in subsequent years.
What are some beneficial effects of Testosterone Therapy?
- SEXUAL POWER Increased sexual potency and frequency.
- CHOLESTEROL Lowers cholesterol levels.
- ENERGY Increased energy, stamina and endurance.
- MEMORY Improved mental functioning and ability.
- MOOD Improves mood and feeling of well-being.
- HEART Protects against heart disease.
- CONCENTRATION Improved concentration and focus.
- MUSCLE Increased muscle strength and mass.
Physicians and endocrinologists are witnessing an explosion of interest in testosterone and testosterone therapy as a result of our growing realization that testosterone levels decline with age and that many men suffer serious consequences to their physical and mental health as a result of an androgen deficiency.
Do women also benefit from Testosterone Replacement?
In women, it is expressed as Menopause, whereas, in men, it is expressed as Andropause or Male Menopause. Many of these symptoms of low T and the disease processes that we come to accept as normal aging are processes that are actually secondary to low testosterone levels and are easily correctable with testosterone replacement in the form of injections, creams, gels or patches.
HOW IS TESTOSTERONE ADMINISTERED?
Testosterone replacement therapy is a treatment that is used to treat low levels of testosterone, by adding additional testosterone in the body. This therapy not only results in an increased libido, but also in an improved sense of overall well being for the person who has had low levels of testosterone in the past. Testosterone can be administered in a number of ways, but which method is best suited for an individual will depend from person to person. Take a look at the most common ways in which testosterone is administered in men.
One of the most standard and cost effective ways of getting testosterone administered is through injections, although it is a method that is not used for men who have any kind of bleeding disorders. The injection method uses an oil based solution that contains about 200-250 mg of testosterone and is released into the bloodstream every 2-3 weeks in the beginning of the treatment.
Now there are also different kinds of injections that are used by medical practitioners to administer testosterone in men. For instance, intramuscular injections are given by injecting testosterone directly into the muscles. On the other hand, there are also subcutaneous injections that are given by injecting testosterone under the skin.
Intramuscular Injections Vs Subcutaneous Injections
Due to the fact that muscle tissues have better supply of blood in comparison to the tissues that are under the skin, intramuscular injections are more likely to provide better results with their quick absorption levels. Other than this, another factor that makes intramuscular injections a better option in comparison to subcutaneous injections is the fact that they allow to hold a larger amount of testosterone in the muscle tissue, which is not likely for tissues just under the skin.
The quantity and frequency of testosterone injections are adjusted from time to time by the doctor as per the response to treatment. For instance, if the results are not as expected, then the doctor might as well increase the dose of injection for a man, and vice-versa.
Apart from this, there are also two other categories of injections that are classified according to the time period for which they are used to administer testosterone in men. As when testosterone injections are used every two weeks, they are known as short-acting injectable testosterones, and when they are used every 3 months, they are known as long-acting testosterone injections.
Another process that is used by medical practitioners to administer testosterone is by implanting testosterone pellets under the skin. Testosterone pellets, like Testopel measure 3 mm by 9 mm, containing crystalline testosterone. These testosterone pellets are implanted under the skin with an instrument named trocar, mostly near the hip area, and take about a period of 3-6 months to gradually release testosterone in the body. Implantation of testosterone is a simple process that usually doesn’t take more than ten minutes.
As pellets take a long course of time to release testosterone in the body, it is quite crucial to use a constant and balanced dose of testosterone while using this treatment to improve low levels of testosterone. Despite the fact that pellets offer a long term dosing solution for men who have low levels of testosterone in their bodies, but still this testosterone therapy does have a few setbacks as well. For instance, when you have pellets implanted under your skin there are chances of catching an infection, or extrusion in cases when pellets can come out of the skin. Hence, it is always advisable to first begin your testosterone therapy in the form of creams or gels, so that your body can prepare itself for testosterone pellets later on.
Testosterone administration can also be done using clear, odorless, and quick drying creams that make way into your skin after application, and gradually help to balance out the testosterone levels in your bodies. Testosterone creams offer you a simple and uncomplicated way to improve low testosterone levels in the body, as they simply need to be applied around your stomach area, arms, or shoulders. Once you have applied the testosterone cream, you must allow that skin area to dry properly, and even cover it with your clothes to avoid any direct contact with any external element, including human touch. For until about 5-6 hours of the application of the testosterone cream, you must also avoid taking a bath or swim, as it would stop the cream from bringing any positive outcomes for your skin.
Both Testosterone creams and gels offer a much simpler treatment to improve your testosterone levels, as they save you from injecting or implanting any external element into your body. Additionally, this non-invasive testosterone therapy also offers a convenient way to deal with the problem for people who follow busy lifestyles and are unable to spare time for any other means of treatment.
Much like creams, Testosterone gels like Testogel contain one percent of testosterone which gets absorbed into the skin after application. If you are using a testosterone gel, you will be advised by your doctor to apply it on your abdomen, shoulder, and arms following a daily routine. The standard dose that is prescribed by doctors for using testosterone gel on a daily basis is five grams, but sometimes this dose is also increased to ten grams for a few people. Whereas, some men even find a daily dose of 2.5 gram working for them with satisfactory results.
There is a lot of care that needs to be taken on the part of men who use testosterone gel to apply on their bodies. You need to make sure that if you have this gel applied on your body, your skin should not make any contact with another person for at least six hours. The reason behind this is the fact that coming in contact with others within six hours of the application of this gel on your body might get it transferred and absorbed by the bodies of others that could lead to dangerous consequences – especially in pregnant women and children.