Testosterone Therapy

Understanding Testosterone Replacement Therapy

According to the CDC, men's life expectancy has increased by 65% over the last 100 years. Consequently, men have been continually redefining what it means to be 50, 60, 70 years, or even older. With age comes a natural drop in testosterone levels. Testosterone is a hormone essential for maintaining bone density, muscle bulk, red blood cells, and sexual and reproductive function.

Testosterone replacement therapy, also known as androgen replacement therapy or TRT, is a type of hormone therapy used to treat low testosterone levels. Patients may have low testosterone levels due to age or a separate medical condition. Recently, testosterone replacement therapy has also been gaining traction for helping patients achieve higher energy levels, build muscle mass, and enhance sexual performance.

Hypogonadism (Low Testosterone Levels)

Hypogonadism is a condition in which the male body fails to produce adequate amounts of testosterone. It is often caused by issues in the hypothalamus, pituitary gland, or testicles. Men who have had an injury to the testicles, have HIV/AIDS, have undergone chemotherapy or radiation therapy, or had undescended testicles as an infant are all considered at risk for this condition.

Adult men with hypogonadism may experience the following symptoms:

• Decreased beard and body hair growth
• Decreased muscle mass
• Decreased sex drive
• Development of breast tissue
• Difficulty concentrating
• Erectile dysfunction
• Fatigue
• Infertility
• Osteoporosis

There are two main types of hypogonadism: primary and central. In primary hypogonadism, the patient has an inadequate amount of sex hormones due to a problem in the gonads. In central hypogonadism, the patient's hypothalamus and pituitary gland cannot control the gonads properly. Most cases of hypogonadism are responsive to appropriate medical treatment.

Andropause (Male “Menopause”)

It has long been well-known that women deal with a decrease in estrogen as they get older. This change of life is often treated by estrogen replacement therapy. However, in recent years, some doctors have theorized that aging men experience many of the same symptoms that women experience during perimenopause and menopause.

This phenomenon of declining testosterone levels is known as andropause or, more simply, low testosterone. Symptoms include:

• Depression
• Fatigue
• Sexual problems
• Weakness

We can diagnose andropause via a thorough physical examination during a personal, one-on-one consultation where we will ask about any signs and symptoms. We can also order any necessary tests to rule out other conditions that may be contributing to the issue at hand.

Ways of Supplementing Testosterone

There are several available ways of supplementing testosterone. These include skin patches (transdermal), gels, mouth patches, injections, and implants. Skin patches must be applied on the arm or upper body once a day, while gels must also be applied once a day.

Mouth patches are applied twice a day and continually release testosterone into the blood through the oral tissues. Finally, injections may be injected directly into the muscles or implanted as pellets in the soft tissues. These methods allow the testosterone to bypass the liver and get directly into the blood.

Benefits of Testosterone Replacement Therapy

Since each individual is so different, it is difficult to predict the benefits of testosterone replacement therapy. However, several patients have reported improvement in energy level, quality of erections, and sex drive. Many men also experience increased bone density, muscle mass, and insulin sensitivity due to testosterone replacement therapy.

Furthermore, men also frequently report an overall improvement in mood from testosterone replacement therapy — though, again, just how noticeable this improvement is highly dependent on the individual. In general, most men have positive responses to testosterone replacement therapy.