Men's Health

Testosterone Replacement Therapy

Testosterone Replacement Therapy

Key Takeaways

  • Testosterone therapy is used for men who have low levels of testosterone.
  • If an individual has low levels of testosterone, there are several symptoms that can occur.

Testosterone therapy may help to improve a man's energy level, sex drive, and mood, if he has low levels of testosterone in his body. However, testosterone replacement therapy is only recommended for those who have the symptoms of low levels of this hormone.

Symptoms of low testosterone levels

The symptoms may be obvious or subtle. They start appearing gradually as a man gets older.

Some of the common symptoms of low testosterone levels include:

The doctor may suggest a treatment if a man has the symptoms, and if the blood report also shows low levels of the hormone. Treatment is generally not recommended for those who do not have any symptoms.

Testosterone supplements

Testosterone replacement therapy is available in different forms, such as:

Transdermal patchAndroderm is a skin patch applied once a day on the arm or the upper body.

Gels – Clear testosterone gels are available that will be directly absorbed through the skin.

Mouth patch – Some of the products can be applied to the upper gums above the incisor, and it will release the hormone into the blood through the oral tissues.

Injections and implants – Testosterone can also be injected directly into the blood or implanted as pellets in the soft tissues. This is then gradually absorbed into the blood stream.

Oral testosterone pills are also available, but many experts are of the belief that oral testosterone may cause damage to the liver. All other methods mentioned above, like gels, skin patches, and injections, bypass the liver and release the hormone directly into the blood.

Benefits of testosterone therapy

Benefits of this therapy differ depending on the individual. This hormone is also known to improve bone density, obesity, insulin sensitivity, and muscle mass in some men. In some cases, testosterone is reported to have improved the mood of the individual who is undergoing this therapy. The effect of the hormone, whether obvious or barely noticeable, varies depending on the individual. According to Karen Herbst, MD, PhD, an endocrinologist at University of California-San Diego, 1 out of 10 men who opted for  testosterone replacement therapy were ecstatic about the results, while the others hardly noticed the results.

The common preparations of this therapy have some slight side effects, including rashes, itching, or irritation at the site of application. No serious issues have been reported from this therapy so far. As large clinical trials have not been done for this therapy, the benefits and risks of this method remain unknown.

Certain health conditions may be affected by this therapy, including:

  • Benign prostatic hypertrophy (BPH) – In this condition, the prostate glands grows under the stimulation of testosterone. Sometimes it grows to such an extent that it pressurizes the urethra resulting in difficulty in urination. Testosterone therapy can worsen this hypertrophic condition of the gland.
  • Prostate cancer – Tumor growth in the prostate gland can be worsened under the stimulation of testosterone, so most experts suggest that the individual should have a screening for prostate cancer before proceeding with the replacement therapy. Men with prostate cancer or elevated prostate specific antigen (PSA) should avoid testosterone treatment.
  • Sleep apnea – This sleep disorder can be worsened by the replacement of the hormone. Sleep study, polysomnography, may be required to make the diagnosis.
  • Erythrocytosis – Testosterone increases the count of red blood cells. This makes the blood thicker and more prone to clotting. Those who have very high blood cell count are at an increased risk for health problems if they have a testosterone replacement therapy.
  • Congestive heart failure – Men who have severe congestive failure should avoid having this therapy as it can worsen the condition.