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Overview of Low Testosterone Therapy
Low testosterone, also known as hypogonadism, affects many men as they age. While testosterone levels naturally decrease over time, certain factors can accelerate or exacerbate this decline, leading to a range of symptoms that impact health, mood, sexual function, and quality of life.
Low testosterone therapy aims to boost testosterone levels and alleviate these symptoms, improving overall well-being.
This article explores the causes and symptoms of low testosterone, the various treatment options available, the benefits of therapy, and the potential risks to be aware of.
Causes and Symptoms of Low Testosterone
However, other factors can also contribute to low testosterone, or hypogonadism, including:
Side effects from medications such as opioids. Opioid use can suppress hormone production, leading to low testosterone.
Testicle injury or cancer. Damage to the testicles from injury or disease can impact their ability to produce testosterone.
Problems with hormone-producing glands. Issues with the pituitary gland or hypothalamus can disrupt signals to the testicles to produce testosterone.
Low thyroid function. An underactive thyroid gland (hypothyroidism) is associated with low testosterone levels.
Obesity and chronic disease. Being overweight or obese and having certain chronic diseases are linked with lower testosterone.
Common symptoms of low testosterone
- Fatigue and lack of energy. Low testosterone can sap endurance and vitality.
- Decreased libido. Low sex drive and reduced sexual performance are hallmark signs of low testosterone.
- Loss of muscle mass. Testosterone is crucial for muscle growth and maintenance. Low levels can lead to muscle loss and fat gain.
- Mood changes. Irritability, depression, and difficulty concentrating may occur with low testosterone.
- Erectile dysfunction. Difficulty achieving or maintaining an erection is often linked with low testosterone.
- Reduced bone density. Low testosterone contributes to bone loss, increasing the risk of osteoporosis over time.
Testosterone replacement therapy can help boost testosterone levels and alleviate these symptoms, however, the treatment options and results vary between individuals. The next sections explore the types of low testosterone therapy available and their pros and cons.
Types of Testosterone Therapy
Injections
Testosterone injections are a common form of hormone therapy. Short-acting injectables, such as testosterone cypionate, require injections every week or two, while long-acting options like testosterone undecanoate need shots only every 10-14 weeks.
Injections are typically given in the glutes, shoulders, or thighs.
Benefits:
- Injections provide a consistent, measured dose of testosterone.
- Long-acting options require fewer injections.
Drawbacks:
- Injections might be painful for some.
- Short-acting versions may cause fluctuations in testosterone levels between doses.
Gels and Creams
Topical gels and creams, such as AndroGel and Testim, are applied directly to the skin, usually the upper arms or shoulders.
They provide a convenient way to administer testosterone, with most options requiring daily application. However, gels and creams may carry the risk of transference to others through skin contact.
Benefits:
- Easy to apply and can provide consistent hormone levels with daily use.
- Avoids the discomfort of injections.
- Can be applied at home rather than going into a clinic.
Drawbacks:
- Risk of testosterone transference to women and children through skin contact. Requires caution to prevent contact with others after application.
- Varying absorption from the skin can lead to fluctuations in testosterone levels.
Patches, Pellets, and Implants
Testosterone patches are applied to the skin daily, while testosterone pellets are implanted under the skin every few months. Testosterone implants involve minor surgery to place flexible rods under the skin that release hormones steadily over time.
Benefits:
- Pellets and implants provide consistent testosterone levels for extended periods without frequent dosing.
- Patches avoid the discomfort of injections.
- Implants have a low risk of transference to others.
Drawbacks:
- Implants require a surgical procedure to insert and remove. Risk of infection or pellet extrusion.
- Patches can lead to skin irritation and may be visible under clothing.
The pros and cons of each treatment depend on individual needs, preferences, and health conditions. Discussing options with your doctor can help determine the best approach to symptom relief and balancing hormone levels.
The potential benefits of therapy, as well as risks to be aware of, are covered in the following sections.
Benefits of Low Testosterone Treatment
Increased Muscle Mass and Strength
Testosterone is essential for building and maintaining muscle mass. Low testosterone therapy can help boost muscle growth and strength, particularly when combined with exercise.
Improved Libido and Sexual Function
Low testosterone is a frequent cause of reduced libido and erectile dysfunction in men. Testosterone replacement therapy can help restore sex drive and improve performance, satisfaction, and orgasm.
Increased testosterone may also benefit other aspects of sexual health by boosting stamina, sensitivity, and pleasure.
Enhanced Mood and Cognitive Function
Testosterone influences both mood and mental ability. Low testosterone therapy is associated with decreased irritability and a more positive outlook.
Many men report improvements in motivation, mental clarity, memory, and concentration. By reducing fatigue and hormonal imbalance, testosterone supplements may help alleviate symptoms of depression and anxiety.
Improved Bone Density and Osteoporosis Prevention
Testosterone is essential for bone health and formation in men. Low levels can accelerate bone loss and increase the risk of osteoporosis.
Testosterone replacement therapy helps preserve bone density by stimulating bone mineralization and slowing bone breakdown. This lowers the risk of fractures and improves osteoporosis prevention.
What affects TRT success?
The impact of systemic burden on testosterone replacement therapy (TRT) outcomes is an important factor to consider when evaluating the success of TRT.
Previous research suggests that men with a higher burden of systemic illness are less likely to continue with TRT and may have a lower likelihood of experiencing symptomatic improvement.
Factors influencing TRT success include the presence of comorbidities, such as diabetes, cardiovascular disease, and sleep apnea. These conditions may contribute to the overall burden of systemic illness and can potentially interfere with the effectiveness of TRT.
Findings from a study suggest that a higher burden of systemic illness may be associated with decreased continuation and symptomatic benefit of TRT in men.
The study analyzed data from 60 men who underwent TRT with Testopel pellets and found that patients with a higher burden of systemic disease were less likely to experience symptomatic improvement with TRT and more likely to discontinue therapy within a year.
They used the ACTIONS men’s health phenotype score (grading severity [0–2] for each of anxiety, cardiovascular disease, low testosterone, diabetes, obesity, neurologic disease, and obstructive sleep apnea, with a total score 0–14) to evaluate patients.
Out of 60 men, 39 (65%) felt symptomatic improvement and continued therapy for a median follow-up of 40.4 months. The remaining 21 men (35%) did not have symptomatic improvement and were treated for a median of 4.1 months. There was no significant difference in age or pre-treatment testosterone values between the two groups.
| Group | ACTIONS Score | Standard Deviation |
| Continued TRT | 4.1 | 1.6 |
| Discontinued TRT | 8.0 | 2.5 |
The study found that men who discontinued TRT had a higher ACTIONS score (8±2.5) than those who continued (4.1±1.6). This suggests that men with a higher burden of systemic disease were less likely to have symptomatic improvement with TRT and more likely to stop therapy.
This study highlights the importance of considering multimodal therapy, including lifestyle modifications and the optimization of concurrent conditions such as diabetes, cardiovascular disease, and sleep apnea, in order to achieve optimal outcomes with TRT.
Additionally, the study introduces the ACTIONS score, which correlates systemic health conditions with urologic symptoms, providing a valuable tool for identifying non-responders to TRT.
Considering Low Testosterone Therapy: Factors to Think About
When testosterone levels decrease measurably below the normal range, the resulting symptoms can significantly disrupt daily life and wellbeing.
But determining if testosterone replacement therapy is right for you, and which treatment suits you best, is a complex decision that depends on multiple individual factors.
Some key considerations in choosing the appropriate path forward include:
Severity of symptoms. Men with moderate to severe symptoms that interfere with mood, relationships, work productivity, and quality of life are typically strong candidates for hormone replacement. For milder symptoms, lifestyle changes or short-term medication may provide relief.
Health conditions. Chronic diseases, especially those impacting hormone levels or linked to low testosterone risk, support a trial of testosterone therapy under medical guidance. However, some conditions like prostate cancer or untreated sleep apnea may contraindicate certain treatments. A comprehensive health assessment is needed.
Risk tolerance. All options come with some risk of side effects or complications. Your willingness to accept these risks, the level of monitoring required, and how well you tend to comply with recommended screening or lifestyle changes are important determinants of a safe treatment choice.
Treatment goals. Clarifying priorities and expectations upfront helps guide the selection process. Options that optimize benefits in sexual function, mood, energy, and cognition while minimizing risks may differ from those focused primarily on bone and muscle health. Discuss goals openly with your physician.
Lifestyle. For active men or those whose jobs demand high performance and endurance, sustaining testosterone levels consistently over weeks or months may be a higher priority. For others, less frequent dosing options may adequately relieve symptoms with less disruption.
Cost and coverage. While health insurance plans typically cover conventional treatment options like injections or gels, newer treatments may come with higher out-of-pocket costs. Comparing options based on affordability and insurance coverage is key.
Personal preferences. How a treatment is administered – through injections, topical gels, patches, or slow-release pellets – and how often, impacts convenience, comfort, and compliance. Your preferences play a significant role in finding the best testosterone therapy for your needs.
Frequently Asked Questions
Will testosterone treatment increase my red blood cell count?
Testosterone therapy may cause a rise in red blood cell levels, known as polycythemia, by stimulating red blood cell production. This can potentially increase the risk of blood clots.
Have your physician monitor your red blood cell and hemoglobin levels with blood tests before and during therapy to determine if dosage adjustments or other precautions are needed. Lifestyle changes like staying hydrated, limiting tobacco and alcohol use can also help minimize risks.
Will testosterone supplements affect my fertility or sperm production?
Testosterone treatment may reduce sperm production, especially at higher doses. This is because testosterone also controls signals for sperm maturation.
Treatment options like gels or patches tend to have a lower impact on fertility than injections. If maintaining fertility is a priority, hormone treatments other than testosterone may provide effective symptom relief with lower risks.
Discussing family planning and fertility preservation options with your doctor is recommended before starting therapy.
Are There any medical conditions that preclude testosterone treatment?
Testosterone therapy may not be recommended or may require close monitoring for some conditions like:
Untreated sleep apnea: Can exacerbate sleep apnea or cause fluid retention. A CPAP machine or other treatment may be required before starting testosterone therapy.
Prostate cancer: Can stimulate prostate growth. Treatment may be delayed until cancer treatment is complete and you are cancer-free. Regular screening is then needed.
Male breast cancer: Can stimulate breast cell growth. An oncologist should determine the safety of testosterone after treatment before moving forward.
Polycythemia (high red blood cell count): May overstimulate red blood cell production. Lower starting doses or alternative treatments may be tried first. Frequent blood monitoring will be required.
Urinary tract blockages: Can worsen urinary tract symptoms in some men. May require treatment or precautions before initiating testosterone therapy.
Can testosterone improve my erectile function?
Testosterone plays an important role in libido and erectile function. Testosterone deficiency is a frequent cause of reduced sex drive and erectile dysfunction in aging men.
Testosterone therapy can often help revive libido, improve erection quality, and enhance other aspects of sexual health like pleasure and stamina. However, erectile dysfunction can also be caused by circulatory problems or other conditions.
Your physician will assess symptoms and blood levels of sex hormones like testosterone and follicle-stimulating hormone (FSH) to determine if hormone therapy may be beneficial for erectile health before proceeding with treatment.
A Roadmap to Wellness: Navigating the TRT Journey
When testosterone levels decrease with age or health conditions, the resulting loss of energy, sex drive, and optimism can represent one of the more distressing aspects of aging for many men.
Physicians Rejuvenation Centers understands these challenges and provides treatment options to help men reclaim vitality as they age.
Testosterone replacement therapy can help you overcome low testosterone and enjoy a renewed sense of wellness.
Regain balance and maximize quality of life – contact Physicians Rejuvenation Centers today to learn more about testosterone replacement therapy and how we can help you navigate the journey ahead with insight and support.
Your vitality lies within reach; take the first step by calling or booking an appointment for a consultation.
Together, we will find your path to hormone health and thriving at every age.
