Testosterone has various effects inside the body, and replacement therapy is not necessarily meant to be an anti-aging therapy solution.
Instead, it is a way to counter the effects of testosterone deficiency in men, a condition that does not only affect seniors but it is also associated with various metabolic and genetic ailments.
While testosterone replacement therapy stands as a solution for the effects of low testosterone levels, it has various safety issues and risks we should take into consideration in each patient. That’s why, even after confirming that we may need this hormone, we will still need lab tests and the experience of a skilled physician to make the appropriate decisions for each individual case.
Testosterone replacement therapy (TRT) will be necessary for around 1 for every 200 senior men, and studies show that a striking 39% of males over 45 years old may have androgen deficiency without experiencing apparent symptoms. Testosterone levels start to decline in patients 20 to 30 years of age, but this reduction does not necessarily require testosterone replacement therapy, and it is often asymptomatic.
Do YOU need Testosterone Replacement Therapy?
Are you wondering whether or not you need testosterone replacement therapy? Low testosterone levels in males can be detected by taking a look at various clinical features we will summarise in this article:
- Sexual and reproductive changes: An impaired sexual function has been recognized as the hallmark of testosterone deficiency. Sexual dysfunction has many different triggers, and some of them will be emotional or psychiatric. However, patients with reduced libido and soft or small testicles are likely to have low levels of sex hormones. These patients have difficulty achieving a complete erection, may have trouble reaching an orgasm, and when they do, they would have a decreased volume of ejaculation. In some cases, patients would also report low genital sensitivity during intercourse and infertility.
- Cognitive changes: Sex hormones in males have a profound influence in their mood, their levels of energy and cognitive function. Therefore, patients with testosterone deficiency would likely experience chronic fatigue and low energy levels. They have mood swings and irritability, suffer from depression more often than those with healthy androgen levels. In some cases, they may even experience memory problems, and testosterone replacement therapy may help them slow down age-related cognitive problems.
- Metabolic changes: Hormones serve as body signals, and testosterone works to maintain homeostasis in almost every tissue, including other glands. That’s why testosterone deficiency would likely cause other metabolic problems, especially those related to the metabolic syndrome: obesity, insulin resistance, increased body fat, and dyslipidemia (abnormal levels of cholesterol and/or triglycerides). These metabolic changes may increase our cardiovascular risk by promoting the formation of atherosclerosis plaques in the arteries and may result in type 2 diabetes mellitus and related metabolic complications.
- Musculoskeletal changes: Body composition and muscle mass are also affected by a drop in testosterone levels. This hormone is essential to maintain and grow healthy muscle, which is why it is acclaimed by fitness enthusiasts and bodybuilders. Testosterone favours the formation of muscle fibres and the reduction in fatty tissue. People with hypogonadism (insufficient secretion of testosterone) would have decreased levels of muscle mass against excessive levels of body fat, with the subsequent increase in cardiovascular and metabolic risk. Testosterone replacement therapy is also evaluated in patients with frailty and sarcopenia, a condition that features a systematic reduction in muscle mass in older adults. On the other hand, testosterone levels should also be evaluated in male patients with osteoporosis and other bone mineralisation
- Other symptoms: There are various other signs and symptoms people relate with a testosterone deficiency, but they should be evaluated by a professional as they may have multiple For example, similar to what happens during menopause, patients requiring testosterone replacement therapy often experience hot flashes. They start losing body hair, do not need to shave often, and may feature mild anemia levels with a propensity to feeling tired after a short exercise session. Other features have been described, as in changes in jaw definition or Adam’s apple, especially in pediatric patients who have not yet experienced puberty changes after a considerable time.
All of the above are common features in patients with testosterone deficiency, but they are not meant to be a checklist for self-diagnosis purposes. Each one should be examined by a doctor, and some of them would need lab tests as a confirmation. Thus, if you have encountered these symptoms in yourself, ask your doctor about your condition and follow his instructions to get proper management of your condition.
What should you expect from Testosterone Replacement Therapy?
In many cases, it will be enough by trying to raise our endogenous production of testosterone. Many alternative treatments may be prescribed to increase testosterone levels in males. For example, Clomid is used in males with low testosterone levels to treat male infertility issues. It can be used at doses of 50 mg every other day for 3 months.
When endogenous testosterone production fails, exogenous androgen replacement is the way to restore our normal testosterone concentration. There are plenty of options, and each one has its own applications and doses. You have intramuscular injections, testosterone patches liquids or gel, and even buccal formulations meant to be applied above the upper incisor teeth.
(with thanks ncbi.nlm.nhi.gov)
What is The Best TRT Dosage?
According to data by Bhasin et al., this is the most common dosage for each one of them:
|Testosterone enanthate (IM)||60 mg twice/week|
|Testosterone patches||1-2 patches every night|
|Testosterone liquid||60-120 mg/day|
|Testosterone gel||5-10 mg/day|
|Bioadhesive buccal testosterone||30 mg every 12 hours|
Note that there are plenty of options available, and each one of them has a recommended dosage depending on each patient and their individual levels of testosterone and needs. As it happens with many other hormones, testosterone maintains a strict balance in the organism, and it is not a good idea to disrupt that balance based on an unconfirmed suspicion. Therefore, if you have any doubt about your testosterone levels and suspect you need testosterone replacement therapy, ask your doctor and follow his instructions to detect and properly treat your condition.
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