Testosterone Replacement Therapy (TRT) is a medical treatment designed to supplement or replace testosterone in men with low levels.
The benefits of TRT are improved energy levels, enhanced mood, increased muscle mass and strength, improved libido and sexual function, and better bone density. These benefits help men maintain a higher quality of life and overall well-being.
Testosterone replacement therapy is primarily used to treat men with low testosterone levels due to aging, medical conditions, or specific treatments like chemotherapy.
What Is Testosterone Replacement Therapy?
Testosterone replacement involves administering synthetic testosterone to restore normal levels and alleviate symptoms associated with low testosterone.
Testosterone is vital for diverse bodily functions such as muscle mass, bone density, red blood cell production, and sexual function. Low testosterone, also known as hypogonadism, leads to major health issues such as fatigue, depression, and reduced libido.
The American Urological Association points out that approximately 40% of men over age 45 and 30% of men over age 70 have low testosterone. Moreover, as one age, especially after 40, serum testosterone concentration declines by 1.6% annually.
Furthermore, the American Urological Association says that about 2.1% of men experience low testosterone levels, and this percentage increases with age. Hypogonadism affects nearly 20% of men over 60, 30% of men over 70, and 50% of men over 80.
Anaissie et al. (2017) in their study Testosterone Deficiency in Adults and Corresponding Treatment Patterns Across the Globe, the global prevalence of testosterone deficiency (TD) ranges from 10% to 40%.
The diagnosis of TD is controversial due to varying thresholds for total testosterone (TT) levels, which range from 200 to 400 ng/dL, and differing emphasis on clinical symptoms by physicians.
Significant global differences exist in testosterone replacement therapy (TRT) prescription patterns. In the United States, TRT prescriptions have increased threefold over the past decade, particularly among eugonadal men, and are substantially higher than in other parts of the world.
Most physicians prioritize clinical symptoms of TD over laboratory values, with up to one-fourth of patients not having documented serum testosterone levels.
There are notable differences among physicians in their willingness to prescribe TRT for patients with prostate cancer.
Limited data exists on testosterone prescribing patterns in Africa, Asia, and the Middle East, highlighting the need for more research to understand regional diagnostic practices for TD better.
What Are the Benefits of Testosterone Replacement Therapy for Men?
The benefits of Testosterone Replacement Therapy for men are increased energy levels and reduced fatigue, improved mood and decreased symptoms of depression, enhanced libido and sexual performance, increased muscle mass and strength, improved bone density, and better cognitive function and memory. As per The Journal of Urology, Testosterone Replacement Therapy (TRT) aims to restore normal testosterone capacity in men, assuaging symptoms of hypogonadism and ameliorating quality of life. Benefits of TRT consist of:
- Feeling more energized and less fatigued makes a big difference in your daily life. You’ll find it easier to get through the day without feeling drained.
- Noticing an elevated mood and fewer symptoms of depression can lift your spirits. You’ll feel more positive and capable of handling life’s challenges.
- Experiencing enhanced libido and better sexual performance boosts your confidence. Your intimate relationships might become more satisfying and enjoyable.
- Seeing an increase in muscle mass and strength is very motivating. You’ll likely feel stronger and more capable in your physical activities.
- Having improved bone density is great for long-term health. Stronger bones mean a lower risk of fractures and osteoporosis.
- Enjoying better cognitive function and memory helps you in many areas of life. You’ll find it easier to remember things and think clearly, which improves your overall quality of life.
What Are the Conditions Treated with TRT?
TRT is primarily used to treat hypogonadism, whether due to aging, medical conditions, or injury.
Testosterone replacement therapies are used to treat various conditions that stem from low testosterone levels. These are:
- Primary Hypogonadism: This is caused by testicle problems, such as injury, infection, or genetic conditions.
- Secondary Hypogonadism: This occurs due to issues with the pituitary gland or hypothalamus, which signals the testicles to produce testosterone.
- Age-Related Low Testosterone: Testosterone levels naturally decline with age, and TRT alleviates symptoms of this natural decrease.
It is also beneficial for men with certain genetic conditions, such as Klinefelter syndrome, and those who have undergone chemotherapy or radiation therapy that affects testosterone production.
What Are the Types of Testosterone Replacement Therapy for Men?
The main types of replacement therapy for men are testosterone injections, testosterone patches, testosterone gels, oral testosterone, and testosterone pellets. When you are interested in a Testosterone Replacement Therapy in West Palm Beach, reach out to us.
Testosterone Replacement Therapy comes in various forms, each with its unique advantages and usage considerations. Below are the different types of TRT available:
Testosterone Injections
Testosterone injections are one of the most standard forms of TRT. They involve injecting testosterone directly into the muscle in the gluteal or thigh muscles. The two main types of testosterone injections are:
- Testosterone Cypionate
- Testosterone Enanthate
The benefits of injections are a controlled release of testosterone, ensuring steady hormone levels. They are effective in rapidly increasing testosterone levels and alleviating symptoms. Injections are usually administered every 1 to 4 weeks, depending on the specific formulation and individual needs.
Testosterone Patches
Testosterone patches are adhesive patches applied to the skin, delivering testosterone through the skin and into the bloodstream. They are accessible as:
- Daily Patches (e.g., Androderm)
Patches are beneficial for continuously releasing testosterone and maintaining stable hormone levels. They are easy to use and noninvasive. Nevertheless, they cause skin irritation in some users and require daily application.
Testosterone Gels
Testosterone gels are topical products applied to the skin, allowing testosterone to be absorbed through the skin. Common brands include:
- AndroGel
- Testim
- Axiron
The benefits of gels offer the convenience of easy application and steady hormone delivery. They are applied daily to the shoulders, upper arms, or abdomen. Nonetheless, care must be taken to avoid skin-to-skin contact with others to prevent inadvertent testosterone transfer.
Testosterone Pellets
Testosterone pellets are small implants placed under the skin, usually in the buttocks or abdomen. They release testosterone slowly over several months.
The benefits of pellets are a long-term solution, with effects lasting 3 to 6 months. This method is convenient for those who prefer not to have daily or weekly treatments. The implantation procedure requires minor surgery and carries the dangers of infection or pellet extrusion.
Oral Testosterone
Oral testosterone comes in pill form, such as testosterone undecanoate (Jatenzo). Unlike other oral formulations that were previously avoided due to liver toxicity, these newer formulations are designed to bypass the liver.
The benefits of oral testosterone offer the convenience of taking a pill, with less risk of liver damage. Yet, it must be taken multiple times a day, and its absorption is affected by food intake.
Buccal Testosterone
Buccal testosterone is a small tablet that adheres to the gum, allowing testosterone to be absorbed through the oral mucosa. An example is Striant.
The benefits of this method are a steady release of testosterone and avoid the gastrointestinal tract, reducing the risk of liver toxicity. It must be applied twice daily. However, it precipitates gum or mouth irritation.
Nasal Testosterone
Nasal testosterone is a gel applied inside the nostrils, such as Natesto.
The benefits of nasal application are that it is non-invasive and steers clear of skin irritation or injection site issues. It requires multiple applications per day and sparks nasal irritation.
Clomiphene Citrate
Clomiphene citrate is a medication that stimulates the body’s production of testosterone by acting on the pituitary gland.
The benefits of clomiphene citrate are that it is taken orally and is useful for men who wish to maintain fertility while increasing testosterone levels. It stimulates natural hormone production and is not a form of testosterone replacement.
Human Chorionic Gonadotropin (HCG)
hCG therapy involves injections that stimulate the testes to produce more testosterone.
The benefits of hCG are that it is used in conjunction with other forms of TRT to maintain fertility and stimulate natural testosterone production.
What Are the Risks and Considerations of Testosterone Replacement Therapy?
The risks and considerations of Testosterone Replacement Therapy are exacerbated cardiovascular events, elevated red blood cell count, sleep apnea, acne and oily skin, breast enlargement or tenderness, testicular shrinkage, and reduced sperm production as expanded in the following:
Exacerbated risk of cardiovascular events, such as heart attacks and strokes
- The use of certain treatments accelerates the possibility of cardiovascular events like heart attacks and strokes. These conditions are life-threatening and require immediate medical attention.
Elevated red blood cell count, increasing the risk of blood clots
- An elevated red blood cell count thickens the blood, heightening the risk of blood clots. Blood clots cause serious complications, such as deep vein thrombosis or pulmonary embolism.
Sleep apnea exacerbation
- Substance use worsens sleep apnea, causing more frequent and severe breathing interruptions during sleep. It augments daytime fatigue and cardiovascular problems.
Acne and oily skin
- Hormonal changes or certain medications can lead to acne and oily skin. This persistent condition requires dermatological treatment to manage.
Breast enlargement or tenderness
- Certain substances can cause hormonal imbalances, leading to breast enlargement or tenderness. This side effect is particularly concerning in males and requires medical evaluation.
Testicular shrinkage and reduced sperm production
- The use of anabolic steroids or other substances can result in testicular shrinkage and reduced sperm production. These changes affect fertility and hormonal balance, necessitating medical intervention.
Consult with a healthcare provider to assess individual perils and benefits and to have regular monitoring to ensure safe and effective treatment.
Personalized medical advice is essential for HRT, requiring a comprehensive evaluation of personal and family medical history, including vulnerabilities to cancer, heart disease, and other conditions.
How to Choose the Right Testosterone Replacement Therapy
Selecting the appropriate TRT method depends on diverse factors, viz:
- Individual health status and medical history
- Lifestyle preferences and convenience
- Potential side effects and personal tolerance
- Cost and insurance coverage
Healthcare providers assist in guiding this decision, offering personalized advice and ensuring frequent follow-ups to monitor treatment efficacy and safety.
How Is Hormone Replacement Therapy Different in Men vs. Women?
Hormone Replacement Therapy for Men
For men, HRT focuses on restoring testosterone levels to allay symptoms of hypogonadism. TRT encompasses variegated methods, such as injections, patches, gels, and pellets, to maintain adequate testosterone levels.
Hormone Replacement Therapy for Women
For women, HRT supplements estrogen and progesterone to manage menopausal symptoms and prevent osteoporosis. The crux is on balancing multiple hormones with treatments of oral tablets, patches, creams, and vaginal rings.
Differences
While these therapies are intent on restoring hormonal balance, TRT for men primarily addresses testosterone deficiency. In contrast, HRT for women is managing a more complex interplay of hormones, counting estrogen and progesterone. The treatment goals, procedures, and threats differ based on the specific hormonal needs and physiological distinctions between men and women.
