A Review of Testosterone Therapy Options for Men

A Review of Testosterone Therapy Options for Men

It is involved in muscle and bone development, hair growth, and development of the sex organs such as the penis and prostate. It also contributes to a man’s sense of overall well-being and sexual function. Dr. Rajat Barua, director of cardiovascular research at the Kansas City VA Medical Center, says he finds nothing surprising in the results of the TTrials. He agrees that larger, long-term studies are needed to reach definitive answers on the risks of testosterone therapy. But he’s the author of past studies on testosterone treatment in relation to Veterans and is also involved in ongoing research on the topic. National Institute on Aging called the Testosterone Trials (TTrials) has produced mixed results.

Doctors inject short-acting testosterone under the skin or into the muscle, while long-acting shots go in the gluteal muscles. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. But there aren’t many studies on the long-term effects of TRT (for example, over decades).

Therefore, estradiol levels in men need to be assessed periodically to rule out hyperestrogenism. Testosterone gels and other external patches offer non-invasive ways how to fix high testosterone in women; http://www.superweb.de/idcard/pgs/index.php?abnehmen_tabletten_2.html, boost your testosterone, as the medication is absorbed through the skin barrier and into your bloodstream. However, it’s important that the gel not come into contact with anyone else, as they might accidentally absorb it themselves. Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health, plus the latest advances in preventative medicine, diet and exercise, pain relief, blood pressure and cholesterol management, and more.

Clinicians wishing to identify laboratories meeting CDC standards are encouraged to refer to the list of sites currently meeting CDC requirements listed on the CDC Hormone Standardization Program. No randomized controlled trial has demonstrated decreased cardiovascular events or mortality with testosterone therapy. Because of circadian variations in testosterone levels, serum testosterone measurement should occur in the morning, or within two hours of awakening in shift workers (Figure 19 ). Although there is no universal laboratory definition of hypogonadism, in most laboratory reference ranges, the lower limit of normal is between 250 and 350 ng per dL (8.7 to 12.2 nmol per L). Based in part on available evidence from published studies, the U.S.

The Panel recommends testing no sooner than four weeks after commencement. Table 6 (featured below) provides pharmacologic information for SERMs, hCG, and AIs. While SERMs, hCG, and AIs are all categorized as “alternative therapies” to testosterone, they are actually a diverse group of agents. These agents share the common overall treatment effect of increasing intrinsic production of testosterone, but there are substantial differences in pharmacologic characteristics and mechanisms of action between them.

“This was not an overly healthy group of individuals,” Matsumoto says. “But I can’t say they were high-risk, either. They were chosen with low prostate cancer risk, but I can’t say they had high cardiovascular risk.” Most men will experience a drop in testosterone production each year as they reach age 40 and beyond. About 15 percent of men will experience a drop in levels that is clinically significant, particularly those who are obese and/or have other chronic illnesses. That said, none of the recent landmark trials instructed the men to exercise. And the trials used only moderate doses of testosterone because the goal was simply to bring levels up to the normal range. “For some older men, raising low testosterone levels can improve some aspects of their physical and mental well-being,” says Dr. Michael O’Leary, a urologist at Harvard-affiliated Brigham and Women’s Hospital.

This includes monitoring your testosterone level and getting other blood tests to make sure TRT isn’t harming your health. To diagnose low T, your doctor will order a laboratory blood test to measure your levels. They may run additional tests to rule out underlying conditions, such as pituitary gland disorders, that could be causing the hormone imbalance.

Some men may have levels below 300 ng/dL and no symptoms, so screening all men for low testosterone is a bad idea, says the Endocrine Society’s guidelines. In one analysis of 13 studies of roughly 4,300 men with obesity, 43 percent had blood levels of testosterone under 300 ng/dL. After you’ve been on TRT for about two months, your doctor will evaluate your symptoms. If there’s no noticeable improvement, the dosage may be increased, continued at its current amount for a bit longer, or stopped. Dr. O’Leary says your doctor might recommend TRT if your levels drop below 300 ng/dL, but it’s not automatic. “The first step is to determine if any symptoms attributed to low testosterone are related to something else that’s treatable.” If you’re a good candidate for TRT, we have several delivery forms, including injections, gels, patches, pellets, and nasal spray.

ADT used alone was for many years the standard treatment for men who, at the time of their initial prostate cancer diagnosis, are found to have castration-sensitive metastatic disease (i.e., disease that has spread to other parts of the body) (9). Some of these men, especially those with extensive metastases, may be treated with ADT plus chemotherapy plus another type of hormone therapy (10). If patients achieve target testosterone levels, but do not feel that they have sufficient improvement in their symptoms, clinicians should question whether testosterone deficiency is the etiology of their symptoms.

Several clinical trials are examining whether exercise can reverse or prevent side effects of hormone therapy for prostate cancer. Researchers have investigated whether a technique called intermittent androgen deprivation can delay the development of hormone resistance. With intermittent androgen deprivation, hormone therapy is given in cycles with breaks between drug administrations rather than continuously, particularly in people with a biochemical recurrence. The goal of intermittent androgen deprivation is to delay the development of hormone resistance.