Testosterone Replacement Therapy: Injections, Patches, and Gels

Risks of testosterone replacement therapy in men

Because of this individualization approach, the procedure was never approved by the FDA. The skin absorbs the medication, but absorption rates vary from patient to patient. Not to mention, creams and gels can transfer from patients to other people, like kids and grandkids, which we don’t want. Symptoms may also be caused by other conditions, such as high blood pressure or diabetes. If any of these symptoms are bothering you, talk with your provider.

We don’t give testosterone as a pill, because it can cause liver toxicity when it’s metabolized through the gut. However, testosterone can be safely administered as a gel that you apply to your skin, injections that you give yourself at home, or as a pellet implant performed in the doctor’s office. Your physician can help you determine which method is right for you. To minimize risk, the goal for people taking masculinizing hormone therapy is to keep hormone levels in the range that’s typical for cisgender men — men whose gender identity aligns with their sex assigned at birth.

Only men with symptoms of low testosterone and blood levels that confirm this as the cause of symptoms should consider testosterone replacement. Talking with your doctor is the only way to know if testosterone therapy is right for you. “But we think it rises to whatever level they would have had if they had normal testosterone to begin with,” notes Anawalt. “If you use a high dose, you get an effect on muscle and strength,” says Anawalt. “But then you’re no longer using testosterone as a hormone replacement therapy. And when you do that, there’s no question that testosterone increases muscle mass and strength.

Also, the steroids are often combined (“stacked”) with other substances like stimulants, pain relievers, and growth hormones to boost the overall muscle-building effect. Most experts recommend screening for prostate cancer before starting testosterone replacement. Men with prostate cancer or elevated prostate-specific antigen (PSA) should probably avoid testosterone treatment. Testosterone levels are highest in men around age 17 and drop as they age, starting between ages 30 and 40. The drop is very gradual (about 1% per year) but increases as you get older. By age 70, the average man’s testosterone is 30% below its peak, but it’s usually still within the normal range.

Age can too, as the glands responsible for regulating testosterone decline over time, along with certain medical conditions like diabetes and genetic disorders. A type of sex hormone, testosterone indeed helps regulate libido and sexual function in men (and women, it should be added). But it’s also responsible for maintaining muscle mass, bone density and fat distribution, and it can even affect your mental wellbeing. In our clinical experience over the past three decades, after stopping therapy, testosterone levels typically return to their baseline from before pursuing treatment. This is often accompanied by a return of symptoms, though this is not always the case. However, it can rarely raise testosterone levels above the mid-range.

We monitor all of our TRT patients for rises in hematocrit, or blood thickness, as well as screening for potential prostate cancer every six months. In addition, TRT is not recommended for men who are currently trying to conceive, as active therapy can decrease sperm count and result in temporary sterility. We understand that this is a major concern for many of our patients, and that misconceptions about testosterone are rampant. But it’s important to consider that TRT is an FDA-approved treatment for a clinically-recognized disorder called “hypogonadism”, where the testes produce inadequate amounts of testosterone, leading to adverse health effects. When taken responsibly under the guidance of a licensed medical professional who is appropriately evaluating patients and routinely monitoring blood work, TRT is considered to be very safe. Testosterone replacement therapy (TRT) is an effective long-term solution for the symptoms of testosterone deficiency – fatigue, low mood, decreased libido, and decreased muscle mass among them.

Normal sperm production depends on a functionally intact hypothalamic-pituitary-gonadal axis with normal secretion of pituitary LH and FSH to support intratesticular testosterone production and spermatogenesis. The general trend indicated that higher doses of testosterone were more likely to result in azoospermia than lower doses, however a dose-response effect was not consistently seen. Until recently, testosterone cypionate and enanthate were frequently used by intramuscular injection of short-acting testosterone esters that usually produces supraphysiological peaks and hypogonadal troughs in testosterone levels. The Evaluation and Management of Testosterone Deficiency AUA Guideline provides guidance to the practicing clinician on how to diagnose, treat and monitor the adult male with testosterone deficiency. The care of testosterone deficient patients should focus on accurate assessment of testosterone levels, symptoms and signs as well as proper on-treatment monitoring to ensure therapeutic testosterone levels are reached and symptoms are ameliorated. Guidance is also given on the management of patients with cardiovascular disease, men who are interested in preserving their fertility and men who are at risk for or have prostate cancer.

rad 140 vs testosterone gels and other external patches offer non-invasive ways to 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. “The andrology field has progressed tremendously just within the last decade, as there are newer FDA-approved testosterone formulations that are safe and efficient,” says Dr. Muthigi. “There are several different forms of testosterone supplementation, including topical gels, nasal sprays, oral tablets and short- and long-acting injections, all of which have their pros and cons.” If you or someone you know are suffering from possible symptoms of low testosterone and are seeking an evaluation, we can help.

If your PCP, Urologist, or Endocrinologist is adequately handling your Testosterone deficiency, then please continue your current care with them. Access guideline recommendations, patient information, and clinical education modules for a range of endocrine topics plus dozens of interactive decision algorithms and other point-of-care tools. In one not-yet-published survey, Dubin found that 40 percent of men under 40 were interested in taking testosterone and 14 percent had used testosterone therapy or taken a testosterone booster (like anabolic steroids). But those and other “non-specific symptoms” like depressed mood and erectile dysfunction could be a result of a host of other problems. “They could be due to inadequate sleep, sleep apnea, vascular disease, or depression,” Irwig points out.