Testosterone Replacement Therapy

As people enter middle age and beyond, the needs of the body change and the production of certain hormones begins to drop. For men, one such hormone is testosterone. Low testosterone (called hypogonadism) can lead to significant, although often overlooked, symptoms, including erectile dysfunction, depression, impaired cognitive function and decreased strength of the bones and muscles. Fortunately, there are ways to treat hypogonadism, including testosterone replacement therapy.

About Testosterone Replacement Therapy

Hormone replacement therapy is any treatment regimen for increasing certain hormone levels. The term is often used to refer to estrogen and progesterone treatments given to menopausal women, but hormone replacement therapy for men is also available and becoming more common. Male hormone replacement therapy with synthetic testosterone can be used to replenish testosterone levels.

Methods for Administering Testosterone

Hormone therapy with synthetic testosterone can be prescribed in several different forms, each with its own advantages and disadvantages. These forms include:

• Injections of testosterone: The shots are given every two weeks. Those who prefer to have the procedure performed by a professional need to visit a medical office.
• Oral testosterone supplements: Pills need to be swallowed on a daily basis. Over a long term, oral supplements can cause liver damage. Consequently, this method is usually only prescribed for a limited period of time.
• Skin patch containing testosterone: The patch is placed on the body at night and worn during sleep. Testosterone is released from the patch and into the skin, where it eventually enters the bloodstream. However, the patch can cause skin irritation, so patients are advised to place the patch on a different area each night.
• Testosterone buccal system: A small piece of gummy substance containing testosterone (called "Striant") is placed along the top gum line twice a day. The substance softens with exposure to saliva and releases testosterone into the gums and, eventually, into the bloodstream.
• Topical testosterone gel: The gel is applied to the arms, legs and torso on a daily basis. The gel slowly absorbs into the skin, and testosterone is taken up. This absorption process can take several hours. During this time, the patient cannot shower and must be careful not to allow the gel to come into contact with any other person.

Testosterone levels are monitored regularly as a part of treatment to ensure they stay within normal range.

Effects of Testosterone Replacement Therapy

All men considering testosterone replacement therapy need to be aware of the possible side effects, which may include:

• Acne
• Decreased fertility
• Decrease in testicle size
• Enlargement of the prostate gland
• Growth of breast tissue.

The effects on the prostate have made some physicians concerned that testosterone replacement therapy could cause an increased risk of prostate cancer. Any history of prostate disease is an important consideration when deciding on a treatment plan.

Testosterone replacement therapy is often effective for men who are seeking treatment for erectile dysfunction or decreased sex drive caused by low testosterone. The treatment can also help hypogonadal men maintain muscle mass and reduce their risk for osteoporosis.

Resources

Faiman, C. (n.d.). Male hypogonadism. Retrieved January 21, 2010 from the Cleveland Clinic Web site: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/male-hypogonadism/#cesec20.

Kemp, S. (2009). Hypogonadism: Treatment and medication. Retrieved January 21, 2010 from the eMedicine Web site: http://emedicine.medscape.com/article/922038-treatment.

Margo, K. and Winn, R. (2006). Testosterone treatments: Why, when and how? Retrieved January 14, 2010 from the American Academy of Family Physicians Web site: http://www.aafp.org/afp/2006/0501/p1591.html.

Mayo Foundation for Medical Education and Research. (2008). Male hypogonadism. Retrieved January 21, 2010 from the Mayo Clinic Web site: http://www.mayoclinic.com/health/male-hypogonadism/DS00300/DSECTION=complications.

WebMD, LLC. (2008). Testosterone. Retrieved January 21, 2010 from the WebMD Web site: http://men.webmd.com/testosterone-15738.

WebMD, LLC. (2008). Erectile dysfunction: Testosterone replacement therapy. Retrieved January 23, 2010 from the WebMD Web site: http://www.webmd.com/erectile-dysfunction/testosterone-replacement-therapy.