We offer a number of options for male hormone therapy: Injections, Bio-Identical Pellet Therapy, and Bio-Identical Creams.
Once the symptoms of low testosterone (low T) have been identified and levels have been measured, testosterone replacement may be prescribed. Testosterone can be administered via transdermal creams, implanted pellets, and subcutaneous or intramuscular injections. Injection form is often the preferred route of administration by medical professionals due to its absorption and ability to make small adjustments to achieve target levels. Caution should be taken when using transdermal creams as they can be potentially transferred to unintended individuals by either direct contact or indirectly through towels, bed sheets, etc.
Side-effects may occur during therapy however they are usually recognized early and easily managed. Men with low T levels may experience symptoms of elevated estrogen or estradiol (E2) when testosterone levels rise quickly with supplementation. The rapid increase in T sometimes results in over conversion of testosterone to estrogen as the body tries to create a balance between the two hormones. Symptoms are mostly localized to the chest area and typically manifest as one or all of the following: swelling, tenderness, sensitivity of the chest, breast, nipple area. Water retention, while less likely, may also occur. Symptoms usually resolve on their own over 2-3 weeks once the body is able to naturally achieve hormonal balance. If symptoms persist or they become highly bothersome, short term use of an estrogen blocker often provides quick relief. It is important however to not over suppress estrogen because of its beneficial properties which aid in reducing heart disease. Therefore, extended use of estrogen blockers, for most, is not recommended. Daily zinc helps the body create a natural balance between testosterone and estrogen levels and is a good alternative to estrogen blockers.
When it comes to testosterone levels more is not always better. If T levels exceed optimal ranges it’s possible to experience “burn out” which can cause reversion back to low T symptoms such as fatigue, decreased libido, erectile disfunction, sleep disturbance, and other unwanted reactions. Burn out is easily avoidable by maintaining appropriate dosing and routine monitoring.
A rise in red blood cell count is not uncommon during testosterone therapy; small increases are usually benign and simply followed by monitoring of blood levels. If levels continue to increase and symptoms occur (e.g. fatigue, sluggishness, shortness of breath), blood donation or phlebotomy may be recommended to lower blood levels.
Prostate cancer (PC) is one of the leading causes of cancer in men and while testosterone has not been shown to increase the risks of PC, it should be screened for. Screening usually begins at or around age 50 and one common method is though the monitoring of PSA in blood lab work. The accuracy of routine screening through PSA has been questioned by some specialists. Appropriate screening is something that should be discussed between each patient and their primary care provider.
Decreased sperm count or fertility may be common, particularly in younger men but is usually reversible after stopping testosterone supplementation. HCG (human chorionic gonadotropin) has been shown to help reduce testicular atrophy and maintain fertility.
Any onset of symptoms or side-effects should be promptly discussed with your hormone specialist or primary care provider.
The benefits of testosterone replacement therapy can be life changing for many individuals. With the appropriate management and monitoring, men should see improvement in most, if not all, of their symptoms related to low T. Frequently, the benefits are noticeable within the first few weeks after initiation of testosterone supplementation. If the desired results are not seen within the first 3-5 months of therapy, adjustments may be needed and should be discussed with your specialist.
- Increased energy.
- Increased lean muscle.
- Decreased fat mass.
- Improved libido.
- Improved erectile function.
- Improved cardiac function.
- Decreased heart disease.
- Improved concentration.
- Decreased joint/muscle pain.
- Improved insulin response.
- Increased strength.
- Improved sleep.
- Improved mood.
- Increased oily skin or acne.
- Increased blood count.
- Water retention.
- Mood swings.
- Elevated E2.
- Sleep Apnea.
- Decreased testicular size.
*Symptoms are usually recognized early, and easily managed.
*Side-effects may vary depending on type of therapy.