Testosterone treatments are used to stop the adverse changes that occur in a man’s body with age. According to a study by the American Urological Association, 4 out of 10 men over the age of 45 have reduced testosterone levels in their blood. This translates into decreased vital energy, slowed metabolism, low libido, problems with sleep, concentration, memory, and depression. Testosterone is the primary male sex hormone. It is responsible for the development of sexual characteristics (e.g. body build, low voice, hair type, muscle development), erection, and sexual desire. It also influences behaviour, such as risk-taking, explosiveness and aggression. Recent studies indicate that the concentration of total testosterone in the blood decreases by 0.4% and free testosterone by 1.3% per year.
Why testosterone treatment?
To stop all the unfavorable changes in the male body, testosterone treatments are increasingly used. But it is important to whom, at what age and what hormone is administered. By itself, testosterone is not a panacea for all the ailments of an aging man.
Most often men who have noticed chronic fatigue and lack of sex drive reach for testosterone treatment. Unfortunately, these are not just men over 50. They are getting younger and younger. Testosterone therapy cannot be compared with hormone replacement therapy used in women who are given hormones because their body has stopped producing them. In men, testosterone is still present, but its levels have decreased, and the idea is to stimulate the body to produce it, rather than, as in the case of women, provide it from the outside.
Testosterone treatments: indications and contraindications
There are many myths about testosterone treatment, such as that taking this hormone contributes to the development of prostate cancer. This is not true, although it is important to remember that this type of cancer is sensitive to testosterone levels. In men with prostate cancer, the level of testosterone will determine the aggressiveness of cancer – the more aggressive it is, the more it is important to begin testosterone treatment with careful history taking and testing. Men who have a hereditary history of prostate cancer should be especially cautious. It can be said that testosterone acts like fertilizer – it strengthens the plants we want to grow, but weeds also benefit from it. The treatment should be tailored, differently for each patient, because the administration of testosterone can – even chronically ill – bring many benefits. There are different forms of administration of the hormone (injections, patches, gels), so the therapy can be tailored to the needs of a particular person. The only absolute contraindication to testosterone administration is cancer.
Symptoms of testosterone deficiency
- decrease in libido and impairment of erection frequency and quality
- deterioration of general well-being
- mood swings
- decline in intellectual activity with cognitive decline
- feeling constantly tired and depressed
- deterioration of sleep quality
- Decrease in muscle mass and strength
- increase in visceral fat mass
- decrease of bone mineral density and consequently – the appearance of osteoporosis
Synthetic testosterone works differently
Synthetic testosterone should be treated differently. Treatment with it is quite risky. If you start taking a synthetic hormone, you have to use it for the rest of your life. Withdrawal of the artificial hormone will lead to a situation that it will not be in the body at all. Why does this happen? Well, the production of the hormone is managed by the pituitary gland, which with the help of luteinizing hormone (LH) stimulates the testicles to produce testosterone. This physiology does not always translate into increased libido, but testosterone levels rise. When synthetic testosterone is used, its concentration in the blood rises quickly. The pituitary gland, which was used to a shortage of the hormone, now gets a signal that there is an excess of it. It blocks the function of the testicles, which stop secreting testosterone and over time they disappear.
Testosterone tablets, gel, injections
Usually the treatment is started (if there are no medical contraindications!) when the testosterone concentration is less than 8 nmol/l. The dose and dosage of the preparation is determined by the doctor individually for each patient, taking into account his age, activity and – if present – systemic diseases. The basic treatment lasts from 3 to 6 months and must be monitored by tests so that the doctor can assess its effectiveness, revise the dose or decide to extend or shorten the therapy. With appropriate breaks, the treatment can be continued for many years. Depending on the method of administration of testosterone, the dosage of the drug varies. Standard injections using the syringe and needle are administered once every 2-3 weeks, and oral medication, like gel preparation, is used daily. The goal of therapy is to achieve age-appropriate testosterone levels in the blood. Exceeding supraphysiological concentrations may lead to testicular atrophy. In 60-70% of men treated with testosterone, a significant increase in libido is observed, and in 30-40% erections improve.