What is Testosterone Replacement Therapy?
Testosterone replacement therapy (TRT) is a medical treatment for men who have low testosterone levels. It involves administering synthetic testosterone to reduce symptoms associated with low testosterone, such as decreased bone density, low sex drive, and physical weakness. TRT is typically given as an injectable, cream, or patch, and doctors may also suggest lifestyle changes to complement therapy.
Testosterone is a male hormone produced by the testes and isresponsible for muscle growth, fat distribution, and sex drive. As men age, their testosterone levels naturally decline, leading to a condition known as “Low-T”. Low-T can cause physical and psychological symptoms such as decreased bone density, fatigue, depression, and mood swings. TRT is used when the testosterone level in a man’s body is too low. While natural remedies can help to boost testosterone levels, they are not always sufficient.
Testosterone is an important hormone for overall wellbeing, and its replacement can help to alleviate many age-related symptoms. TRT can improve energy levels, physical strength, libido, and mood. It can also help to reduce body fat and increase muscle mass. Additionally, TRT may improve bone density and reduce risk of some age-related conditions, such as osteoporosis.
Risks and Side Effects
TRT carries some risks and potential side effects. It can cause prostate enlargement and may increase risk of heart attack or stroke. TRT is contraindicated for those with prostate or breast cancer, heart disease, or liver or kidney conditions. Additionally, users of TRT may be more susceptible to blood clots and prostate inflammation. Side effects may include acne, flu-like symptoms, hair loss, and headache. These risks and potential side effects must be weighed against the potential benefits of TRT.
The expected results of TRT will vary from person to person. Generally, users should expect to experience increased energy levels, improved concentration, and better sleep. They may also experience an increase in sex drive, improved muscle tone, and increased bone density. Results can take several weeks to become noticeable. It is important to consult a doctor regularly to ensure that TRT levels are not too high, as this can lead to unwanted side effects.
TRT is not suitable for everyone, as it carries certain risks and potential side effects. Those considering TRT should ensure that their doctor has checked their hormone levels and ruled out underlying medical conditions. In addition, they should discuss all potential risks and side effects with their doctor before embarking on TRT. The doctor should be informed of all medications taken and any lifestyle changes that may affect results. It is also important to get regular health checkups during TRT to ensure that levels are appropriate.
Testosterone replacement therapy can be an effective treatment for men who have low testosterone levels. It can alleviate the physical and psychological symptoms of Low-T and may also reduce risk of certain age-related conditions. However, it carries certain risks and side effects which must be taken into account when deciding whether or not to undertake TRT. Working closely with a doctor will help to ensure that TRT is safe and effective.
التعريف والنظرة العامة
Testosterone replacement therapy, also known as androgen replacement therapy, is often prescribed to patients suffering from the effects of male hypogonadism, a condition characterised by the diminished functional activity of the gonads or testes.
Testosterone is a type of steroid hormone primarily secreted by the testicles and adrenal glands. It is important in the development of male reproductive tissues and promotes secondary sexual characteristics including increased bone and muscle mass, as well as growth of body hair. Other than its physical contributions to the male (and in small amounts, female) body, it is also essential to an individual’s health and well-being. Research shows that testosterone plays a key role in fueling a man’s mental and physical energy, and in regulating the fight-or-flight response and other key evolutionary features exclusive to humans. It also helps prevent the onset of osteoporosis.
The production of the testosterone hormone slows down due to the natural process of aging. Andropause, the male version of menopause, is speculated to be the result of this process. Individuals going through this condition can experience a variety of symptoms, including depression, increased body fat levels, reduced muscle mass, difficulty in concentrating or sleeping, decreased motivation to perform productive or pleasurable tasks, physical weakness, decreased bone density, gynaecomastia (or the appearance of breasts in male patients), reduced libido, and erectile dysfunction.
Research shows that a majority of men experience a fifty percent drop in testosterone levels when they reach age 80. Some patients, however, experience the same thing much earlier, which can seriously affect their daily lives. In these patients, the early onset of andropause symptoms can be addressed with testosterone replacement therapy.
من يجب أن يخضع للنتائج المتوقعة
Aside from patients experiencing low testosterone levels at an early age, testosterone replacement therapy can also be recommended to alleviate some of the symptoms experienced by patients suffering from the following conditions:
- Hypogonadism, especially in patients who are experiencing symptoms such as fatigue and anaemia
- هشاشة العظام
- Diabetes mellitus
- الضعف الجنسي لدى الرجال
- Chronic heart failure
The therapy can also be recommended to transgender men, so their bodies can manifest the physical characteristics of the gender they identify with.
كيف يتم إجراء العملية؟
There are several forms in which testosterone replacement therapy is administered and most can be performed by the patient himself under the supervision of a qualified medical professional. These include the following:
Transdermal TRT. This involves the application of a skin patch containing the medication on the upper body or arms once a day for the duration of the treatment. The medication is then absorbed through the skin and enters the bloodstream to normalise the patient’s testosterone levels.
Topical gels. This involves the application of clear gel infused with testosterone on the shoulders, upper arms, or abdomen. Testosterone gels are available only through prescription. Available brands in the market include AndroGel, Fortesta, and Axiron. There is also a brand that can be applied inside the patient’s nose called Natesto.
Injections or implants. With these options, a qualified medical professional injects the testosterone directly into the patient’s muscles or surgically place pellet-sized implants in the soft tissues. The implants are designed to provide a slow but constant infusion of testosterone into the body. The insertion is performed under local anaesthesia and one pellet typically lasts up to six months.
Pills. Oral testosterone pills are available in the market, but many doctors advise against them as they can damage the liver. Other forms of TRT bypasses the liver and gets testosterone directly into the blood.
Mouth patch. This involves placing a patch or tablet in the mouth two times a day. The patch releases the hormone into the bloodstream through the tissues in the mouth.
المخاطر والمضاعفات المحتملة
Testosterone replacement therapy is linked to both mild and serious medical conditions. As such, patients are highly advised to discuss and weigh the therapy’s pros and cons with their physicians before the treatment starts. Risks and possible complications include:
- Development of benign prostatic hypertrophy, a condition that involves the enlargement of the prostate gland.
- Worsening of sleep apnoea
- Formation of blood clots in the veins, which can increase the risk of deep vein thrombosis and pulmonary embolism
- Increased risk of prostate cancer
- Worsening of congestive heart failure
Bhasin S, et al. Testosterone therapy in men with androgen deficiency syndromes: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism. 2010;95:2536.
Longo DL, et al. Disorders of the testes and male reproductive system In: Harrison’s Principles of Internal Medicine. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.com. Accessed Feb. 4, 2015.