Testosterone is produced by the testes in a percentage of more than 90%, the rest of the insignificant amount is produced by the adrenal glands. It is possible to disrupt the flow of androgen into the blood under the influence of external and internal factors.
Conditions for lowering testosterone:
Drinking beer containing phytoestrogen, as well as smoking, poisoning the body, has a negative effect. With prolonged exposure to testosterone deficiency syndrome, it is possible to reduce the vegetation on the body and change the timbre of the voice.
FACT... Irregular sex life suppresses sexual reflexes - testosterone in the blood decreases.
What to do in such a situation? Medicines or folk remedies?
Herbs and other natural ingredients are used if testosterone decreases for a short period of time. The hormonal background is most easily corrected after the elimination of destabilizing factors, especially alcohol abuse, the effects of nervous tension and malnutrition.
However, there are prerequisites for the need for drug treatment if significant physiological disorders are diagnosed.
Rationality of therapy for:
- mechanical damage to the genitals;
- genetic diseases;
- pituitary tumors;
- orchitis and cryptorchidism;
- varicocele, spermatocele and hydrocele.
Infectious inflammation of the scrotum organs, which often occur when infected with sexually transmitted diseases, are also dangerous. Against the background of emerging damage to the skin, balanoposthitis and epididymitis occur.
When infected with mycoplasmosis and trichomoniasis in men, testosterone levels also decrease simultaneously with a deterioration in spermatogenesis.
Chlamydia provokes inflammation of the appendages, bladder and impaired potency.
The destruction of extraneous pathogens is carried out mainly by taking powerful antibiotics, and only then therapy is carried out to restore the balance of testosterone in the blood.
With diagnosed asthenospermia (the number of motile sperm is less than half of their total number) and azoospermia (active germ cells are completely absent), the help of natural components will no longer be enough.
Congenital forms of a lack of male hormone are called Kallman syndrome and Klinefelter syndrome.... In the latter case, not only testosterone deficiency is observed, but also poorly developed genitals.
Andrologists in such situations prescribe medications that force the return of a healthy hormonal background. In old age, you need to be prepared for the appearance of andropause: after 50 years, a significant decrease in androgen is a natural process that can only be corrected with medication.
WARNING... For men with prostate cancer or other diseases of the prostate gland, an increase in the concentration of testosterone in the blood is contraindicated.
Tactics for treating a lack of testosterone in men: exercises, recommendations, medications
Phytoproducts are used as conservative methods to restore healthy hormone levels. Tinctures of ginseng, eleutherococcus, schisandra chinensis and leaves of the ginkgo tree have a strong tonic effect.
A tangible help is provided by the use of multi-complexes(Vitrum, Alphabet, Multitabs) containing vitamins from which testosterone is built (B, C, E, D), and trace elements (zinc and selenium). Of the products, andrologists advise to “lean” on nuts, ginger, dried fruits, garlic, eggs and seafood.
Physical activity is similarly included in the list of what is called a must-have for androgen deficiency syndrome.
Helpful Exercises to Boost Testosterone Production:
- warm-up (5 to 10 minutes);
- barbell lifting exercises (10 to 40 minutes);
- strength training for large muscles (legs, chest, back);
- abdominal exercises (10–20 min).
Male rivalry is a traditional source of testosterone boosts. Since ancient times, domination has made men feel euphoric after victories in wars or hunting.
In modern conditions, these methods can be viewed as barbaric and unethical by some men, so it is rational to choose more civilized methods of uplifting.
Participation in sports - from running to boxing- can be helpful in treating insufficient androgen levels in the blood using the most natural methods.
Career success is also seen as an element of social dominance that restores a man's natural strength. The peak rise in testosterone is observed during the period of promotion, with active self-development and career achievements.
The production of the hormone occurs in the same way when contemplating the female naked body, therefore, to strengthen the sexual constitution, the number of sexual contacts should be increased.
Less androgen is formed during verbal communication with the opposite sex without erotic contact.
Along with the above recommendations, you should increase physical activity - the best option is to sign up for the gym. Muscle tension automatically activates the male reflex, forcing the production of more testosterone.
If conservative methods are ineffective, then the doctor has the right to prescribe drugs of the androgenic group. Common injection options: Sustanon 250, Nebido, Testosterone propionate, Omnadren. Andriol can be prescribed as tablets, Androgel ointments.
Duration of taking testosterone products:
- ampoules - within 7-10 days;
- tablets are taken up to 1 month;
- gel - 1-3 months.
These drugs inject artificially created testosterone into the bloodstream, but there are also medications that force the reproductive system to reanimate the production of its own hormone.
Medicines of this group: Arimatest, Evo-Test, Vitrix, Tribulus, Animal Test... By suppressing aromatase, a testosterone antagonist, anabolic substances lead to a sharp increase in the male hormone, but their intake is recommended in conjunction with a trip to fitness clubs or sports complexes.
WARNING... Lifelong administration of injections is possible only with congenital insufficient development of the testicles - hypogonadism - or the loss of their functions by the testicles during life.
Conclusion
Treatment of patients with low testosterone is necessary: the long presence of a weak hormonal background leads to obesity, impotence and even premature aging of a man.
Maintaining the production of sufficient androgen concentrations helps to prolong well-being and permanently consolidate the behavioral and physiological qualities that are truly inherent in the stronger sex.
In conclusion, watch a video about drugs for increasing testosterone in men based on tribulus:
Severe androgenic deficiency can develop in men for a variety of reasons and at any age.
Testosterone replacement therapy is prescribed to restore the endocrine system of the male body and improve the quality of life.
A decrease in the concentration of testosterone in the blood serum negatively affects the functioning of various organs and systems of the male body. The process of testosterone decline is slow and begins to develop after 30 years. By the age of forty, many men become overweight, their belly begins to grow and their sex drive decreases. Testosterone deficiency in men leads to the development of cardiovascular disease and osteoporosis. Testosterone replacement therapy enables men suffering from male hormone deficiency to avoid negative consequences.
The only way to find out about the lack of the male hormone in the blood serum is to measure its level in the blood. To find out its exact amount, several samples are taken. Blood is taken for analysis from 8 to 9 in the morning, when it is at its highest level. With the right doses after long-term use of androgenic hormone, the health of men with symptoms of testosterone deficiency improves. They restore their weight, their blood pressure normalizes, libido and potency return.
Why does testosterone deficiency occur?
The decline in testosterone levels does not always occur naturally over the years. There can be various reasons for the decrease in its production by the endocrine glands. Injuries to the testes can lead to a lack of male hormone. The cause is genetic diseases and the development of oncological neoplasms. Excess iron in the body suppresses the production of testosterone by the endocrine system. Dysfunction of the pituitary gland and the use of various hormonal drugs can cause a developing deficiency. Chronic diseases associated with alcoholism, nicotine addiction and drug use lead to early aging of the body and a decrease in the production of androgenic hormone.
When to start treatment with testosterone drugs
All men with symptoms of androgen deficiency and the elderly after 50 years of age are advised to undergo a diagnostic examination for hormonal levels in the blood serum. The test readings give true information about the production of hormones in the body. Replacement therapy is prescribed in the presence of symptoms of androgen deficiency, tests confirming an insufficient amount of testosterone in the blood and in the absence of malignant tumors in the prostate gland. Laboratory diagnostics should exclude or confirm the presence of prostate cancer. With a lack of testosterone, the likelihood of developing carcinoma of this male organ increases. For men with a history of cancer, the administration of testosterone preparations is contraindicated. The therapy will worsen the patient's condition. After collecting all the necessary information, testosterone preparations are prescribed.
The symptoms of androgen deficiency syndrome are:
- Prostration.
- Decreased stamina and performance.
- Decreased growth.
- Long-term depression.
- Increased irritability.
- Erectile dysfunction.
- Need for afternoon naps.
- Increase in body fat mass.
- Breast growth.
- Anemia.
- Osteoporosis.
- Increased cholesterol.
If there are 3 or more symptoms in the anamnesis, then you should consult a doctor for examination.
How to properly administer testosterone therapy
Replacement therapy with testosterone drugs should be carried out only as directed by a physician and under constant medical supervision. The uncontrolled use of hormonal drugs leads to an addiction of the body, which reduces the natural production of testosterone by the organs of the endocrine system. The most common hormonal treatment option is intramuscular administration of drugs containing the hormone.
In addition to injections, there are other types of administration of medicinal hormonal agents into the human body. Preparations containing testosterone are produced by manufacturers in the form of tablets, gels and patches.
Pharmaceutical companies offer crystal implants for use, which are inserted under the skin, making an incision in the abdomen. This drug, dissolving, provides a uniform release of testosterone for about six months. The implant is placed and removed surgically.
Substitution therapy using various types of drugs containing testosterone is lifelong. The effectiveness of the treatment can be seen after the body has accumulated the required concentration of testosterone and the symptoms of androgen deficiency are eliminated. If testosterone is taken under medical supervision, the therapy will be safe. It allows men of any age with androgen deficiency to maintain their health by leading an active lifestyle.
Hypogonadism therapy
Male hypogonadism is a functional failure of the testicles. The development of the disease is accompanied by low serum testosterone levels and characteristic clinical manifestations.
The causes of the development of the disease can be testicular trauma or disorders of the hypothalamic-pituitary system. Development pathologies can be genetically determined. Treatment of the disease involves the mandatory use of testosterone replacement therapy.
Signs of hypogonadism often begin to develop in boys during childhood. If the developing disease is not treated, then the adolescent will have a delay in the development of secondary sexual characteristics. Adult men with hypogonadism have insufficient muscle development, a high-pitched voice, and a small scrotum and testicles.
They have a small penis, rare hair on the pubis and in the armpits. Breast growth and eunuchoid body composition may be observed.
Hormone replacement therapy for this disease is recommended from adolescence and continues for life, because androgen deficiency will accompany a man suffering from hypogonadism throughout his life.
There are various techniques for eliminating testosterone deficiency in this disease, which the doctor uses during treatment.
Substitution therapy in the elderly
Hormone replacement therapy in older men is performed to improve the quality of life. More and more men, having crossed the 40-year mark, want to look young and strong. They do not accept old age and agree to substitution therapy if there is an indication for use.
The main goal is to reduce the symptoms of age-related androgen deficiency. Such men are recommended to wear patches, intramuscular injections, gels and capsules for insertion.
Studies have shown that such therapy leads to a decrease in blood cholesterol, reduces the risk of heart attacks and cardiovascular diseases.
Side effects of replacement therapy
Testosterone therapy can lead to side effects. Skin that becomes oily develops acne. Careful hygiene should be observed during treatment. Using lotions with the addition of alcohol, hard brushes for the body, gels for oily skin will help eliminate the development of acne.
Retention of fluids in the body may occur due to urinary retention, an increase in the size of the testicles. All these phenomena indicate an overabundance of the hormone. Testosterone therapy will be temporarily canceled if the doctor discovers the development of side effects. With the normalization of the condition, testosterone treatment continues, but the doctor reduces the dose of the injected drug.
Therapy results
When carrying out testosterone replacement therapy, conditions that develop with various somatic diseases are improved. Reduction of signs of male hormone deficiency occurs in men of different ages. One month after starting replacement therapy, resistance to stress increases, an increase in stamina during exercise and a decrease in the cholesterol level that is required to produce testosterone. Substitution therapy has a positive effect on the cardiovascular system. It reduces the symptoms of heart failure in elderly patients, normalizes blood pressure, and reduces the number of angina attacks. Numerous studies have shown that testosterone therapy improves myocardial contractile function and accelerates myocardial recovery after a heart attack.
Replacement therapy with hormonal drugs helps many men cope with inferiority complexes, find the joy of fatherhood, and stop the onset of old age. If there are any symptoms of a deficiency of the male hormone in the body, you should consult an andrologist for advice and treatment.
For young androgen-deficient men, testosterone treatment has many benefits and is associated with a low risk of serious adverse effects. In a systematic review of most open-label studies in healthy androgen-deficient men, testosterone treatment was associated with significant beneficial effects on muscle tissue, maximum voluntary strength, and vertebral bone mineral density, as well as significant reduction in whole body fat mass.
Testosterone treatment improves performance and sex drive. The purpose of this hormone affects many areas of sexual function: it increases the frequency of spontaneous sexual thoughts, improves responsiveness to erotic stimuli, and increases the frequency and duration of nocturnal penile erections. Therapy does not alter the erectile response to visual erotic stimulus or the frequency of orgasms in hypogonadal men, although it does increase ejaculate volume. In open-label studies, it was found that therapy improves the positive and reduces the negative aspects of mood; data from randomized clinical trials on the effect of therapy on mood are limited and do not show significantly greater improvement in mood compared to placebo.
However, androgen deficient men report improved feelings of health and energy after starting testosterone treatment. Several studies describe small and inconsistent effects on visuospatial recognition, auditory memory, and fluency. Studies of the effects of therapy on insulin sensitivity have produced conflicting results. Most of the studies were open-label, with patient selection based on low testosterone concentrations.
Testosterone preparations
Replacement therapy can be prescribed using one of several dosage forms available.
Testosterone esters given by injection
Esterification of testosterone in the 17-p-hydroxyl position makes the molecule hydrophobic and increases the duration of its action. The slow release from the oil depot in the muscle explains its extended duration of action. More side chain, more hydrophobicity of the ester and longer duration of action. Thus, testosterone enanthate and cypionate with longer side chains have a longer duration of action than propionate. The de-esterification of ethers quickly occurs in plasma, is not limited in speed and cannot explain the long duration of action.
Within 24 hours after intramuscular administration of 200 mg of testosterone enanthate or cypionate, serum hormone levels rise to the upper normal range or to the supraphysiological range and then gradually decline to the hypogonadal range over the next 2 weeks. A bimonthly regimen of enanthate or cypionate results in peaks and troughs in serum testosterone levels, which may be associated with changes in the patient's mood, sexual desire, activity level, and alertness. With appropriate monitoring, adequate tolerated doses of injectable testosterone formulations can be selected (they are the least expensive drugs available).
Percutaneous Testosterone Gel
There are two testosterone gels available on the market. Pharmacokinetic studies have confirmed that 5-10 gram doses applied daily to the skin can increase and maintain serum total and free testosterone concentrations in the mid-normal range in hypogonadal men, although significant variations are possible throughout the day in individual patients. The current recommendation is to start at 5 g and adjust the dose based on serum levels of the hormone.
The advantages of testosterone gel are ease of application, its invisibility after application and flexibility in dosage. The main feature of using the gel is the potential for its transfer to a sexual partner or child who comes into close contact with the patient. Skin tolerance is good, skin irritations are rare.
Transdermal Testosterone Patch
One or two 5 mg extra-sex testosterone patches may be applied to the skin outside the scrotum. Testosterone and estradiol levels are in the normal range for 4-12 hours after patch application. Extra-sex patches provide physiological serum testosterone levels. One 5 mg patch may not be sufficient to increase serum hormone concentrations to the mid-normal range in all hypogonadal men, and some patients may require two 5 mg patches daily to achieve the target level. In some patients, skin irritation is associated with the use of extra-sex patches.
Bioadhesive testosterone tablets
Bioadhesive 30 mg testosterone controlled release tablets applied every 12 hours to the buccal mucosa normalize serum hormone levels in hypogonadal men. In 16% of treated men, the use of cheek pills was associated with gum problems.
Crystalline testosterone implants are inserted into the subcutaneous tissue using a trocar through a small skin incision. The hormone is released by surface erosion of the implant and is absorbed into the systemic circulation. Four to six 200 mg implants can maintain serum concentrations in the mid-normal and high-normal range for 6 months. The need for a skin incision for insertion and removal, spontaneous extrusion and fibrosis at the site of implant insertion are potential drawbacks of this dosage form.
The intramuscular form of testosterone undecanoate in the form of an oily solution can maintain serum hormone levels in the normal range for 10-12 weeks after intramuscular injection. The usual regimen of testosterone undecanoate administration includes an initial injection of 1000 mg of the drug intramuscularly, a second injection of 1000 mg after 6 weeks, and then intramuscular injections of 1000 mg every 12 weeks. The relative advantage of this injectable form is its long-lasting effect and weaker fluctuations in serum hormone levels. However, undecanoate is prescribed in a large volume of oil, which causes discomfort in the patient.
Orally administered testosterone derivatives
Testosterone is well absorbed after oral administration, but rapidly undergoes first-pass metabolism. This is why it is impossible to achieve stable blood levels after ingestion of a crystalline preparation. Alkylated derivatives are relatively resistant to hepatic degradation and can be administered orally, however, due to the potential hepatotoxicity and the availability of alternative and safer dosage forms, alkylated testosterone derivatives are not recommended for replacement therapy.
The latest androgenic dosage forms
A number of newer dosage forms of androgens with better pharmacinetics or a more selective activity profile are under development. The dosage form of biodegradable testosterone microspheres provides physiological levels of the hormone for 10-11 weeks. Long-acting esters - bucyclate and undecanoate, when injected intramuscularly, can maintain circulating testosterone concentrations in the male range for 7-12 weeks. Initial clinical trials have shown that testosterone can be administered by the sublingual or buccal route.
Contraindications to testosterone treatment
Testosterone therapy should not be used in men with metastatic prostate cancer, breast cancer, as it can promote the growth of these tumors. Therapy can worsen preexisting erythrocytosis, untreated severe obstructive sleep apnea, and severe congestive heart failure. Because a lump in the prostate, induration, or elevated PSA levels can be indicators of unrecognized prostate cancer, men with these conditions should have a urologic examination before considering testosterone treatment.
It is not known how safe testosterone treatment is for men who have undergone radical prostatectomy for localized prostate cancer and appear to be cured; some experts believe that therapy can be prescribed on an individual basis to such men if they have not found PSA for more than 2 years. However, there is insufficient data to recommend this approach.
Testosterone side effects
The incidence of adverse effects associated with testosterone treatment in open-label studies in young hypogonadal men was low. The most common T-linked adverse effects are erythrocytosis, acne, oily skin, and breast tenderness. Although there are reports of gynecomastia and induction or worsening of obstructive sleep apnea, the incidence of these adverse effects during therapy is low.
The widespread belief that testosterone treatment increases the risk of atherosclerotic heart disease is not supported by the available evidence. The long-term implications for the risk of heart disease remain unknown. Although supraphysiological doses of androgens commonly used by bodybuilders and athletes reduce plasma HDL levels, physiological testosterone replacement in older men has been associated with only moderate or no plasma HDL reductions. Profile studies of middle-aged men have revealed a direct rather than inverse relationship between serum hormone levels and HDL plasma concentrations and an inverse correlation between testosterone levels and visceral fat volume.
Open-label studies of testosterone use mainly in young hypogonadal men have shown small reductions in total cholesterol, HDL cholesterol, and LDL cholesterol in blood plasma. Placebo-controlled studies in older men have not found significant changes in blood HDL levels with long-term testosterone administration.
Spontaneous and experimentally induced androgen deficiency is associated with increased adipose tissue mass. Testosterone treatment reduces body fat mass in older men who have low levels of the hormone. There have been reports of decreased visceral fat volume, serum glucose concentration and blood pressure, and increased insulin sensitivity with testosterone supplementation in middle-aged men.
Effects of testosterone on the risk of atherosclerotic heart disease
Research data suggest that both supraphysiologic and subphysiologic circulating testosterone concentrations are associated with increased cardiovascular risk, although the evidence for this is far from conclusive. The effects of testosterone treatment on the progression of atherosclerosis and the incidence of cardiovascular events have not been studied in men in randomized clinical trials, but they are important because even small changes in the incidence of cardiovascular disease can have a significant impact on the health of the population.
Testosterone and prostate cancer risk
There is no proven evidence that testosterone treatment is a cause of prostate cancer. There is also no consistent relationship between endogenous serum hormone levels and prostate cancer risk. However, there are a number of concerns.
Many older men have microscopic foci of cancer in their prostate gland. It is not known whether therapy will increase these subclinical cancer loci and make them clinically apparent.
Prostate cancer is a typical androgen-dependent tumor, and androgen therapy can promote its growth. That is why therapy is contraindicated in men with metastatic prostate cancer.
An increase in PSA levels during testosterone therapy may trigger examination and biopsy in some patients. More intensive PSA screening and monitoring of men on T-therapy can lead to an increased number of prostate biopsies and the detection of subclinical prostate cancer that would otherwise go unnoticed.
Testosterone replacement therapy can be safely prescribed for men with benign prostatic hyperplasia who have mild to moderate symptom scores. Androgen deficiency is associated with reduced prostate volume, and androgen replacement increases prostate volume to levels in age-matched controls. In patients with pre-existing severe symptoms of adenoma, even a small increase in prostate volume can increase the symptoms of obstruction. In these men, testosterone should either not be used or given with close monitoring of obstruction symptoms.
Testosterone treatment and erythrocytosis
Testosterone preparations dose-dependently increase erythrocyte mass, apparently through effects on erythropoietin and stem cell proliferation. That is why testosterone replacement is not indicated for men with a baseline hematocrit of 50% or higher without appropriate examination and treatment of erythrocytosis. The administration of the hormone to young men with androgen deficiency is usually due to a slight increase in hematocrit. Clinically significant erythrocytosis is uncommon in young hypogonadal men during treatment, but it can appear in men with severe smoking or COPD sleep apnea.
The increase in hemoglobin during therapy is higher in the elderly than in younger men. Erythrocytosis is the most common drug-induced adverse effect and also the most common reason for discontinuing therapy. Treatment with transdermal systems has been found to cause less increases in hemoglobin levels.
Testosterone treatment should be discontinued when the hematocrit level exceeds 54%, and therapy should be abstained from until the hematocrit has dropped to less than 50%, after which therapy can be restarted at a lower dose.
Testosterone is converted by aromatization to estradiol in many peripheral tissues and can exacerbate, so it should not be given to men with breast cancer.
Testosterone can induce sleep apnea syndrome or exacerbate existing sleep apnea syndrome due to its neuromuscular effects on the upper respiratory tract, and should not be given to men with severe obstructive sleep apnea syndrome without appropriate assessment and treatment. Men with sleep apnea syndrome may have low levels of this hormone.
Testosterone administration can transiently induce sodium and water retention and should therefore not be given (or given with great caution) to patients with severe congestive heart failure and Class 4 symptoms.
Monitoring testosterone therapy
The Endocrinological Society recommends that men on testosterone treatment be evaluated 3 months after initiation of therapy and annually thereafter using a standard monitoring plan for effective management of symptoms and signs associated with testosterone deficiency and to facilitate early detection of adverse effects. Therapy should be aimed at increasing serum hormone levels to the mid-normal range. Even in primary testicular failure, serum luteinizing hormone (LH) levels are not normalized by doses of testosterone that restore sexual function and induce clinical improvement. This is why serum LH levels have not been used to monitor the adequacy of treatment in men with androgen deficiency. Determinations of hemoglobin, hematocrit, PSA concentration and digital prostate examinations should be performed at regular intervals in addition to general health examinations as recommended by local standards.
| Medicinal | Therapy regimen | Pharmacokinetic | Dihydrotestosterone and estradiol | Advantages | Flaws |
| T-enanthate or cypionate | 10 and mg / week or 20 and mg at 2 weeks intramuscularly | After one intramuscular injection, serum testosterone levels rise above the physiological range and then gradually decline to the hypogonadal range towards the end of the dosing interval | Dihydrotestosterone and estradiol levels rise in proportion to the increase in testosterone concentrations | Corrects symptoms of androgen deficiency; relatively inexpensive if administered alone: dosage flexibility |
Requires intramuscular injection, peaks and troughs in serum hormone levels |
| Extrasexual percutaneous system | One or two patches, nominally delivering 5-10 mg testosterone over a 24-hour period, applied daily to non-pressurized areas | Restores serum testosterone and estradiol levels to physiological levels in men | Levels are in the physiological range for men | Ease of use, corrects the symptoms of androgen deficiency and mimics the normal daily rhythm of secretion; increases hemoglobin less than esters given by injection | Serum testosterone levels in some men with androgen deficiency may be in the lower normal range; these men may need to apply two patches daily, skin irritation at the site of attachment can be a problem for some patients |
| Testosterone | 5-10 g of gel containing 50-100 mg of testosterone should be applied daily | Restores serum testosterone and estradiol levels to physiological levels in men | Serum DHT levels are higher and the T: DHT ratio is lower in hypogonadal men treated with the gel than in healthy men with normal sex gland function | Corrects symptoms of androgen deficiency, provides dosing flexibility. ease of use, well tolerated by the skin | Potential transfer to a female partner or child through direct skin-to-skin contact; moderately high levels of DHT |
| 17- methyl testosterone |
This 17a alkylated derivative should not be used due to the potential for liver toxicity. | Actively when taken orally | Clinical responses are variable; potentially toxic to the liver; should not be used to treat androgen deficiency |
Table continuation
| Cheek bio- adhesive testosterone tablets |
30 mg bioadhesive controlled release tablets used 2 times daily | Absorbed through the buccal mucosa | Normalizes serum testosterone concentrations in hypogonadal men | Corrects Androgen Deficiency Symptoms in Healthy Men with Hypogonadism | In 16% of patients, adverse effects associated with the gums |
| 40-80 mg orally 2-3 times a day with meals | When given in oleic acid, T-undecanoate is absorbed through the lymphatic vessels of the portal system significant variability in the same patient on different days and among different patients |
High DHT: T ratio | Convenience of ingestion | Not permitted in the United States; variable clinical responses, variable serum testosterone levels, high DHT: T ratio | |
| Injectable, long acting T-undecanoate in oil | 1000 mg administered intramuscularly followed by 1000 mg after 6 weeks and then 1000 mg every 12 weeks | When given at a dose of 1000 mg intramuscularly, serum levels are maintained within the normal range in most men | DHT and estradiol levels rise in proportion to the increase in testosterone concentrations; the relations T: DHT and T: E 2 do not change | Corrects symptoms of androgen deficiency; requires infrequent appointments |
Requires high volume intramuscular injection (4 ml) |
| Testosterone implants | 4-6 implants 200 mg subcutaneously | Serum testosterone peaks at 1 mo and is then maintained in the normal range for 4-6 mo | T: DHT ratios do not change | Corrects symptoms of androgen deficiency | Requires a surgical incision for insertion; spontaneous extrusions |
| Form | Dosage |
| T-enanthate or cypiopath | 75-100 mg / week or 150-200 mg every 2 weeks given intramuscularly |
| Extra-Sexual Testosterone Patches | One or two 5 mg patches applied at night to the back, thigh, or upper arm, away from pressure areas |
| Testosterone gel | 5-10 g applied to the covered areas of the skin |
| Bioadhesive cheek testosterone tablets' | 30 mg tablets superimposed on the buccal mucosa 2 times a day |
| T-undecanoate for oral administration | Usually 40-80 mg by mouth 2 or 3 times a day with meals |
| T-undecanoate for injection | Usually 1000 mg intramuscularly at the beginning and after 6 weeks and then 1000 mg every 12 weeks |
| Testosterone implants | 4-5 implants 200 mg subcutaneously every 4-6 months |
Most men with low testosterone levels report improvements in energy, sexual arousal, and mood after testosterone therapy. If testosterone isn't enough, why not replace it? Take your time. In fact, people with low testosterone levels do not need treatment.
Substitution therapy has side effects, but it is not known what benefits it brings and how much it can threaten health. Only men with symptoms of low testosterone and blood tests showing that this is a problem should consider therapy. Only in consultation with your doctor can you determine that this therapy is right for you.
Testosterone replacement therapy - video
Hidden symptoms of testosterone deficiency
Symptoms of testosterone deficiency are sometimes obvious but can be difficult to see. Testosterone levels in men usually decrease with age, however, it can also decrease due to various conditions.
- weak sexual excitability (libido);
- erectile dysfunction;
- tiredness and lack of energy;
- decrease in muscle mass;
- hair loss on the face and body;
- depression;
- absent-mindedness;
- irritability;
- deterioration in health.
If a man has these symptoms and the test shows low testosterone levels, the doctor may prescribe treatment. Millions of men with corresponding symptoms, but with normal test results therapy is not recommended... It is also not suitable for men whose testosterone decline is associated with age.
Types of testosterone medications
- patches (transdermal type): "Androderm" - a patch that is attached to the arm or torso, taken once a day.
- gels: "Androgel" and "Testim" - sachets with transparent gel. Testosterone is absorbed into the skin and is applied once a day. "Androgel", "Axiron" and "Fortesta" are also produced in the form of aerosols, which makes it convenient to take the daily dose prescribed by the doctor. "Natesto" -gel is applied to the surface of the nasal cavity.
- absorbable in the mouth: "Striant" is a small tablet attached to the upper gums above the incisors for absorption. It is taken twice a day and for a long time it restores the level of testosterone in the blood.
- injections and implants: testosterone is also injected directly into the muscles or implanted in small granules into the soft tissues of the body. It is gradually absorbed into the bloodstream.
Why can't you just take a testosterone pill? Some experts believe that these forms of drugs have a negative effect on the liver. All other forms - patches, lozenges, injections - deliver testosterone directly into the bloodstream and pass through the liver by the side.
What are the benefits of testosterone therapy?
What can you expect from testosterone treatment? It is impossible to say for sure, because the body of each person has its own characteristics. Most men notice improvements in potency and energy. Testosterone also increases bone hardness, muscle mass and, in some, insulin sensitivity. Men also report that their mood is lifted after substitution therapy. Whether these changes are pronounced or barely noticeable, they are very individualized.
About one in ten men speaks enthusiastically about therapy, and about the same number say almost nothing. Most of the reviews are generally positive, and slightly different from each other.
What are the dangers of testosterone therapy?
Side effects of replacement therapy are mainly rashes, itching or irritation where testosterone enters the body.
However, there have been cases of heart attack or seizures associated with the use of testosterone drugs. Experts emphasize that the benefits and harms of long-term therapy are unknown, since large-scale clinical trials have not yet been conducted. Testosterone therapy can lead to:
- benign prostatic hyperplasia (BPH): the prostate gland enlarges under the influence of testosterone. In most men, it increases with age, pinching the urethra, resulting in problem urination. For example, BPH may worsen with testosterone therapy.
- Prostate Cancer: Testosterone may contribute to the development of prostate cancer. Most experts recommend screening for cancer before starting substitution therapy. For men with prostate cancer or elevated levels of prostate specific antigen (PSA), therapy is contraindicated.
- Temporary respiratory arrest during sleep (apnea): This problem can also develop and worsen with testosterone exposure. It will be difficult for a man himself to identify her, but a person sleeping with him can tell about it. Sleep testing (polysomnography) is necessary to make a diagnosis.
- Blood clots: The FDA says testosterone replacement drugs are dangerous because they can cause blood clots. This develops the risk of deep vein thrombosis, thromboebolism of the pulmonary artery (its life-threatening blockage). The drugs can also cause blood clots due to polycythemia - an increase in the volume of red blood cells in the blood, which also develops under the influence of testosterone. Now this applies even to men who do not suffer from polycythemia.
- heart failure: Testosterone therapy is also not recommended for men with heart failure, as it can only worsen the condition.
Years will pass until large laboratory studies give results and answer the question of what is the benefit and what is the harm of testosterone replacement therapy. As with any treatment, it is up to you and your doctor to decide whether therapy is worth the threat it poses.
Testosterone is one of the main hormones in the human body. It can be found in the blood of both men and women. A deficiency of this hormone can occur for various reasons and lead to serious consequences, since the work of not only the genital area, but also other body systems is disrupted.
The decrease in testosterone can also take place for physiological reasons, as a result of the aging of the man's body. Therefore, many men suffer from excess weight precisely because of a decrease in the level of this hormone. Testosterone deficiency can lead to cardiovascular disease. The process of decreasing testosterone levels begins after thirty years, and with a decrease in the amount of the hormone, libido also decreases.
In order to find out the level of the hormone in the blood, it is necessary to take a blood test, this must be done in the morning on an empty stomach. It is during these hours that the level of the hormone in the body is maximum.
Low testosterone levels can be returned to normal, and replacement therapy will help. There are preparations containing artificially synthesized testosterone. All men who have crossed the age of fifty years must be prescribed an examination in order to determine the level of testosterone in the blood. With its deficiency, the necessary treatment is prescribed.
Testosterone deficiency can also be found in fairly young men. The normal synthesis of the hormone can be disrupted due to smoking and regular consumption of alcoholic beverages. Constant stress and a sedentary lifestyle lead to the same result.
In the presence of symptoms of testosterone deficiency in the body, treatment is prescribed only after a comprehensive examination, which should exclude the presence of a malignant tumor of the prostate. In this disease, treatment with drugs containing testosterone is prohibited. All men with a history of malignant neoplasms do not receive such treatment.
Taking hormonal pills with these pathological changes in the patient's body will lead to a sharp deterioration in his health. Therefore, without the availability of all laboratory data and MRI data, treatment is not prescribed.
What are the signs of testosterone deficiency in a man's body?
- Weakening of sex drive.
- Decreased body tone.
- Frequent and prolonged depression.
- Changes in patient behavior.
- Erectile dysfunction.
- Drowsiness.
- Weight gain.
- Breast growth.
- Decrease in the level of hemoglobin in the blood.
- Increased blood cholesterol levels.
It is believed that if a man reveals at least three of the symptoms from the above list, he should see a doctor for treatment.
HRT
Men who have been diagnosed with testosterone deficiency should undergo regular medical examinations and take medications. During the course of replacement therapy, testosterone levels should be monitored.
Testosterone replacement therapy in men can be performed only after consultation with the attending physician. He also determines the required dose of the drug. The effect of drugs containing testosterone becomes outwardly noticeable only after the required level of the substance in the blood is reached.
Testosterone deficiency can be treated with injections, tablets, special gels, and patches. A new method of treatment has recently been developed. With it, special implants containing crystalline testosterone are inserted under the patient's skin in the abdomen. Dissolving, the crystals provide a constant flow of the hormone into the blood. The effect of such an implant is designed for six months. HRT with testosterone is carried out for life.
Some drugs used to treat hormone deficiency are hepatoxic and their use is limited, or even banned in some countries. This is another reason why treatment should only be prescribed by a doctor. The patient may not be aware of all the characteristics of hormonal drugs, and making a decision about self-treatment can be harmful to his health.
Testosterone cypionate, Testosterone enanthate are referred to injectable forms of testosterone analogs. These two drugs are administered at 200-400 mg once every three to four weeks. These injections cannot be used to treat heart failure, kidney or liver disease. In case of lung diseases, preparations containing an analogue of testosterone can be taken in color, but with extreme caution and under strict medical supervision. Diabetes mellitus and acute urinary retention, manifested against the background of inflammation of the prostate, can become a contraindication to treatment with these drugs.
Hormonal tablet forms: Fluoxymesterone, Methyltestosterone. These two drugs are hepatoxic. It is forbidden to prescribe them to patients with liver and kidney diseases. The daily dose of Fluoxymesterone can be up to 20 mg, for Methyltestosterone - up to 30 mg.
Subcutaneous forms of drugs include implants. 1200 mg of the drug is sewn under the skin, the effect of which lasts about six months.
Transdermal forms act through the skin. These include Testosterone gel and Testosterone patches. The indications and contraindications for these drugs are the same as for tablets and injections.
Testosterone deficiency began to be treated in the forties of the last century. During this time, many drugs have been created with its content. Each time, synthetic testosterone is more and more similar in its characteristics to that which is present in the human body.
Taking hormonal drugs can improve the quality of a man's life, prolong his youth, as evidenced by the reviews of many patients. Some of these drugs are used not only for medicinal purposes. Sometimes athletes take these drugs to improve their athletic performance. But again, this must be done under the strict supervision of doctors.
