Category Archives: Testosterone

Tired? Low sex drive? Problems sleeping? Wouldnt it be nice if there was an easy answer to these common problems often caused simply by aging?

For men, one solution promoted by drug advertisers is testosterone replacement therapy. Having low testosterone even has its own snappy name: Low T.

But as the use of these medications increases, so do concerns about possible harm if theyre taken unnecessarily.

The Food and Drug Administration requires prescription testosterone replacement therapy products be clearly labeled to inform men about a possible increased risk of heart attacks and stroke.

So is low T a real thing? And when is it OK to embark on testosterone replacement therapy?

Testosterone is the male sex hormone made in the testicles. It is what makes a boys voice drop lower and facial and other body hair grow. It is also necessary for male sexual functions like erections and the production of sperm.

If you are not producing enough testosterone it can lead to several symptoms:

Testosterone replacement therapy usually comes in the form of patches, injections, pellets that are implanted under the skin or gels. Testosterone cannot be given in pill form because the liver breaks it down very quickly.

Our experts say there are many people who would benefit from testosterone replacement therapy. If you have had a serious medical treatments like chemotherapy or radiation, or you have injured a testicle, you may need testosterone replacement therapy.

But taking it to solve problems with fatigue, low energy or sinking sex drive without a full check-up can mean the real causes of these symptoms are overlooked.

There are a lot of reasons why you could have low testosterone. Assessing it in the right way is essential, says Conor Best, M.D., assistant professor in Endocrine Neoplasia and Hormonal Disorders at MD Anderson Cancer Center.

Testosterone should be checked at least twice using a blood test. Both tests should be done in the morning between 7 a.m. and 10 a.m.

If the tests do show a low level, you should discuss the possible causes with your doctor before deciding if testosterone replacement therapy is right for you.

Diabetes and obesity, as well as increasing age, can lead to low testosterone.

If theres no clear cause for low testosterone, working on your diet and increasing exercise can often be the answer.

Over-the-counter supplements for testosterone generally do not contain any of the hormone. Manufacturers claim that the herbs and minerals in them will increase your natural production of testosterone.

But our expert says there is no herbal supplement that will reliably increase testosterone.

And over-the-counter supplements are not regulated. This means that the ingredients in them are not checked, so supplements might include more than what is written on the label, or less.

We are concerned that an unregulated supplement that boosts testosterone could have potentially toxic versions of testosterone in it, or another medication with unintended side effects, says Best.

If you are concerned about your testosterone level, the best thing to do is talk to your doctor and get properly tested.

In addition to masking the underlying problem, testosterone supplements come with their own risks.

Testosterone replacement therapy can lead to blood clotting problems because they cause the body to make more red blood cells.

Excess testosterone can turn into estrogen, which comes with risks. Extra estrogen also can lead to blood clots. And it can cause breast tissue to develop, which puts you at a higher risk of male breast cancer, although this risk is small.

Problems with heart disease have also been seen in some large population studies, which led to the FDA warnings about heart attacks and strokes.

Were still learning new things about what all these hormones do. You cant always predict what the downstream effects will be, says Best.

If someone has a pretty normal level, maybe supplementing does potentially do more harm because youre overriding the bodys natural state.

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Testosterone replacement therapy: Yes or no - MD Anderson Cancer Center

Erectile dysfunction is defined as the persistent inability to achieve or maintain penile erection sufficient for satisfactory sexual performance. The Massachusetts Male Aging Study surveyed 1,709 men aged 4070 years between 1987 and 1989 and found there was a total prevalence of erectile dysfunction of 52 percent. It was estimated that, in 1995, over 152 million men worldwide experienced ED. For 2025, the prevalence of ED is predicted to be approximately 322 million worldwide.

In the past, erectile dysfunction was commonly believed to be caused by psychological problems. It is now known that, for most men, erectile dysfunction is caused by physical problems, usually related to the blood supply of the penis. Many advances have occurred in both diagnosis and treatment of erectile dysfunction.

According to the NIH, erectile dysfunction is also a symptom that accompanies many disorders and diseases.

Direct risk factors for erectile dysfunction may include the following:

Prostate problems

Type 2 diabetes

Hypogonadism in association with a number of endocrinologic conditions

Hypertension (high blood pressure)

Vascular disease and vascular surgery

High levels of blood cholesterol

Low levels of HDL (high-density lipoprotein)

Chronic sleep disorders (obstructive sleep apnea, insomnia)

Drugs

Neurogenic disorders

Peyronie's disease (distortion or curvature of the penis)

Priapism (inflammation of the penis)

Depression

Alcohol use

Lack of sexual knowledge

Poor sexual techniques

Inadequate interpersonal relationships

Many chronic diseases, especially renal failure and dialysis

Smoking, which exacerbates the effects of other risk factors, such as vascular disease or hypertension

Age appears to be a strong indirect risk factor in that it is associated with increased likelihood of direct risk factors, some of which are listed above.

Accurate risk factor identification and characterization are essential for prevention or treatment of erectile dysfunction.

The following are some of the different types and possible causes of erectile dysfunction:

Organic ED involves abnormalities the penile arteries, veins, or both and is the most common cause of ED, especially in older men. When the problem is arterial, it is usually caused by arteriosclerosis, or hardening of the arteries, although trauma to the arteries may be the cause. The controllable risk factors for arteriosclerosis--being overweight, lack of exercise, high cholesterol, high blood pressure, and cigarette smoking--can cause erectile failure often before progressing to affect the heart.

Many experts believe that atrophy, a partial or complete wasting away of tissue, and fibrosis, the growth of excess tissue, of the smooth muscle tissue in the body of the penis (cavernous smooth muscle) triggers problems with being able to maintain a firm erection. Poor ability to maintain an erection is often an early symptom of erectile dysfunction. Although the condition is called venous leak, the real problem is not with the veins but malfunction of the smooth muscle that surrounds the veins. The end result is difficulty with maintain a firm erection (losing an erection too quickly) that is now believe to be an early manifestation of atherosclerosis and vascular disease.

Diabetes. Erectile Dysfunction is common in people with diabetes. An estimated 10.9 million adult men in the U.S. have diabetes, and 35 to 50 percent of these men are impotent. The process involves premature and unusually severe hardening of the arteries. Peripheral neuropathy, with involvement of the nerves controlling erections, is commonly seen in people with diabetes.

Depression. Depression is another cause of ED and is closely related to erectile dysfunction. Because there is a triad relationship between depression, ED and cardiovascular disease, men with depression should be fully evaluated for medical illness as well as psychological factors. Some antidepressant medications cause erectile failure.

Neurologic causes. There are many neurological (nerve problems) causes of ED. Diabetes, chronic alcoholism, multiple sclerosis, heavy metal poisoning, spinal cord and nerve injuries, and nerve damage from pelvic operations can cause erectile dysfunction.

Drug-induced ED. A great variety of prescription drugs, such as blood pressure medications, antianxiety and antidepressant medications, glaucoma eye drops, and cancer chemotherapy agents are just some of the many medications associated with ED.

Hormone-induced ED. Hormonal abnormalities, such as increased prolactin (a hormone produced by the anterior pituitary gland), steroid abuse by bodybuilders, too much or too little thyroid hormone, and hormones administered for prostate cancer may cause ED. Low testosterone can contribute to ED but is rarely the sole factor responsible for ED.

Premature ejaculation is a male sexual dysfunction characterized by:

Ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration.

Inability to delay ejaculation on all or nearly all vaginal penetrations; and, negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy.

Premature ejaculation is divided into lifelong and acquired categories:

Lifelong premature ejaculation. With lifelong premature ejaculation, the patient has experienced premature ejaculation since first beginning coitus.

Acquired premature ejaculation. With acquired premature ejaculation, the patient previously had successful coital relationships and only now has developed premature ejaculation.

Performance anxiety. Performance anxiety is a form of psychogenic ED, usually caused by stress.

Diagnostic procedures for ED may include the following:

Patient medical or sexual history. This may reveal conditions or diseases that lead to impotence and help distinguish among problems with erection, ejaculation, orgasm, or sexual desire.

Physical examination. To look for evidence of systemic problems, such as the following:

A problem in the nervous system may be involved if the penis does not respond as expected to certain touching.

Secondary sex characteristics, such as hair pattern, can point to hormonal problems, which involve the endocrine system.

Circulatory problems could be indicated by an aneurysm.

Unusual characteristics of the penis itself could suggest the basis of the impotence.

Laboratory tests. These can include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. Measurement of testosterone in the blood is often done in men with ED, especially with a history of decreased libido or diabetes.

Psychosocial examination. This is done to help reveal psychological factors that may be affecting performance. The sexual partner may also be interviewed to determine expectations and perceptions encountered during sexual intercourse.

Specific treatment for erectile dysfunction will be determined by yourdoctor based on:

Your age, overall health, and medical history

Extent of the disease

Your tolerance for specific medications, procedures, or therapies

Expectations for the course of the disease

Your opinion or preference

Some of the treatments available for ED include:

Sildenafil. A prescription medication taken orally for the treatment of ED. This drug works best when taken on an empty stomach and many men can get an erection 30 to 60 minutes after taking the medication. Sexual stimulation is required for sildenafil citrate to have the best efficacy.

Vardenafil. This drug has a similar chemical structure to sildenafil citrate and works in a similar manner.

Tadalafil. Studies have indicated that tadalafil citrate stays in the body longer than other medications in its class. Most men who take this medication find that an erection occurs within 4 to 5 hours after taking the pill (slow absorption) and the effects of the medication may last up to 24 to 36 hours.

Avanafil

The FDA recommends that men follow general precautions before taking a medication for ED. Men who are taking medications that contain nitrates, such as nitroglycerin, should NOT use these medications. Taking nitrates with one of these medications can lower blood pressure too much. In addition, men who take tadalafil or vardenfil should use alpha blockers with care and only as instructed by their physician, as they could result in hypotension (abnormally low blood pressure). Experts recommend that men have a complete medical history and physical examination to determine the cause of ED. Men should tell theirdoctor about all the medications they are taking, including over-the-counter medications.

Men with medical conditions that may cause a sustained erection, such as sickle cell anemia, leukemia, or multiple myeloma, or a man who has an abnormally-shaped penis, may not benefit from these medications. Also, men with liver diseases or a disease of the retina, such as macular degeneration or retinitis pigmentosa, may not be able to take these medications, or may need to take the lowest dosage.

These medical treatments should NOT be used by women or children. Elderly men are especially sensitive to the effects of these medical treatments, which may increase their chance of having side effects.

Testosterone replacement therapy may improve energy, mood, and bone density, increase muscle mass and weight, and heighten sexual interest in older men who may have deficient levels of testosterone. Testosterone supplementation is not recommended for men who have normal testosterone levels for their age group due to the risk of prostate enlargement and other side effects. Testosterone replacement therapy is available as a cream or gel, topical solution, skin patch, injectable form and pellet form placed under the skin.

Two types of implants are used to treat ED, including:

Inflatable Penile Prosthesis (3-piece hydraulic pump). A pump and two cylinders are placed within the erection chambers of the penis, which causes an erection by releasing a saline solution; it can also remove the solution to deflate the penis.

Semi-rigid Penile Prosthesis. Two semi-rigid but bendable rods are placed within the erection chambers of the penis, which allows manipulation into an erect or non-erect position.

Infection is the most common cause of penile implant failure and occurs less that 2 percent of the time. Implants are usually not considered until other methods of treatment have been tried but they have a very high patient satisfaction rate and are an excellent treatment choice in the appropriate patient.

Erectile dysfunction can cause strain on a couple. Many times, men will avoid sexual situations due to the emotional pain associated with ED, causing their partner to feel rejected or inadequate. It is important to communicate openly with your partner. Some couples consider seeking treatment for ED together, while other men prefer to seek treatment without their partner's knowledge. A lack of communication is the primary barrier for seeking treatment and can prolong the suffering. The loss of erectile capacity can have a profound effect on a man. The good news is that ED can usually be treated safely and effectively.

Feeling embarrassed about sexual health problems may prevent many men from seeking the medical attention they need, which can delay diagnosis and treatment of more serious underlying conditions. Erectile Dysfunction itself is often related to an underlying problem, such as heart disease, diabetes, liver disease, or other medical conditions.

Since ED can be a forewarning symptom of progressive coronary disease, doctors should be more direct when questioning patients about their health. By asking patients more directly about their sexual function through conversation or a questionnaire during a checkup, doctors may be able to detect more serious health conditions sooner.

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Erectile Dysfunction | Johns Hopkins Medicine

Hypogonadism, or Low Testosterone

Dr. Raymond Costabile and Dr. Ryan Smith specialize in the diagnosis and treatment of low testosterone.

Hypogonadism, also known as low testosterone or low T, can lead to symptoms of decreased energy and libido, difficulty building lean muscle mass, moodiness, difficulty concentrating, and even loss of bone density. Men who have some or all of these symptoms and demonstrate low testosterone on a blood draw are candidates for testosterone replacement therapy (TRT).

There are many options for TRT, each of which has its benefits and disadvantages. The decision about which one is right for you will depend on your personal preferences and a discussion with your doctor. In some cases, different insurance companies may cover one option and not another, which may also be taken into consideration. If the desired effects are not achieved with your initial choice, a different option can be tried to see if it is a better fit for you, your health, and your lifestyle.

Regardless of the type of testosterone replacement therapy chosen, you will need to first be evaluated by your doctor and then monitored at regular intervals (usually every 3-6 months) to confirm good control of your hypogonadal symptoms, check levels of testosterone and perform other related bloodwork, and to ensure that there are no potentially dangerous side effects.

The evaluation and follow-up regimen usually consists of the following:

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Testosterone Replacement Therapy - Department of Urology

TRT can be administered in a variety of ways, says Judson Brandeis, M.D., a board-certified urologist and sexual medicine expert in San Ramon, California. Consult with your health care provider to determine the best option for you.

TRT injections, self-administered under the skin or muscle, can be short-acting (one to two injections per week) or long-acting (one injection every two weeks), explains Dr. Brandeis. Testosterone levels are inconsistent with this delivery, with levels being highest right after injection and lowest before the next injection, he says.

Topical gels, creams, liquids and patches often last for about four days, says Dr. Brandeis. Theyre easy to apply and produce relatively steady levels.

Though tablet-like in appearance, buccal patches are placed on the gum line above your incisor teeth, says Dr. Brandeis, adding that the drug needs to be used every 12 hours.

Delivered as a gel thats pumped into each nostril, intranasal TRT is usually taken three times a day, says Dr. Brandeis, adding that this therapy can be expensive.

Pellets are fast-acting and placed under the skin of the upper hip or buttocks in about five to 10 minutes in a physicians office, says Dr. Brandeis. Over the course of four to six months this pellet dissolves, providing a consistent and stable level of medication, he says.

The FDA has approved two testosterone capsules that may be taken orally for the treatment of low testosterone. The capsules can be taken twice daily with food.

More:
Testosterone Replacement Therapy (TRT): Is It Right For You?

Welcome to Testosterone HQMen's Health's guide to the exciting, complicated, and revolutionary world of testosterone. For everything you need to know about T, click here.

TOPICAL TREATMENTS FOR hair loss. Gummy multivitamins. Generic formulations of Viagra. The online market for mens wellness is booming. And in the last couple years, that includes testosterone, which is easier to get than ever before.

Critical for regulating the male sex drive, testosterone plays a number of other key functions in the body. Its required for generating sperm. It helps to increase muscle mass, distribute body fat, and generate red blood cells. For men lacking in testosterone, the symptoms can be debilitating. Severe fatigue and depression. Irritability. No sex drive, brain fog, and anemia. Low-T guys have a harder time putting on muscle, and generally see more fat around their abdomen.

Testosterone levels, which are measured in nanograms per deciliter of blood, naturally wane as we age. The conventional wisdom, as spelled out by the American Urological Association, is that a healthy level is higher than 300 ng/dL; some experts argue that low is a little lower and starts at 264 ng/dL. Either way, doctors who specialize in hormone therapies say they are seeing a glut of guys whose testosterone levels are above 300 and are dealing with all the symptoms associated with a clinical diagnosis of testosterone deficiency.

Various boutique health companies, in response, now offer a spectrum of testosterone therapies, which have been extolled by the likes of Joe Rogan and Sylvester Stallone. There are straight-up replacement therapiesTRT, as its calledthat replenish levels of the hormone via creams, gels, pellets, or injections of either the subcutaneous or intramuscular kind. Tablets and supplements, intended to optimize the testosterone a guys already got, are also increasingly available. And forget in-person visits: The wellness businesses of today sell products that are shipped directly to consumers.

Administering testosterone is not like popping a multivitamin, to be sure. Replacing testosterone exogenously shuts down the bodys own production, which means you have to stay on it to maintain any positive effects. Younger guys should also consider their own fertility, since TRT can hinder or stop sperm production. And there are certainly ways to naturally keep your own testosterone levels at their peak: proper exercise, a good diet, and sufficient sleep are all good places to start. But many men with low or lower-than-average levels notice that their moods, muscles, and movesin the gym and in the bedroomare all improved by boosting or optimizing their T.

We recognize, though, that sifting through the options out there can be a bit daunting. What you need and where to get it are important questions. To say nothing of if you need testosterone therapy at all. So consider this your what-to-know-before-you-go shopping guide to online testosterone therapy.

Roman is a wellness company known for its array of services and its simplicitythat is, ease of use. Part of the reason is how Roman gets you going: a DIY blood test shipped to your home. The kit comes with all the materials required for finger-prick draws on two consecutive days. A smartphone app guides you step-by-step through the draws. The kit also comes with pre-printed postage so you can mail it back for analysis, which is completed in a week.

The other part? Roman has only two offerings. One is a supplement billed as testosterone support for guys with healthy levels. It contains ingredients common in multivitamins, as well as ashwagandha, a plant that has been shown, in some studies, to modestly increase your bodys natural testosterone levels.

Clomiphene citrate is the other, although its better known by its brand name, Clomid. Assume your blood test comes back showing low or lower-than-average T. A call with a doctor or nurse practitioner follows, and theyll help you decide your dosage of Clomid (if signs point to that drug being right for you in the first place, of course). The drug itself is not testosterone replacement at all. Rather, Clomid is a pill that stimulates more natural testosterone production, which it does by blocking estrogen receptors in the brain. (When that happens, the pituitary gland boosts production of luteinizing hormone, which acts on the Leydig cells in the testes to make more testosterone endogenously.)

Clomids main advantage is fewer of the side effects associated with traditional testosterone replacement, which can include testicular shrinkage and, in some cases, infertility. Our approach really has to do with maximizing the interaction between safety and efficacy, says Tzvi Doron, D.O., Romans chief clinical officer.

Costs:

Maximus caters to all men looking to optimize their testosterone, but its an appealing option for young guys who want to maintain their fertility but also need a boost in T.

Founded by clinical psychologist Cameron Sepah, Maximus doesnt offer testosterone replacement therapy at all. He calls it testosterone stimulation rather than replacement. (And his personal view is that TRT should be a last resort.) The company prescribes custom compounds of pure enclomiphene, one of Clomids two ingredients. Sepah says the reason for this is that Clomids other ingredient, zuclomiphene, can have estrogenic side effects. His sales pitch is pretty easy to boil down: The enclomiphene will quickly help your body generate more natural testosterone, minus the side effects that sometimes accompany replenishing with synthetic testosterone or popping Clomid.

Of the options here, Maximus is the quickest way to get going on testosterone optimization. You start with a quantitative ADAM, a series of questions on symptoms associated with low testosterone. Within 24 hours, a doctor makes an eligibility decision, and initiates a blood test thats shipped to consumersin this case, a shoulder-mounted device that uses microneedles to remove about a pinky-tips worth of blood. Within a week of shipping your blood sample back, youll have your first bottle of enclomiphene, if you qualify. A follow-up blood test after 30 days determines if your dosage needs any tinkering.

All Maximus patients are assigned a physician; all communication is done asynchronously through text and email. The company also provides health coaching to help guys optimize their diet, exercise, sleep schedules, and stress levels.

Our philosophy is that pharmacology and behavior change are synergistic, says Sepah. One of the biggest benefits of testosterone is increased motivation. We find it helps people make the behavior changes.

Costs:

If youre unclear about whether testosterone therapy is right for you, try Hone Health. According to Jack Jeng, M.D., Hones chief medical officer, the company only accepts patients with lower-than-normal testosterone levels. For guys who are borderline, Hones clinicians might suggest lifestyle changes (sleep, exercise, diet) for three months before jumping into a prescription.

We turn away a lot of patients, Dr. Jeng says. You have to make sure the benefits of treatment outweigh the risks.

You start with a blood test, usually self-administered at home via finger prick, to check biomarkers such as your levels of testosterone and estrogen. A 30-minute telehealth visit follows, and if the doctor deems you a good candidate for testosterone therapy, a second blood test is ordered to confirm the first reading. Within a few weeks, you could be on testosterone replacement, delivered at home in the form of creams, injections, or troches, depending on your preference.

If replacement isnt warranted, Hone can instead send Clomid. Unique to Hone is anastrozole, an inhibitor that blocks the conversion of testosterone to estrogenthat conversion can happen when aromatase, an enzyme contained in fat cells, breaks down testosterone. Whatever the case, patients receive follow-up blood tests and telehealth visits every three months in the first year to check for side effects and titrate dosages if necessary.

Give it at least 10 weeks before deciding whether or not this is working for you, says Dr. Jeng. Thats around the time when people start to notice that the benefits have started to really kick in.

Costs:

Blokes is for anyone who wants doctors controlling their testosterone therapy from start to finish. Every interaction with Blokes begins with a blood test, but these arent self-administered. Instead, Blokes schedules an appointment at a Labcorp or Quest Diagnostics facility. (For a surcharge, a phlebotomist can meet you at your home or workplace.)

These tests are the more conventional CBC, or complete blood count. Testosterone and estrogen levels are assessed, and so are your levels of luteinizing and follicle-stimulating hormonesthe pituitary hormones responsible for testosterone and sperm production, respectivelyas well as your cholesterol and lipids. A one-on-one clinical visit of at least 30 minutes then follows.

You want to know who that patient is before you start prescribing anything, says Amy Killen, M.D., one of Blokes clinicians. You dont want to throw this stuff out like candy.

Once youre in the Blokes system, youre assigned a physician and health coach who guide your therapy and make recommendations on nutrition, exercise, and other lifestyle factors. Testosterone replacement options include creams, injections, and troches, as well as nasal sprays and pellets (inserted into the body via a minor procedure). Clomid is on hand, too, as is pure enclomiphene. After 30 days: another blood test, along with another telehealth appointment. Its usually at this mark that Blokes consults with you to figure out if youre on the right form of testosterone therapy or drug.

We prioritize service over automation, says founder Josh Whalen. Every patient is getting some type of one-on-one follow-up with a provider.

Costs:

If youre as interested in health span and longevity medicine as you are in testosterone, then Opt Health is for you. Graham Simpson, M.D., one of the cofounders, has himself been on testosterone therapy for 27 years; hes 72, but doesnt look much older than 50.

Opt Health starts its prospective patients with a blood draw like all the other companies. These are done at a local Labcorp (or at home, with a visit from a nurse or phlebotomist). The blood test triggers an initial consultation, at which point Simpson, his cofounder Jeremie Walker, M.D., or one of Opts other half-dozen clinicians can take you through their testosterone options, which include creams, injections, and Clomid that are shipped directly in three-month allotments. Chances are that any testosterone treatment you end up taking will be paired with Opts offerings of amino-acid peptides or nutraceuticals.

Testosterone is a big part of our business, says Dr. Walker. But I actually have guys that are not on testosterone. Were focused on lifestyle optimizations.

Every three to four months, Opt Health repeats a blood draw followed by a consult with your clinician. A personalized online dashboard helps you track your progress, side effects, symptoms, and something Dr. Simpson calls your DNA age. (Theres your chronological ageyour birthdayand your biological age, he says.) In Opts view, fighting insulin resistance and inflammation is just as important to Opt as prescribing the right form of testosterone treatment.

Were very focused on reversing biological age, Dr. Simpson says. We look at nutrition, we look at exercise, we look at hormones, we look at stress, we look at sleep. We look at many, many things that optimize mens health.

Costs:

Andrew Zaleski, a writer based near Washington, D.C., covers science, technology, and business.

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5 Best Testosterone Replacement Therapy Services 2023

You can! Even if your T levels are within normal parameters, there are benefits to optimizing your testosterone levels.

The American Urology Association (AUA) cites a range of 300 to 800 nanograms per deciliter (ng/dL) as normal for the average male. Men whose testosterone levels fall below 300 ng/d are classified as having Low T and would definitely benefit from TRT programs like those provided by Renew Vitality.

Older men are more likely to have Low T; as men get older, their testosterone levels drop at a rate of approximately 1% per year after age 30 or 40. Nearly half of all men over the age of 80 suffer from Low T, but it is also present in a small percentage of younger men as well.

However, while some men may not technically have a testosterone level that ranks below 300 ng/dLs, they may still experience symptoms of Low T slightly diminished sexual function, minor fluctuations in mood and cognition.

For these people (whose T levels typically range between 300-500 ng/dL), it is entirely possible to optimize their testosterone levels with a dedicated TRT regimen. It is perfectly normal and safe to engage in TRT if you have slightly lower testosterone levels, and simply wish to get them back to levels higher in the normal range.

Renew Vitality welcomes patients who want to improve their physical health through testosterone replacement therapy. Our team of wellness professionals is more than happy to work with clients to figure out a treatment program that works for the individual, in addition to wellness programs that emphasize diet, exercise and other lifestyle changes.

Read more:
FAQ | Renew Vitality

Taking charge of your health is a big step. SynergenX is here to guide you through the rest of your journey towards achieving optimal health. If you are suffering from symptoms of Low T, chances are its not just one aspect of your life that is being negatively impacted. For men, testosterone replacement therapy is commonly used to treat hypogonadism, a condition that causes low levels of testosterone (low-t). Mens testosterone levels can decline naturally, typically around age 30. Certain health conditions, or even lifestyle habits can also cause Low T. Symptoms such as persistent tiredness, chronic fatigue, brain fog, sexual deficiencies, even depression could start to appear. Testosterone replacement therapy can help correct T levels and reverse these symptoms to get you feeling like you again. Finding out if you have Low T is easy. Just schedule an appointment at one of our clinics. A simple blood test will reveal if your T levels are low.

For men, testosterone replacement therapy is commonly used to treat hypogonadism, which can cause unnaturally low levels of testosterone (Low-T). Men can experience this condition at any age, so testosterone replacement therapy can help correct these levels and support sexual health, muscle mass and bone density.

If you would like to know more about the benefits or age-related side effects of testosterone replacement therapy, call SynergenX at 888.219.7259. Our skilled providers can help you determine if testosterone replacement therapy is right for you.

SynergenX Low-T clinics are located across Houston including Galleria, Katy, Kingwood, The Woodlands, Sugar Land, Vintage Park, Webster, Atascocita, Spring and Cypress; two Dallas locations located in McKinney and Walnut Hill; or if you are in the San Antonio area, visit clinics including NorthWest, NorthEast, New Braunfels, Sonterra, or Alamo Ranch. Experiencing the symptoms of Low-T in Chicago? Get more information about testosterone replacement therapy for men at the Burr Ridge office.

Link:
Testosterone Replacement Therapy for Men | SynergenX

Many pharmaceutical professionals promote the benefits of testosterone replacement therapy. They state that administering this hormone in the form of a gel, injection, or pellet can relieve the symptoms of low testosterone.

These symptoms can include:

Using a product such as testosterone pellets may relieve some of the symptoms associated with low testosterone levels. However, testosterone pellets have many risks and side effects. People should discuss these with a doctor before trying this treatment.

Testosterone pellets are a form of hormone replacement therapy. They are about the size of a grain of rice, and a doctor will implant them under the skin.

These pellets contain crystallized testosterone and deliver a steady, low dose of this hormone to the individual for up to 6 months at a time.

Although many people believe that testosterone replacement therapy can be beneficial, it can cause side effects and increase the risk of certain health conditions.

The possible side effects of testosterone replacement therapy include the following:

Too much testosterone can increase a persons risk of the following conditions:

Testosterone pellets also come with specific health risks. These risks include:

Taking testosterone supplements disrupts the bodys ability to make testosterone.

This means that when a person stops taking testosterone supplements, they may feel worse suddenly because their body has not adjusted to making testosterone on its own again yet.

Testosterone pellets work by emitting a steady, low level of testosterone over a period of several months. A doctor will typically implant the pellets under the skin, or subcutaneously, near the hip or on the buttocks. This procedure is quick and can take place in the doctors office.

First, the doctor will thoroughly clean the area where they plan to implant the pellets. They will then administer a local anesthetic before making a small incision in the skin and using a tool called a trocar to insert about ten pellets.

The pellets should release a steady dose of the hormone for several months following the implantation.

Testosterone pellets have received mixed feedback.

Many people who use some form of testosterone replacement therapy, including the pellets, report feeling an immediate boost in energy and sex drive.

In a 2014 study, only 17 percent of people who had testosterone replacement therapy chose to use testosterone pellets. However, of those who did, 70 percent were satisfied. The rate of satisfaction was similar for the testosterone gels and injections.

The same study shows that 64 percent of the people who chose testosterone pellets favored them over the other forms of therapy due to their ease of use.

A 2013 study investigating mens decisions to begin and stop using testosterone pellets reported that there was no difference in the testosterone levels of the men who continued to use testosterone pellets and those who discontinued the therapy.

Even so, many doctors still recommend testosterone pellets as an option for males with hypogonadism, a condition in which the body does not produce enough testosterone.

It can take some trial and error to achieve the correct testosterone dosage in replacement therapy.

However, the dosage is difficult to adjust when using testosterone pellets because adding or removing pellets requires an additional medical procedure each time.

As a result, some doctors recommend that people start with another form of testosterone replacement therapy, such as gels or injections, to get the dosage right before switching to testosterone pellets.

Most doctors will consider using testosterone pellets for a person once they have determined a dosage that alleviates the symptoms of low testosterone without raising red blood cell counts.

Medical professionals remain divided regarding the benefits of testosterone replacement therapy and whether or not it can help alleviate the symptoms of hypogonadism.

Harvard Mens Health advise people considering testosterone therapy to consult a doctor and learn about all of the side effects and risks before making a decision. They also recommend that people interested in this therapy try to boost their energy by making lifestyle changes first.

However, for people using testosterone replacement therapy, testosterone pellets may offer benefits over other forms of this treatment. Potential advantages include:

More research on testosterone replacement therapy is necessary to verify its benefits and minimize its potential risks. Testosterone pellets may be a more convenient treatment option than other forms of testosterone replacement therapy for those with hypogonadism.

However, people should not view testosterone pellets as a quick fix to boost their energy levels and sex drive. It is vital to always speak with a doctor before starting testosterone replacement therapy and to be aware of the potential side effects and risks.

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How effective are testosterone pellets: Side effects and benefits

FDA reviewed five observational studies4-8 and two meta-analyses of placebo-controlled trials9,10 to examine the risk of cardiovascular events associated with testosterone replacement therapy (TRT). The five observational studies were retrospective cohort studies that reported conflicting results. Two of these studies found statistically significant cardiovascular harm with TRT (Vigen and Finkle), 4-5 two studies found a statistically significant mortality benefit with TRT (Shores and Muraleedharan), 6-7 and one study was inconclusive (Baillargeon).8

The Vigen study evaluated male veterans who underwent angiography and had low testosterone concentrations. On average, testosterone-treated men were 64 years old and untreated men were 61 years old. This study found an increased risk with TRT compared to no TRT for the composite cardiovascular outcome of myocardial infarction, stroke, and death (Hazard Ratio [HR]=1.29, 95% Confidence Interval [CI]: 1.04-1.58).4

The Finkle study evaluated TRT users in a large claims database. The men included in this study were on average 54 years old. This study found an increased risk of non-fatal myocardial infarction during the 90 days following an initial prescription for TRT compared to the pre-TRT period (Relative Risk [RR]=1.36, 95% CI: 1.03-1.81).5

The Shores study evaluated a population of male veterans older than 40 years of age with low testosterone and found a decreased risk of all-cause mortality with TRT compared to no TRT (HR=0.61, 95% CI: 0.42-0.88).6

The Muraleedharan study evaluated men with type 2 diabetes in the United Kingdom. The main analysis assessed mortality in men with low serum testosterone concentrations compared to men with normal serum testosterone concentrations. Mortality was also assessed in a subgroup analysis of treated and untreated men with low serum testosterone; an increased risk of all-cause mortality in men with no TRT compared to those on TRT was found (HR=2.30, 95% CI: 1.30-3.90).7

Finally, the Baillargeon study evaluated men older than 65 years of age enrolled in Medicare and found no overall increase in risk of hospitalization for myocardial infarction when comparing those treated with TRT to those receiving no TRT (HR=0.84, 95% CI: 0.69-1.02).8

The Xu meta-analysis involved 27 published, randomized, placebo-controlled trials representing 2,994 mostly middle-aged and older male participants (1,773 treated with testosterone and 1,261 treated with placebo) who reported 180 cardiovascular-related adverse events.9 This study found that testosterone therapy was associated with an increased risk of adverse cardiovascular events (Odds Ratio [OR]=1.5, 95% CI: 1.1-2.1); however, methodological issues limit conclusions. These limitations include inconsistent and incomplete reporting of adverse events; substantial clinical heterogeneity in the design and conduct of the component trials and the types of cardiovascular outcomes included in the analyses; potential bias resulting from selection of component trials; and variable quality of the trials, particularly with regard to ascertainment of cardiovascular safety outcomes and balance in cardiovascular risk factors and discontinuation rates across study arms.

The Corona meta-analysis involved 26 published, randomized, controlled trials, 20 of which were also included in the Xu meta-analysis. The included studies represented 3,236 men (1,895 men treated with testosterone, 1,341 men treated with placebo) who reported 51 major adverse cardiovascular events, defined as cardiovascular death, non-fatal myocardial infarction or stroke, and serious acute coronary syndromes or heart failure.10 This study did not find a statistically significant increased risk of these cardiovascular events associated with testosterone treatment. Similar to the first meta-analysis, this study had methodological issues that limit conclusions. These issues include incomplete adverse event reporting in the published trials, clinical trial heterogeneity, possible treatment arm imbalances in cardiac risk factors, high or unbalanced discontinuation rates in some component trials, and the potential for bias in trial selection and interpretation of reported adverse events.

The five observational studies and the Xu meta-analysis were discussed at a joint meeting of the Bone, Reproductive and Urologic Drugs Advisory Committee and the Drug Safety and Risk Management Advisory Committee on September 17, 2014. Based on these findings, the advisory committee members were in general agreement that the signal of cardiovascular risk is weak and that only a prospective, well-controlled clinical trial could determine whether testosterone causes cardiovascular harm. The Corona study was recently published and could not be reviewed in time to be presented at the Advisory Committee meeting; however, we have reviewed the study and factored its findings into our overall assessment.

For complete reviews, background information, and minutes of the September 17, 2014, Advisory Committee meeting, click here.

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FDA Drug Safety Communication: FDA cautions about using testosterone ...

Hypogonadism is a common condition in the male population, with a higher prevalence in older men, obese men, and men with type 2 diabetes. It is estimated that approximately 35% of men older than 45 years of age and 30-50% of men with obesity or type 2 diabetes have hypogonadism.

Testosterone is an important sex hormone in men. It is secreted by the testes and is responsible for the typical male characteristics, such as facial, pubic, and body hair as well as muscle. This hormone also helps maintain sex drive, sperm production, and bone health. The brain and pituitary gland (a small gland at the base of the brain) control the production of testosterone by the testes.

Be open with your doctor about your medical history, all prescription and nonprescription drugs you are now taking, sexual problems, and any major changes in your life. Your doctor will take a thorough history of your symptoms and then complete a physical exam, including your body hair, breast tissue, and the size and consistency of the testes and scrotum.

Your doctor will also use blood tests to see if your total testosterone level is low. The normal range depends on the lab that conducts the test. To get a diagnosis of hypogonadism, you need at least two early morning (710 AM) blood tests that reveal low testosterone in addition to signs and symptoms typical of low testosterone. The cause of hypogonadism can be investigated further by your doctor. This might include additional blood tests, and sometimes imaging such as a pituitary MRI.

Male hypogonadism is a combination of low testosterone levels and the presence of any of these symptoms:

Over time, low testosterone may cause a man to lose body hair, muscle bulk, cause weak bones (osteoporosis), low red blood cells and smaller testes. Signs and symptoms (what you see and feel) vary from person to person.

There are many causes of hypogonadism. They may involve a problem with the testes or with the signal from the brain that controls testosterone secretion. Low testosterone can result from:

Improvement of testosterone levels can improve sexual concerns, bone health, muscle and anemia (low red cells in the blood). Hypogonadism can be treated with the use of doctor-prescribed testosterone replacement therapy. This treatment is safe and can be effective for men who are diagnosed with consistently abnormal low testosterone production and symptoms that are associated with this type of androgen (hormone) deficiency.

Although testosterone replacement therapy is the primary treatment option, some conditions that cause hypogonadism, such as obesity, can be reversible without testosterone therapy. These should be addressed before testosterone therapy is contemplated. If testosterone therapy is needed, goals of treatment are to improve symptoms associated with testosterone deficiency and maintain sex characteristics.

There are many different types of testosterone therapy. Method of treatment depends on the cause of low testosterone, the patients preferences, cost, tolerance, and concern about fertility. You should discuss the different options with your physician "your partner in care" to find out which therapy is right for you.

Injections: Self or doctor administered in a muscle every 12 weeks; administered at a clinic every 10 weeks for longer-acting. Side effects: uncomfortable, fluctuating symptoms.

Gels/Solutions: Applied to upper arm, shoulder, inner thigh, armpit. Side effects: may transfer to others via skin contact must wait to absorb completely into skin.

Patches: Adhere to skin every day to back, abdomen, upper arm, thigh; rotate locations to lessen skin reaction. Side effects: skin redness and rashes.

Buccal Tablets: Sticky pill applied to gums twice a day, absorbs quickly into bloodstream through gums. Side effects: gum irritation.

Pellets: Implanted under skin surgically every 36 months for consistent and long-term dosages. Side effects: pellet coming out through skin, site infection/ bleeding (rare), dose decreasing over time and hypogonadism symptoms possibly returning towards the end of dose period.

Nasal Gel: Applied by pump into each nostril 3x a day. Side effects: nasal irritation or congestion.

Sometimes a medication called clomiphene citrate is used to treat hypogonadism, but this is not FDA approved for this indication. A thorough discussion is needed with your doctor.

You should discuss with your physician how to monitor for prostate cancer and other risks to your prostate. Men with known or suspected prostate or breast cancer should not receive testosterone therapy. You should also talk to your doctor about the risks of testosterone therapy if you have, or are at risk for, heart disease or stroke. In addition, if you are planning fertility, you should not use testosterone therapy.

You should not receive testosterone therapy if you have:

Possible risks of testosterone treatment include:

If you are treated with testosterone, your doctor will need to see you regularly, along with blood tests.Testosterone therapy is only recommended for hypogonadism patients. Boosting testosterone is NOT approved by the US Food and Drug Administration (FDA) to help improve your strength, athletic performance, physical appearance, or to treat or prevent problems associated with aging. Using testosterone for these purposes may be harmful to your health.

There is no firm scientific evidence that long-term testosterone replacement is associated with either prostate cancer or cardiovascular events. The FDA requires that you are made aware that the possibility of cardiovascular events may exist during treatment. Prostate cells are stimulated by testosterone, so be extra vigilant about cancer screenings. African American men over age 45 especially those with family history of cancer are already at risk for prostate cancer.

Read the rest here:
Hypogonadism in Men | Endocrine Society