Category Archives: Testosterone

For the Consumer

Applies to testosterone: buccal patch extended release

Along with its needed effects, testosterone may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking testosterone:

Get emergency help immediately if any of the following symptoms of overdose occur while taking testosterone:

Some side effects of testosterone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Applies to testosterone: buccal film extended release, compounding powder, intramuscular solution, nasal gel, subcutaneous implant, transdermal cream, transdermal film extended release, transdermal gel, transdermal ointment, transdermal solution

The most frequently reported side effects with this drug are edema, acne, site pain, injection site erythema, cough or dyspnea during or immediately after injection.

The most frequently reported side effects with testosterone topical are skin reaction (16.1%) and allergic contact dermatitis (up to 37%).[Ref]

Very common (10% or more): Testosterone topical: Skin reaction (16.1%), burn-like blisters (12%), itching, allergic contact dermatitis (up to 37%)Common (1% to 10%): Acne, induration, burningUncommon (0.1% to 1%): Alopecia, erythema, rash (including rash popular), pruritus, dry skin, folliculitis (testosterone topical)Frequency not reported: Seborrhea, urticaria, male pattern baldness, hirsutism injection site inflammationPostmarketing reports: Angioedema, angioneurotic edema, hyperhidrosis, discolored hair, leukocytoclastic vasculitis[Ref]

Very common (10% or more): Accelerated growthCommon (1% to 10%): Increased estradiol, hypogonadismUncommon (0.1% to 1%): Increased blood testosteroneFrequency not reported: Signs of virilization in women (e.g., hoarseness, acne, hirsutism, menstrual irregularity, clitoral enlargement, and alopecia), precocious puberty (in prepubertal males)Postmarketing reports: Hyperparathyroidism, prolactin increased, testosterone increased[Ref]

Very common (10% or more): Testosterone buccal film: Gingivitis (32.6%)Common (1% to 10%): Diarrhea, oily stools (due to IM injection oily solvent); Testosterone topical: Gastroesophageal reflux disease, gastrointestinal bleeding, gum or mouth irritation (9.2%), taste bitter, gum pain, gum tenderness, gum edema, taste perversionUncommon (0.1% to 1%): NauseaRare (less than 0.1%): Abdominal painFrequency not reported: Abdominal disorder, intraabdominal hemorrhagePostmarketing reports: Vomiting; Testosterone buccal film: Dry mouth, gingival swelling, lip swelling, mouth ulceration, stomatitis[Ref]

The majority of gum-related adverse events were transient.[Ref]

Very common (10% or more): Testosterone topical: Application site pruritus (up to 37%), application site blistering (12%)Common (1% to 10%): Injection site pain, injection site discomfort, injection site pruritus, erythema, injection site hematoma, injection site irritation, injection site inflammation; injection site reaction; Topical testosterone: Application site erythema, application site warmth, application site irritation, application site vesicles, application site exfoliation, application site burning, application site induration, bullae at application site, mechanical irritation at application site, rash at application site, contamination of application sitePostmarketing reports: Injection site abscess, procedural pain, application site swelling (topical testosterone)[Ref]

Common (1% to 10%): Hot flush, hypertensionUncommon (0.1% to 1%): Cardiovascular disorderFrequency not reported: Venous thromboembolismPostmarketing reports: Angina pectoris, cardiac arrest, cardiac failure, coronary artery disease, coronary artery occlusion, myocardial infarction, tachycardia, cerebral infarction, cerebrovascular accident, circulatory collapse, deep venous thrombosis, syncope, thromboembolism, thrombosis, venous insufficiency, stroke[Ref]

Common (1% to 10%): Abnormal prostate examination, benign prostate hyperplasia (BPH), ejaculation disorder, prostatitisUncommon (0.1% to 1%): Prostate induration, prostatic disorder, testicular pain, decreased urine flow, urinary retention, urinary tract disorder, nocturia, dysuriaRare (less than 0.1%): Micturition disorders, epididymitis, bladder irritability, impotence, inhibition of testicular function and testicular atrophyFrequency not reported: Oligospermia, priapism, benign prostatic hyperplasia (prostatic growth to eugonadal state), excessive frequency and duration of erections; Pediatrics: Precocious sexual development, an increased frequency of erections, phallic enlargementPostmarketing reports: Prostate infection, calculus urinary, dysuria, hematuria, urinary tract disorder, pollakiuria[Ref]

Common (1% to 10%): Polycythemia, hematocrit increasedUncommon (0.1% to 1%): Increased red blood cell count, increased hemoglobin, prolonged activated partial thromboplastin time, prolonged prothrombin timeFrequency not reported: Blood and lymphatic system disorders, suppression of clotting factors II, V, VII, and X, bleeding in patients on concomitant anticoagulant therapyPostmarketing reports: Thrombocytopenia, anemia[Ref]

Common (1% to 10%): Weight increased, appetite increased, fluid retention (sodium, chloride, water, potassium, calcium, and inorganic phosphates)Uncommon (0.1% to 1%): Increased glycosylated hemoglobin, hypercholesterolemia, increased triglycerideFrequency not reported: Abnormal lipids (decrease in serum LDL, HDL, and triglycerides), metabolism and nutrition disorders, hypercalcemiaPostmarketing reports: Hypoglycemia, diabetes mellitus, fluid retention, hyperlipidemia, hypertriglyceridemia, blood glucose increased[Ref]

Common (1% to 10%): Back pain, hemarthrosis (testosterone topical)Uncommon (0.1% to 1%): Arthralgia, pain in extremity, muscle spasm, muscle strain, myalgia, musculoskeletal stiffness, increased creatine phosphokinaseFrequency not reported: Pediatrics: Premature epiphyseal closure, increased bone formationPostmarketing reports: Musculoskeletal chest pain, musculoskeletal pain, myalgia, osteopenia, osteoporosis, systemic lupus erythematosus[Ref]

Common (1% to 10%): Headache, vertigo (topical testosterone)Uncommon (0.1% to 1%): Migraine, tremor, dizzinessFrequency not reported: Nervousness, paresthesiaPostmarketing reports: Cerebrovascular insufficiency, reversible ischemic neurological deficiency, transient ischemic attack, amnesia[Ref]

Common (1% to 10%): Prostatic specific antigen (PSA) increased, prostate cancerUncommon (0.1% to 1%): Prostatic intraepithelial neoplasiaRare (less than 0.1%): Neoplasms benign, malignant, and unspecified (including cysts and polyps)[Ref]

Common (1% to 10%): Fatigue, hyperhidrosis; chills, body pain, smell disorderUncommon (0.1% to 1%): Breast induration, breast pain, sensitive nipples, gynecomastia, increased estradiol, increased testosterone, asthenia, night sweats Rare (less than 0.1%): Fever, malaiseFrequency not reported: EdemaPostmarketing reports: Sudden hearing loss, tinnitus, Influenza like illness[Ref]

Common (1% to 10%): Irritability, insomnia, mood swings, aggression,Uncommon (0.1% to 1%): Depression, emotional disorder, restlessness, increased libido, decreased libidoFrequency not reported: Hostility, anxietyPostmarketing reports: Korsakoff's psychosis nonalcoholic, male orgasmic disorder, restlessness, sleep disorder[Ref]

Common (1% to 10%): Sinusitis, nasopharyngitis, upper respiratory tract infection, bronchitisUncommon (0.1% to 1%): Cough, dyspnea, snoring, dysphoniaRare (less than 0.1%): Pulmonary microembolism (POME) (cough, dyspnea, malaise, hyperhidrosis, chest pain, dizziness, paresthesia, or syncope) caused by oily solutionsFrequency not reported: Sleep apneaPostmarketing reports: Chest pain, asthma, chronic obstructive pulmonary disease, hyperventilation, obstructive airway disorder, pharyngeal edema, pharyngolaryngeal pain, pulmonary embolism, respiratory distress, rhinitis, sleep apnea syndrome[Ref]

Signs and symptoms of pulmonary microemboli may occur during or immediately after the injections and are reversible.[Ref]

Uncommon (0.1% to 1%): Abnormal LFT, increased ASTRare (less than 0.1%): Abnormal hepatic functionFrequency not reported: Jaundice, benign liver tumor, malignant liver tumor, liver enlargement, peliosis hepatitisPostmarketing reports: ALT increased, AST increased, bilirubin increased, transaminases increased, gamma-glutamyltransferase increased[Ref]

Uncommon (0.1% to 1%): Hypersensitivity reactionsFrequency not reported: Anaphylactic reactionsPostmarketing reports: Anaphylactic shock[Ref]

Uncommon (0.1% to 1%): Testosterone topical: Lacrimation increasedPostmarketing reports: Testosterone topical: Intraocular pressure increased, vitreous detachment[Ref]

Postmarketing reports: Nephrolithiasis, renal colic, renal pain[Ref]

1. "Product Information. Fortesta (testosterone)." Endo Pharmaceuticals (formally Indevus Pharmaceuticals Inc), Lexington, MA.

2. "Product Information. AndroGel (testosterone)." Unimed Pharmaceuticals, Buffalo Grove, IL.

3. Cerner Multum, Inc. "Australian Product Information." O 0

4. "Product Information. Testosterone Enanthate (testosterone)." West-Ward Pharmaceutical Corporation, Eatontown, NJ.

5. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

6. "Product Information. Axiron (testosterone)." Lilly, Eli and Company, Indianapolis, IN.

7. "Product Information. Testopel (testosterone)." Bartor Pharmacal Co, Inc, Rye, NY.

8. "Product Information. Aveed (testosterone)." Endo Pharmaceuticals Solutions Inc, Malvern, PA.

9. "Product Information. Testim (testosterone)." A-S Medication Solutions, Chicago, IL.

10. "Product Information. Androderm (testosterone topical)." SmithKline Beecham, Philadelphia, PA.

11. "Product Information. Depo-Testosterone (testosterone)." Pfizer U.S. Pharmaceuticals Group, New York, NY.

12. Bates GW, Cornwell CE "Iatrogenic causes of hirsutism." Clin Obstet Gynecol 34 (1991): 848-51

13. Dobs AS, Meikle AW, Arver S, Sanders SW, Caramelli KE, Mazer NA "Pharmacokinetics, efficacy, and safety of a permeation-enhanced testosterone transdermal system in comparison with bi-weekly injections of testosterone enanthate for the treatment of hypogonadal men." J Clin Endocrinol Metab 84 (1999): 3469-78

14. O'Driscoll JB, August PJ "Exacerbation of psoriasis precipitated by an oestradiol-testosterone implant." Clin Exp Dermatol 15 (1990): 68-9

15. Fyrand O, Fiskaadal HJ, Trygstad O "Acne in pubertal boys undergoing treatment with androgens." Acta Derm Venereol 72 (1992): 148-9

16. Traupe H, von Muhlendahl KE, Bramswig J, Happle R "Acne of the fulminans type following testosterone therapy in three excessively tall boys." Arch Dermatol 124 (1988): 414-7

17. Wu FC, Farley TM, Peregoudov A, Waites GM "Effects of testosterone enanthate in normal men: experience from a multicenter contraceptive efficacy study. World Health Organizatio Task Force on Methods for the Regulation of Male Fertility." Fertil Steril 65 (1996): 626-36

18. Bennett NJ "A burn-like lesion caused by a testosterone transdermal system." Burns 24 (1998): 478-80

19. Buckley DA, Wilkinson SM, Higgins EM "Contact allergy to a testosterone patch." Contact Dermatitis 39 (1998): 91-2

20. DeSanctis V, Vullo C, Urso L, Rigolin F, Cavallini A, Caramelli K, Daugherty C, Mazer N "Clinical experience using the Androderm (R) testosterone transdermal system in hypogonadal adolescents and young men with beta-thalassemia major." J Pediatr Endocrinol Metab 11 (1998): 891-900

21. Cefalu WT, Pardridge WM, Premachandra BN "Hepatic bioavailability of thyroxine and testosterone in familial dysalbuminemic hyperthyroxinemia." J Clin Endocrinol Metab 61 (1985): 783-6

22. Matsumoto AM "Effects of chronic testosterone administration in normal men: safety and efficacy of high dosage testosterone and parallel dose-dependent suppression of luteinizing hormone, follicle-stimulating hormone, and sperm production." J Clin Endocrinol Metab 70 (1990): 282-7

23. Tripathy D, Shah P, Lakshmy R, Reddy KS "Effect of testosterone replacement on whole body glucose utilisation and other cardiovascular risk factors in males with idiopathi hypogonadotrophic hypogonadism." Horm Metab Res 30 (1998): 642-5

24. Becker U, Gluud C, Bennett P "The effect of oral testosterone on serum TBG levels in alcoholic cirrhotic men." Liver 8 (1988): 219-24

25. Ferrera PC, Putnam DL, Verdile VP "Anabolic steroid use as the possible precipitant of dilated cardiomyopathy." Cardiology 88 (1997): 218-20

26. Jackson JA, Waxman J, Spiekerman AM "Prostatic complications of testosterone replacement therapy." Arch Intern Med 149 (1989): 2365-6

27. Zelissen PM, Stricker BH "Severe priapism as a complication of testosterone substitution therapy." Am J Med 85 (1988): 273-4

28. Wang C, Leung A, Superlano L, Steiner B, Swerdloff RS "Oligozoospermia induced by exogenous testosterone is associated with normal functioning residual spermatozoa." Fertil Steril 68 (1997): 149-53

29. Endres W, Shin YS, Rieth M, Block T, Schmiedt E, Knorr D "Priapism in Fabry's disease during testosterone treatment." Klin Wochenschr 65 (1987): 925

30. Parker LU, Bergfeld WF "Virilization secondary to topical testosterone." Cleve Clin J Med 58 (1991): 43-6

31. Zhang GY, Gu YQ, Wang XH, Cui YG, Bremner WJ "A clinical trial of injectable testosterone undecanoate as a potential male contraceptive in normal Chinese men." J Clin Endocrinol Metab 84 (1999): 3642-7

32. Anderson FH, Francis RM, Faulkner K "Androgen supplementation in eugonadal men with osteoporosis-effects of 6 months of treatment on bone mineral density and cardiovascula risk factors." Bone 18 (1996): 171-7

33. Bhasin S, Storer TW, Javanbakht M, et al. "Testosterone replacement and resistance exercise in HIV-infected men with weight loss and low testosterone levels." JAMA 283 (2000): 763-70

34. Bagatell CJ, Heiman JR, Matsumoto AM, Rivier JE, Bremner WJ "Metabolic and behavioral effects of high-dose, exogenous testosterone in healthy men." J Clin Endocrinol Metab 79 (1994): 561-7

35. Lajarin F, Zaragoza R, Tovar I, Martinezhernandez P "Evolution of serum lipids in two male bodybuilders using anabolic steroids." Clin Chem 42 (1996): 970-2

36. Zmuda JM, Thompson PD, Dickenson R, Bausserman LL "Testosterone decreases lipoprotein(a) in men." Am J Cardiol 77 (1996): 1244

37. Stannard JP, Bucknell AL "Rupture of the triceps tendon associated with steroid injections." Am J Sports Med 21 (1993): 482-5

38. Pollard M "Tumorigenic effect of testosterone." Lancet 336 (1990): 1518

39. Uzych L "Anabolic-androgenic steroids and psychiatric-related effects: a review." Can J Psychiatry 37 (1992): 23-8

40. Nuzzo JL, Manz HJ, Maxted WC "Peliosis hepatis after long-term androgen therapy." Urology 25 (1985): 518-9

41. Carrasco D, Prieto M, Pallardo L, Moll JL, Cruz JM, Munoz C, Berenguer J "Multiple hepatic adenomas after long-term therapy with testosterone enanthate. Review of the literature." J Hepatol 1 (1985): 573-8

42. Yu MW, Chen CJ "Elevated serum testosterone levels and risk of hepatocellular carcinoma." Cancer Res 53 (1993): 790-4

43. Falk H, Thomas LB, Popper H, Ishak KG "Hepatic angiosarcoma associated with androgenic-anabolic steroids." Lancet 2 (1979): 1120-3

Some side effects of testosterone may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

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Testosterone Side Effects in Detail - Drugs.com

Testosterone therapy: Potential benefits and risks as you age

Considering testosterone therapy to help you feel younger and more vigorous as you age? Know the risks before you make your decision.

The promise of testosterone therapy may seem enticing, but there are a lot of misconceptions about what the treatment can and can't do for you. As you get older, testosterone therapy may sound like the ultimate anti-aging formula.

Yet the health benefits of testosterone therapy for age-related decline in testosterone aren't as clear as they may seem. Find out what's known and not known about testosterone therapy for normal aging.

Testosterone is a hormone produced primarily in the testicles. Testosterone helps maintain men's:

Testosterone levels generally peak during adolescence and early adulthood. As you get older, your testosterone level gradually declines typically about 1 percent a year after age 30 or 40. It is important to determine in older men if a low testosterone level is simply due to the decline of normal aging or if it is due to a disease (hypogonadism).

Hypogonadism is a disease in which the body is unable to produce normal amounts of testosterone due to a problem with the testicles or with the pituitary gland that controls the testicles. Testosterone replacement therapy can improve the signs and symptoms of low testosterone in these men. Doctors may prescribe testosterone as injections, pellets, patches or gels.

Not necessarily. Men can experience many signs and symptoms as they age. Some may occur as a result of lower testosterone levels and can include:

Some of these signs and symptoms can be caused by various underlying factors, including medication side effects, obstructive sleep apnea, thyroid problems, diabetes and depression. It's also possible that these conditions may be the cause of low testosterone levels, and treatment of these problems may cause testosterone levels to rise. A blood test is the only way to diagnose a low testosterone level.

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Testosterone therapy: Potential benefits and risks as you ...

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In 1962 when Oakland became the first port on the West Coast to build terminals for container storage, the idea of container ship operations was still considered revolutionary by many. However, when you are considering Testosterone Replacement Therapy Cost in Oakland CA, keep in mind that male hormone replacement therapy is a proven medical treatment that has been in use for more than half a century. Our local doctor prescribed treatments have already helped scores of men in the Bay Area to restore their low t levels to the levels they had in their twenties, when their bodys naturally produced supply was at its highest. Because our therapy is prescribed on a patient by patient basis with individual requirements and goals in mind, we cannot provide you with a one-size-fits-all cost when it comes to receiving Testosterone Replacement Therapy in Oakland CA. However, we can assure you that our cost is always fair and competitive. We can also assure you that the vast majority of our patients consider the cost of treatments to be a priceless investment in their ongoing sexual satisfaction. You should also keep in mind that the outstanding and long-lasting benefits of testosterone cypionate injections will reward you with years of improved healthiness and vitality, and our therapy even encourages your body to resume producing its own natural male hormone supply once again! Just as investment in the Port of Oakland has resulted in a resource that today supports approximately 50,000 jobs in Northern California, our local doctor prescribed low t therapy is an investment in yourself that will continue to give back for years to come. We believe that every man deserves the opportunity to continue to feel as confident in your masculinity as you did in your twenties throughout your life and that the Testosterone Replacement Therapy Cost in Oakland CA is a small price to pay in exchange for years of enhanced healthiness and sexual satisfaction.

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Hormone replacement therapy (HRT) of the female-to-male (FTM) type is a form of hormone therapy and sex reassignment therapy that is used to change the secondary sexual characteristics of transgender and transsexual people from feminine (or androgynous) to masculine. It is one of two types of HRT for transgender and transsexual people (the other being male-to-female), and is predominantly used to treat transgender men. Some intersex people also receive this form of HRT, either starting in childhood to confirm the assigned sex or later if the assignment proves to be incorrect.

The purpose of this form of HRT is to cause the development of the secondary sex characteristics of the desired sex, such as voice deepening and a masculine pattern of hair, fat, and muscle distribution. It cannot undo many of the changes produced by naturally occurring puberty, which may necessitate surgery and other treatments (see below). The medications used in HRT of the FTM type include, mainly, androgens (namely testosterone) and GnRH analogues.

While HRT cannot undo the effects of a person's first puberty, developing secondary sex characteristics associated with a different gender can relieve some or all of the distress and discomfort associated with gender dysphoria, and can help the person to "pass" or be seen as the gender they identify with. Introducing exogenous hormones into the body impacts it at every level and many patients report changes in energy levels, mood, appetite, etc. The goal of HRT, and indeed all somatic treatments, is to provide patients with a more satisfying body that is more congruent with their gender identity.

Several contraindications to androgen therapy exist.[1] An absolute medical contraindication is pregnancy.

Relative medical contraindications are:

Hormone therapy for transgender individuals has been shown in medical literature to be safe in adults, when supervised by a qualified medical professional.[2]

Testosterone is metabolized by the cytochrome P450 enzyme system (specifically CYP3A isoforms) in the liver. There are certain drugs that increase or decrease the activity of cytochrome P450 enzymes and may cause increased or decreased levels of testosterone:

Testosterone can also alter the effects of other drugs:

Because of these interactions, it is advised that trans men make their healthcare providers aware of their hormone therapy, when this is relevant to their treatment for other medical issues.

The terminal half-life of testosterone in blood is about 70 minutes, so it is necessary to have a continuous supply of the hormone for masculinization.

'Depot' drug formulations are created by mixing a substance with the drug that slows its release and prolongs the action of the drug. The two primarily used forms in the United States are the testosterone esters testosterone cypionate (Depo-Testosterone) and testosterone enanthate (Delatestryl) which are almost interchangeable. Testosterone enanthate is purported to be slightly better with respect to even testosterone release, but this is probably more of a concern for bodybuilders who use the drugs at higher doses (2501000mg/week) than the replacement doses used by transgender men (50100mg/week). These testosterone esters are mixed with different oils, so some individuals may tolerate one better than the other. Testosterone enanthate costs more than testosterone cypionate and is more typically the one prescribed for hypogonadal males in the United States. Testosterone cypionate is more popular in the United States than elsewhere (especially amongst bodybuilders). Other formulations exist but are more difficult to come by in the United States. A formulation of injected testosterone available in Europe and the United States, testosterone undecanoate (Nebido, Aveed)[3][4] provides significantly improved testosterone delivery with far less variation outside the eugonadal range than other formulations with injections required only four times yearly. However, each quarterly dose requires injection of 4mL of oil which may require multiple simultaneous injections. Testosterone undecanoate is also much more expensive as it is still under patent protection. Testosterone propionate is another testosterone ester that is widely available, including in the United States, Canada, and Europe, but it is very short-acting compared to the other testosterone esters and must be administered once every 2 or 3 days, and for this reason, is rarely used.

The adverse side effects of injected testosterone esters are generally associated with high peak levels in the first few days after an injection. Some side effects may be ameliorated by using a shorter dosing interval (weekly or every ten days instead of twice monthly with testosterone enanthate or testosterone cypionate). 100mg weekly gives a much lower peak level of testosterone than does 200mg every two weeks, while still maintaining the same total dose of androgen. This benefit must be weighed against the discomfort and inconvenience of doubling the number of injections.

Injected testosterone esters should be started at a low dose and titrated upwards based on trough levels (blood levels drawn just before your next shot). A trough level of 500ng/dl is sought. (Normal range for a cisgender male is 290 to 900ng/dl).

Both testosterone patches, creams and gels are available. Both approximate normal physiological levels of testosterone better than the higher peaks associated with injection. Both can cause local skin irritation (more so with the patches).

Patches slowly diffuse testosterone through the skin and are replaced daily. The cost varies, as with all medication, from country to country, it is about $150/month in the US, and about 60 Euros in Germany.

Transdermal testosterone is available throughout the world under the brand names Andromen Forte, Androgel, Testogel and Testim. They are absorbed quickly when applied and produce a temporary drug depot in the skin which diffuses into the circulation, peaking at 4 hours and decreasing slowly over the rest of the day. The cost varies, as with all medication, from country to country, from as little as $50/month to about $280/month (in US Dollars).

Transdermal testosterone poses a risk of inadvertent exposure to others who come in contact with the patient's skin. This is most important for patients whose intimate partners are pregnant or those who are parents of young children as both of these groups are more vulnerable to the masculinizing effects of androgens. Case reports of significant virilization of young children after exposure to topical androgen preparations (both prescription and 'supplement' products) used by their caregivers demonstrates this very real risk.

Implants, as subcutaneous pellets, can be used to deliver testosterone (brand name Testopel). 6 to 12 pellets are inserted under the skin every three months. This must be done in a physician's office, but is a relatively minor procedure done under local anesthetic. Pellets cost about $60 each, so the cost is greater than injected testosterone when the cost of the physician visit and procedure are included. The primary advantages of Testopel are that it gives a much more constant blood level of testosterone yet requires attention only four times yearly.

Oral testosterone is provided exclusively as testosterone undecanoate. It is available in Europe and Canada, but not in the United States. Once absorbed from the gastrointestinal tract, testosterone is shunted (at very high blood levels) to the liver where it can cause liver damage (albeit very rarely) and worsens some of the adverse effects of testosterone, like lower HDL (good) cholesterol. In addition, the first pass metabolism of the liver also may result in testosterone levels too low to provide satisfactory masculinization and suppress menses. Because of the short terminal half-life of testosterone, oral testosterone undecanoate must be administered two to four times per day, preferably with food (which improves its absorption).

In 2003 the FDA approved a buccal form of testosterone (Striant). Sublingual testosterone can also be made by some compounding pharmacies. Cost for Striant is greater than other formulations ($180210/month). Testosterone is absorbed through the oral mucosa and avoids the 'first pass metabolism' in the liver which is cause of many of the adverse effect with oral testosterone undecanoate. The lozenges can cause gum irritation, taste changes, and headache but most side effects diminish after two weeks. The lozenge is 'mucoadhesive' and must be applied twice daily.

Synthetic anabolicandrogenic steroids (AAS), like nandrolone (as an ester like nandrolone decanoate or nandrolone phenylpropionate), are agonists of the androgen receptor (AR) similarly to testosterone but are not usually used in HRT for transgender men or for androgen replacement therapy (ART) in cisgender men. However, they can be used in place of testosterone with similar effects, and can have certain advantages like less or no local potentiation in so-called androgenic tissues that express 5-reductase like the skin and hair follicles (which results in a reduced rate of skin and hair-related side effects like acne, oily skin, seborrhea, excessive body hair growth, and, in particular, male-pattern baldness), although this can also be disadvantageous in a few aspects of masculinization (specifically facial hair growth, body hair growth, and clitoral enlargement). Although many AAS are not potentiated in androgenic tissues, they have similar effects to testosterone in other tissues like bone, muscle, fat, and the voice box. Also, many AAS, like nandrolone esters, are aromatized into estrogens to a greatly reduced extent relative to testosterone or not at all, and for this reason, are associated with reduced or no estrogenic effects (e.g., gynecomastia). AAS that are 17-alkylated like methyltestosterone, oxandrolone, and stanozolol are orally active but carry a high risk of liver damage, whereas AAS that are not 17-alkylated, like nandrolone esters, must be administered by intramuscular injection (via which they act as long-lasting depots similarly to testosterone esters) but have no more risk of liver damage than does testosterone.

For the sake of clarification, it should be noted that the term "anabolicandrogenic steroid" is essentially synonymous with "androgen" (or with "anabolic steroid"), and that natural androgens like testosterone are also AAS. These drugs all share the same core mechanism of action of acting as agonists of the AR and have similar effects, although their potency, pharmacokinetics, oral activity, ratio of anabolic to androgenic effects (due to differing capacities to be locally metabolized and potentiated by 5-reductase), capacity for aromatization (i.e., conversion into an estrogen), and potential for liver damage may all differ.

Dihydrotestosterone (DHT) (referred to as androstanolone or stanolone when used medically) can also be used in place of testosterone as an androgen. The availability of DHT is limited; it is not available in the United States or Canada, for instance, but it is available in certain European countries, including the United Kingdom, France, Spain, Belgium, Italy, and Luxembourg.[5] DHT is available in formulations including topical gel, buccal or sublingual tablets, and as esters in oil for intramuscular injection.[6] Relative to testosterone, and similarly to many synthetic AAS, DHT has the potential advantages of not being locally potentiated in so-called androgenic tissues that express 5-reductase (as DHT is already 5-reduced) and of not being aromatized into an estrogen (it is not a substrate for aromatase).

In all people, the hypothalamus releases GnRH (gonadotropin-releasing hormone) to stimulate the pituitary to produce LH (luteinizing hormone) and FSH (follicle-stimulating hormone) which in turn cause the gonads to produce sex steroids. In adolescents of either sex with relevant indicators, GnRH analogues, such as leuprorelin can be used to suspend the advance of sex steroid induced, inappropriate pubertal changes for a period without inducing any changes in the gender-appropriate direction. GnRH analogues work by initially over stimulating the pituitary then rapidly desensitizing it to the effects of GnRH. Over a period of weeks, gonadal androgen production is greatly reduced. There is considerable controversy over the earliest age, and for how long it is clinically, morally and legally safe to do this. The Harry Benjamin International Gender Dysphoria Association Standards of Care permit from Tanner Stage 2, but do not allow the addition of gender-appropriate hormones until 16, which could be five or more years. The sex steroids do have important other functions. The high cost of GnRH analogues is often a significant factor.

Antiestrogens (or so-called "estrogen blockers") like aromatase inhibitors (AIs) (e.g., anastrozole) or selective estrogen receptor modulators (SERMs) (e.g., tamoxifen) can be used to reduce the effects of high levels of endogenous estrogen (e.g., breast development, feminine fat distribution) in transgender men. In addition, in those who have not yet undergone or completed epiphyseal closure (which occurs during adolescence and is mediated by estrogen), antiestrogens can prevent hip widening as well as increase final height (estrogen limits height by causing the epiphyses to fuse).

5-Reductase inhibitors like finasteride and dutasteride can be used to slow or prevent androgenic alopecia (pattern hair loss) and various other adverse androgenic symptoms (e.g., acne) in transgender men taking testosterone.[7] However, they may also slow or reduce certain aspects of masculinization, such as facial and body hair growth and clitoral enlargement.[7] A potential solution is to start taking a 5-reductase inhibitor after these desired aspects of masculinization have been established.[7]

Depo-Provera (depot medroxyprogesterone acetate, or DMPA) may be injected every three months just as it is used for contraception. Generally after the first cycle, menses are greatly reduced or eliminated. This may be useful for transgender men prior to initiation of testosterone therapy.

In those who have not yet undergone or completed epiphyseal closure, growth hormone can be administered, potentially in conjunction with an aromatase inhibitor or a GnRH analogue, to increase final height.

The main effects of HRT of the FTM type are as follows:[8]

Many transgender men are unable to pass as cisgender men without hormones. The most commonly cited reason for this is that their voice may reveal them.

Facial changes develop gradually over time, and sexual dimorphism (physical difference between the sexes) tends to increase with age. Within a population of similar body size and ethnicity:

Frequently the first sign of endometrial cancer is bleeding in post-menopausal women. Transgender men who have any bleeding after the cessation of menses with androgen therapy should have an endometrial biopsy (and possibly an ultrasound) done to rule-out endometrial cancer.

A number of skeletal and cartilaginous changes take place after the onset of puberty at various rates and times. Sometime in the late teen years epiphyseal closure (in other words, the ends of bones are fused closed) takes place and the length of bones is fixed for life. Consequently, total height and the length of arms, legs, hands, and feet are not affected by HRT. However, details of bone shape change throughout life, bones becoming heavier and more deeply sculptured under the influence of testosterone. Many of these differences are described in the Desmond Morris book Manwatching.

The psychological changes are harder to define, since HRT is usually the first physical action that takes place when transitioning. This fact alone has a significant psychological impact, which is hard to distinguish from hormonally induced changes. Most trans men report an increase of energy and an increased sex drive. Many also report feeling more confident.

While a high level of testosterone is often associated with an increase in aggression, this is not a noticeable effect in most trans men. HRT doses of testosterone are much lower than the typical doses taken by steroid-using athletes, and create testosterone levels comparable to those of most cisgender men. These levels of testosterone have not been proven to cause more aggression than comparable levels of estrogen. It is assumed that the effect of the start of physical treatment is such a relief, and decreases pre-existing aggression so much, that the overall level of aggression actually decreases.

Some transgender men report mood swings, increased anger, and increased aggressiveness after starting androgen therapy. Many transgender men, however, report improved mood, decreased emotional lability, and a lessening of anger and aggression.

During HRT, especially in the early stages of treatment, blood work should be consistently done to assess hormone levels and liver function.

Israel et al. have suggested that for pre-oophorectomy trans men, therapeutic testosterone levels should optimally fall within the normal male range, whereas estrogen levels should optimally fall within the normal female range. Before oophorectomy, it is difficult and frequently impractical to fully suppress estrogen levels into the normal male range, especially with exogenous testosterone aromatizing into estrogen, hence why the female ranges are referenced instead. In post-oophorectomy trans men, Israel et al. recommend that both testosterone and estrogen levels fall exactly within the normal male ranges. See the table below for all of the precise values they suggest.[10]

The optimal ranges listed for testosterone only apply to individuals taking bioidentical hormones in the form of testosterone (including esters) and do not apply to those taking synthetic AAS (e.g., nandrolone) or dihydrotestosterone.

Original post:
Hormone replacement therapy (female-to-male) - Wikipedia

Introduction to testosterone replacement therapy

Testosterone replacement therapy is a treatment in which additional testosterone is added to a mans body (e.g. by injecting medicines that contain testosterone), to increase the concentration of testosterone in his body. It is used to treat hypogonadism, a condition characterised by low levels of testosterone in the blood and clinical symptoms of testosterone deficiency (e.g. lack of body hair, excessive breast growth). Hypogonadism occurs when a mans testes do not produce enough testosterone, either because the testes are not working properly, or because the hypothalamus or pituitary glandin the brain are not working properly. The hypothalamus and pituitary glands produce hormones that stimulate testosterone production in the testes.

The aim of testosterone replacement therapy is to increase blood testosterone concentrations to normal levels. In doing so, it can also restore the mans sex drive and expression of male sex characteristics (e.g. deep voice, body hair).

Testosterone is one of the oldest marketed drugs and has been used in testosterone replacement therapy since the 1930s.

Testosterone replacement therapy is used to treat men who have received a definitive diagnosis of hypogonadism. In order to be diagnosed with hypogonadism, a man musthave both low blood concentrations of testosterone and clinical symptoms of deficiency (e.g. lack of body hair, breast growth). As most of the causes that underlie testosterone deficiency (e.g. testicular dysfunction) are untreatable, most men who commence testosterone replacement therapy must be treated for the rest of their lives. In men with reversible or age-related causes of testosterone deficiency, testosterone replacement therapy is not used.

Ageing men (> 40 years of age)

As men age, their testosterone levels naturally decrease in a process sometimes called andropause or male menopause. This can lead to clinical symptoms of testosterone deficiency and/or low blood testosterone levels. There is no evidence that testosterone replacement therapy is beneficial for these men.

For older men, treatments that address the conditions causing or worsening testosterone deficiency (e.g.obesity, diabetes, chronic illness) may be effective.

Chronic or transient illness or recent trauma

Testosterone replacement therapy is rarely beneficial where hypogonadism is caused by illness (e.g. diabetes) or trauma (e.g. injury to the testicles). In these cases, the illness or trauma causing testosterone deficiency should be treated.

Prostate or breast cancer

Testosterone replacement therapy is not used to treat men with breast or prostate cancer, because there is a hypothetical risk that treatment may stimulate the growth of these cancers.

Competitive athletes

Use of testosterone replacement therapy may lead to disqualification for professional athletes.

Others

Testosterone replacement therapy is not used to treat men with the following conditions:

Testosterone replacement therapy is not used totreat infertility, erectile dysfunction or non-specific symptoms.

Certain conditions require special consideration before testosterone replacement therapy is used. Tell your doctor if you have:

The goal of testosterone replacement therapy is to restore blood testosterone to normal levels. When used to treat men with hypogonadism, it may also result in other benefits, including:

Improvements in blood testosterone levels and libido generally occur within the first week of treatment, and other benefits usually occur within two months.

It is important to note that testosterone replacement therapy typically induces a strong placebo effect in the initial stages of therapy. This means that many men who are treated with testosterone notice an improvement (e.g. bettersex drive), not because of the testosterone-containing medication has improved their testosterone concentrations, but because of the psychological effect of taking it. In short, some men think testosterone therapy is working and then feel better, even though the treatment does not work. This may lead to confusion and dissatisfaction as the placebo effect of treatment diminishes.

Most adult men begin receiving replacement testosterone at a dose sufficient for restoring blood testosterone to normal levels in men aged < 40 years. In boys who have not yet reached puberty and elderly men, lower doses are usually used at the beginning to avoid excessive increases in libido or energy, which may be dangerous. Once treatment has started, the doctor will monitor the mans blood testosterone levels and symptoms, and may need to adjust the dose depending on how these change.

Testosterone can be administered in various ways, depending on the person. Most men will first receive treatment in the form of testosterone injections every two weeks. Men who cannot receive injections (e.g. those with bleeding disorders) will receive different modes of testosterone treatment. The doctor may also change the type of testosterone administered if the man is dissatisfied with thecurrenttreatment. A doctor will try to prescribe a type of testosterone therapy that suits the patient in terms of cost, response and convenience, and individuals should talk to their doctor if they have concerns about any aspects of treatment.

Injectable testosterone

Injectable testosterone is the standard and most cost-effective treatment option. It can be used in all men except those with bleeding disorders. The injection is an oil-based solution containing testosterone. It is administered by intramuscular injection. Once injected, the solution gradually releases testosterone into the bloodstream.

The standard starting dose is one injection containing 200250 mg of testosterone every 23 weeks. The dose may be reduced to as little as 100 mg in very young or old men. The quantity and frequency of the dose will be adjusted by the doctor, according to the response to treatment. Men who do not achieve adequate increases in blood testosterone may have the dose increased, while those who gain too much blood testosterone may have the dose reduced.

Testosterone injections which are administered every two weeks are known as short-acting injectable testosterones(e.g. Sustanon). While they are effective in increasing blood testosterone levels and often improve symptoms (e.g.libido, mood, energy), testosterone levels and symptoms tend to fluctuate between injections. Men using these injections may experience very high peaks intestosterone levels and a resulting increase in libido and energy in the period immediately following the injection, followed by a period of much lower blood testosterone. Long-acting injections of testosterone (e.g. Reandron), which are administered every 3 months, provide an alternative for men who experience the peaktrough effect.

Long-acting testosterone injections provide testosterone replacement for 1014 weeks.They areadministered by injection deep into the gluteal muscle. The testosterone is released gradually into the bloodstream.

For more information on long-acting testosterone injections, see testosterone undecanoate (Reandron).

Transdermal testosterone patches

Testosterone patches that adhere to the skin may also be suitable for long-term testosterone replacement therapy. However, the patches contain substances that increase the absorption of testosterone, and these cause skin irritation in up to 50% of men who use them. Some 10% of men stop using testosterone patches because of skin irritation.Men may also discontinue use because they find the patches cosmetically displeasing. They may find other transdermal methodsof administrationmore appropriate (e.g. gels, creams).

Most men require a single patch containing 5 mg of testosterone daily. The patch can be applied to the abdomen, upper arm or thigh, and should be left in place for 24 hours after application, when a new patch should be applied.

For more information on testosterone patchess, seetestosterone (Androderm).

Oral testosterone

Oral testosterone therapy (e.g. Andriol Testocaps) uses testosterone undecanoate, the only natural form of testosterone that can be absorbed when taken orally. It may be more expensive and less effective than other modes of testosterone replacement, and is therefore usually used by men who cannot use other forms of testosterone. Oral therapy may also be used to treat older men who are starting therapy, as treatment can be stopped quickly if they are diagnosed with prostate cancer.

The starting dose varies and may be as low as 40 mg daily, although men typically require 160240 mg a day, taken in 24 doses. The doctor will adjust the dose, depending on the response to treatment. Oral testosterone should be taken with food, as this increases the amount of testosterone absorbed by the body.

Testosterone implants

Testsosterone implants contain 800 mg of testosterone (usually in the form of four 200 mg pellets). They are implanted into the buttocks or abdomen, and provide testosterone replacement for around six months. Implants are replaced periodically, once symptoms of testosterone deficiency recur. Inserting the testosterone pellets is a minor surgical procedure, requiring local anaesthetic; this is the major limitation of this method of treatment. However, men using this form of testosterone replacement are usually satisfied with the method, and are more likely to continue being treated than men using other modes of testosterone replacement.

Testosterone implants are not safe for use by older men, who have an increased risk of prostate cancer. If prostate cancer is diagnosed, testosterone replacement must be stopped immediately, which cannot be done if an implant is being used. Implants are also unsuitable for young men with bleeding disorders. Another form of testosterone replacement must be used first, so that a doctor can be sure they will not have any negative reaction to testosterone, before starting this long-term mode of treatment.

For more information on testosterone implants, see testosterone(Testosterone Implants).

Testosterone gel

Testosterone gels (e.g. Testogel)contain 1% testosteronethat is absorbed through the skin. The gel is applied to the skin on the abdomen, shoulder or arm on a daily basis. The standard dose is 5 g (50 mg testosterone), although the dose may be increased to as much as 10 g daily in some men, while others will respond adequately to 2.5 g daily.

Care must be taken to ensure the gel does not come into contact with the skin of individuals other than the man being treated (e.g. sexual partners, children) for at least six hours following application, as this may cause testosterone to be transferred to the contacts skin and absorbed by their body. Absorbing testosterone may be dangerous for children and women, especially pregnant women.

For more information on testosterone gel, see testosterone (Testogel).

Testosterone cream

Andromen forte (testosterone) is a cream containing 5% testosterone. It is ideally applied to the skin of the scrotum on a daily basis. The cream can be applied to the skin of the torso, back, chest, arms and legs, although a higher dose might be required if these sites are used, as less testosterone is absorbed compared to if the cream is applied to the scrotum. The usual starting dose is 1 g of cream (5 mg testosterone), but a doctor may adjust the dose depending on how the man responds to the treatment.

As the causes of testosterone deficiency are typically irreversible, testosterone replacement therapy is usually lifelong. Men who use testosterone replacement therapywill be monitored throughout their treatment to assess their response.

To assess the mans response to treatment, levels of testosterone in his blood are usually measured three months after the start of treatment. Levels of luteinising hormone (LH) may also be measured three to six months after treatment starts, as low levels of LH indicate that the treatment is effective.

If blood tests show that testosterone replacement therapy has failed to adequately increase concentrations of testosterone in the mans blood, hypogonadism may not be the cause of the symptoms. In these cases, testosterone replacement therapy will be stopped and the doctor will start treating other conditions that may contribute to testosterone deficiency.

A doctor will monitor changes to symptoms of testosterone deficiency and side effects of the treatment. This monitoring usually occurs three and six months after treatment commences and annually thereafter. A doctor will typically examine a man for signs of:

Tests that will usually be conducted periodically include:

Testosterone replacement therapy may sometimes be combined with treatment using PDE-5 inhibitors, a medication used to treat erectile dysfunction, for men with both hypogonadism and erectile dysfunction. It should be noted, however, that testosterone deficiency is rarely associated with erectile dysfunction.

Effective testosterone therapy has numerous immediate and long term benefits. These include:

Physical

Sexual

Psychological

The side effects associated with testosterone replacement therapy are rare and vary depending on the age of the man being treated, his life circumstances and health condition. They include:

Testosterone replacement therapy increases the risk of some health conditions, including:

Read more here:
Testosterone Replacement Therapy in Men | myVMC

What is Testosterone?Testosterone is the hormone produced by the testicles. It is responsible for the proper development of male sexual characteristics. It helps promote the circulation of blood, and is responsible for the maintenance of muscle bulk. Without an adequate testosterone level there can be important psychological affects such as loss of libido, reduced brain and intellectual activity and mood changes.What causes the Andropause? As all men age there is a gradual decline in the level of testosterone. This natural decline starts after 30 and continues throughout life. By the age of 40, testosterone levels drop by 1% every year. Many men however can experience a lack of testosterone production sufficient to result in significant symptoms. This will apply to approximately 50% of men by age 55. Damaged testicles or disease will affect testosterone production as will long-term stress, smoking and excessive alcohol consumption. In 60% of cases no cause can be identified and hereditary factors are implicated. Are there any health issues associated with the Andropause? Low levels of testosterone may result in an increase in tummy and chest fat, a decline in the amount of muscle in the body and decline in strength. Low levels can also lead to Brittle bones, (osteoporosis) which may lead to hip and spinal fractures. In addition the bone marrow is less active and produces less haemoglobin and red blood cells to transport oxygen around the body.

A consultation is required and blood tests will be necessary. The blood tests include an examination for prostate cancer, as this is a contraindication to testosterone treatment. Any suspicion of prostate cancer may require further investigations. The aim of therapy is to return the blood testosterone level in the bloodstream to the normal range for the man's age. This is achieved by using bio-identical testosterone cream that is rubbed onto the skin daily.

IF YOU THINK YOU MIGHT HAVE LOW TESTOSTERONE, check out our quick online self assessment test.

More:
Testosterone Replacement Therapy - Men's Health

Many men with low testosterone report improved energy levels, sex drive, and mood after testosterone treatment. If testosterone is low, why not replace it?

Not so fast. A low testosterone level by itself doesn't need treatment. Testosterone replacement therapy can have side effects, and the long-term risks and benefits aren't known. Only men with symptoms of low testosterone and blood levels that confirm this as the cause of symptoms should consider testosterone replacement. Talking with your doctor is the only way to know if testosterone therapy is right for you.

The symptoms of low testosterone are sometimes obvious, but they also can be subtle. Testosterone levels decline naturally in men as they age over decades. But certain conditions can also lead to an abnormally low level. Symptoms of low testosterone include:

If a man has symptoms of low testosterone and tests show he has an abnormally low testosterone level, a doctor may suggest treatment. For millions of men who have low testosterone levels but no symptoms, no treatment is currently recommended. It is has also not been approved for treating men with low levels because of aging.

Testosterone replacement therapy is available in several forms. All can improve testosterone levels:

Why not a simple testosterone pill? Oral testosterone is available. However, some experts believe oral testosterone can have negative effects on the liver. Using other methods, such as skin patches, gels, orally disintegrating tablets, or injections, bypasses the liver and gets testosterone into the blood directly.

What can you expect from testosterone treatment? It's impossible to predict, because every man is different. Many men report improvement in energy level, sex drive, and quality of erections. Testosterone also increases bone density, muscle mass, and insulin sensitivity in some men.

Men also often report an improvement in mood from testosterone replacement. Whether these effects are barely noticeable, or a major boost, is highly individualized.

Karen Herbst, MD, PhD, an endocrinologist at University of California-San Diego, specializes in testosterone deficiency. She estimates about one in 10 men are "ecstatic" about their response to testosterone therapy, while about the same number "don't notice much." The majority have generally positive, but varying responses to testosterone replacement.

Testosterone replacement therapy side effects most often include rash, itching, or irritation at the site where the testosterone is applied.

However, there is also evidence of an increased risk of heart attack or stroke associated with testosterone use. Experts emphasize that the benefits and risks of long-term testosterone therapy are unknown, because large clinical trials haven't yet been done.

There are a few health conditions that experts believe testosterone therapy can worsen:

It will be years before large clinical trials bring any answers on the long-term benefits and risks of testosterone therapy. As with any medicine, the decision on whether the possible benefits outweigh any risks is up to you and your doctor.

Isn't taking testosterone replacement basically the same as taking steroids, like athletes that "dope"? It's true that anabolic steroids used by some bodybuilders and athletes contain testosterone or chemicals that act like testosterone.

The difference is that doses used in testosterone replacement only achieve physiologic (natural) levels of hormone in the blood. The testosterone forms some athletes use illegally are in much higher doses, and often combined ("stacked") with other substances that boost the overall muscle-building (anabolic) effect.

SOURCES:

Drugs.com: "Androderm Side Effects."

Swerdloff, R. Journal of Clinical Endocrinology & Metabolism, 2000.

Striant.com.

Wilson, J. American Journal of Medicine, 1980.

Bhasin, S. Journal of Clinical Endocrinology and Metabolism, 2006.

Karen Herbst, MD, PhD, assistant professor in medicine, University of California, San Diego.

News release, FDA.

More here:
Testosterone Replacement Therapy: Testosterone Injections ...

Testosterone is a hormone produced by the testicles and is responsible for the proper development of male sexual characteristics. Testosterone is also important for maintaining muscle bulk, adequate levels of red blood cells, bone growth, a sense of well-being, and sexual function.

Inadequate production of testosterone is not a common cause of erectile dysfunction; however, when ED does occur due to decreased testosterone production, testosterone replacement therapy may improve the problem.

As a man ages, the amount of testosterone in his body naturally gradually declines. This decline starts after age 30 and continues throughout life. Some causes of low testosterone levels are due to:

Without adequate testosterone, a man may lose his sex drive, experience erectile dysfunction, feel depressed, have a decreased sense of well-being, and have difficulty concentrating.

Low testosterone can cause the following physical changes:

The only accurate way to detect the condition is to have your doctor measure the amount of testosterone in your blood. Because testosterone levels fluctuate throughout the day, several measurements will need to be taken to detect a deficiency. Doctors prefer, if possible, to test levels early in the morning, when testosterone levels are highest.

Note: Testosterone should only be used by men who have clinical signs and symptoms AND medically documented low testosterone levels.

Testosterone deficiency can be treated by:

Each of these options provides adequate levels of hormone replacement; however, they all have different advantages and disadvantages. Talk to your doctor to see which approach is right for you.

Men who have prostate cancer or breast cancer should not take testosterone replacement therapy. Nor should men who have severe urinary tract problems, untreated severe sleep apnea or uncontrolled heart failure. All men considering testosterone replacement therapy should undergo a thorough prostate cancer screening -- a rectal exam and PSA test -- prior to starting this therapy.

In general, testosterone replacement therapy is safe. It is associated with some side effects, including:

Laboratory abnormalities that can occur with hormone replacement include:

If you are taking hormone replacement therapy, regular follow-up appointments with your doctor are important.

Like any other medication, directions for administering testosterone should be followed exactly as your doctor orders. If you are unsure or have any questions about testosterone replacement therapy, ask your doctor.

SOURCE:

Get-Back-On-Track.com.

The Hormone Foundation.

News release, FDA.

Follow this link:
Testosterone Replacement Therapy - webmd.com

Testosterone is a hormone produced by the testicles and is responsible for the proper development of male sexual characteristics. Testosterone is also important for maintaining muscle bulk, adequate levels of red blood cells, bone growth, a sense of well-being, and sexual function.

Inadequate production of testosterone is not a common cause of erectile dysfunction; however, when ED does occur due to decreased testosterone production, testosterone replacement therapy may improve the problem.

As a man ages, the amount of testosterone in his body naturally gradually declines. This decline starts after age 30 and continues throughout life. Some causes of low testosterone levels are due to:

Without adequate testosterone, a man may lose his sex drive, experience erectile dysfunction, feel depressed, have a decreased sense of well-being, and have difficulty concentrating.

Low testosterone can cause the following physical changes:

The only accurate way to detect the condition is to have your doctor measure the amount of testosterone in your blood. Because testosterone levels fluctuate throughout the day, several measurements will need to be taken to detect a deficiency. Doctors prefer, if possible, to test levels early in the morning, when testosterone levels are highest.

Note: Testosterone should only be used by men who have clinical signs and symptoms AND medically documented low testosterone levels.

Testosterone deficiency can be treated by:

Each of these options provides adequate levels of hormone replacement; however, they all have different advantages and disadvantages. Talk to your doctor to see which approach is right for you.

Men who have prostate cancer or breast cancer should not take testosterone replacement therapy. Nor should men who have severe urinary tract problems, untreated severe sleep apnea or uncontrolled heart failure. All men considering testosterone replacement therapy should undergo a thorough prostate cancer screening -- a rectal exam and PSA test -- prior to starting this therapy.

In general, testosterone replacement therapy is safe. It is associated with some side effects, including:

Laboratory abnormalities that can occur with hormone replacement include:

If you are taking hormone replacement therapy, regular follow-up appointments with your doctor are important.

Like any other medication, directions for administering testosterone should be followed exactly as your doctor orders. If you are unsure or have any questions about testosterone replacement therapy, ask your doctor.

SOURCE:

Get-Back-On-Track.com.

The Hormone Foundation.

News release, FDA.

See original here:
Testosterone Replacement Therapy - WebMD

Bryant Stamford, Special to the Courier-Journal Published 7:00 a.m. ET Sept. 7, 2017

A study suggests that exercise can reduce the risk of heart damage for middle-aged adults and seniors. According to the study, even those who are obese will benefit from physical activity. Wochit

Man working out(Photo: Minerva Studio, Getty Images/iStockphoto)

Testosterone (T) is a naturally occurring hormone in men, and most of it is produced in the testicles.

At puberty, T production escalates, bringing about masculinizing changes in muscle mass. also promotes sex drive, sperm and red blood cell production, bone massand determines how men store body fat.

It can impact quality of life issues as well, like mood, energy and motivation.

Beginning at about age 30, T production begins to decline on average by about 1 percent per year, plummeting late in life. This causes all sorts of problems, including lack of sex drive, inability to sleep, loss of muscle and bone mass, increased belly fat, the list goes on. Reversing these symptoms and improving the quality of life is the reason T replacement therapy (TRT) clinics supervised by physicians have sprung up around the country.

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Although it is considered a male hormone, women also produce a modest amount of T in the ovaries. After menopause, estrogen production declines, which alters the ratio of estrogen to T, explaining why women begin taking on some male characteristics, like storing more fat around the midsection, rather than on the hips, thighs and buttocks as occurs earlier in life.

Is TRT a good thing? It can bewhen managed responsibly. If you are older, and your T level is very low and falls below the normal range, it makes sense to address it with TRT because it can negatively impact health, increasing risks associated with diabetes, obesity and osteoporosis. Low T also may shorten life, but this is controversial because when TRT raises T levels it has not been shown to extend life.

More is not always better, and many TRT clinics are viewed with suspicion because they advertise that its possible to feel like you are 25 years old again, even though you are decades older. Perhaps this is possible, but at what price, and if you are taking huge doses of T, could you be damaging your health?

Research studies in 2013 and 2014 indicated that TRT increased the risk of heart disease in men 65 and older, and in younger men with a history of heart disease. However, subsequent studies refute these findingsand some show a deceased risk of heart disease. Another area of concern is an increased risk of prostate cancer, but this, too, is controversial. There does appear to be solid evidence that TRT can increase the risk of blood clots and stroke, plus sleep apnea, acne and breast enlargement.

All in all, some experts believe the benefits outweigh the risks, while others are more cautious because TRT hasnt been around long enough or impacted enough men to draw meaningful conclusions. Time will tell. In the meantime, like most things in life, moderation is the best approach.

Anabolic steroids (AS) are synthetic steroid hormones that resemble T. AS require a doctors prescription and were developed to promote muscle mass in postsurgical patients, particularly older patients. Unfortunately, AS use spilled over to strength athletes who wanted the advantages associated with increased muscle mass, and AS delivered as promised. This, in turn, inspired gross overdosing with AS as a means to producing freaky muscular proportions and super human strength.

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AS can cause a long list of negative side effects, the most serious being growth of tumors in the liver and acceleration of atherosclerosis (clogging of the arteries). AS suppress HDL (good cholesterol) production, which leads to a ratio of bad to good cholesterol that is out of whack, promoting clogged arteries and ultimately leading to a heart attack. Worse, because a doctors prescription is required, AS often are obtained illegally from foreign countries through the mail, with no sense of the quality of the product or the dangers involved.

When I was young, I was an enthusiastic weight lifter, working out hours every day. Some of my friends went the AS route and developed amazing physiques. Recently, I have endeavored to track them down to see how they are doing, and I was saddened to learn that too many have died prematurely, in their fifties and sixties, some even earlier. The most likely cause was a heart attack.

TRT has a place and can be beneficial if managed prudently. Just be careful of extreme approaches and promises that seem too good to be true. As for AS, there is no justifiable reason for athletes to be taking them. Ever!

Reach Bryant Stamford, a professor of kinesiology and integrative physiology at Hanover College, at stamford@hanover.edu.

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Is testosterone replacement therapy the right thing for aging males? - The Courier-Journal