When Should Men Consider Testosterone Replacement Therapy?
Testosterone Replacement Therapy TRT: What to Know
Good luck finding a supplement study that measured testosterone more than once at the beginning and once at the end of the study. “You can’t have a sensible conversation about testosterone,” says Bradley Anawalt, chief of medicine at the University of Washington Medical Center. “Everybody thinks it’s going to make you stronger, faster, better looking, and better at sex. It doesn’t do that.” Here’s what “T-therapy” can do, how risky it is, and who might need it.
Researchers performed a clinical trial on men aged over 65 who took TRT for a period of 12 months. At the end of the 12 months results showed an increase of 4.0 ng/mL in antigen levels in 5% of the men. Certain existing health conditions make TRT unsafe, like prostate cancer, breast cancer and heart failure. This is why healthcare providers do extensive evaluations and tests before approving the use of TRT. If you don’t have these health concerns, TRT is generally safe. If you don’t notice an improvement in your symptoms after taking TRT for three to six months, your provider may recommend stopping the therapy.
Some testosterone supplements have been shown to cause health conditions such as erectile dysfunction and kidney failure. So, before you call that low-T clinic or click on an outlandish ad for testosterone-boosting supplements, find out what’s at stake for your health. There are safer, more cost-effective options to restore youthful energy – and potentially reverse fertility loss from previous testosterone products. Pharmacists should verify dosing, check for potential interactions, and provide thorough counseling for drug administration, which will vary depending on the treatment modality and formulation chosen. Hyperestrogenism can be an adverse effect of replacement therapy because testosterone undergoes aromatization to estrogen.[24] Aromatase inhibitors may be necessary.
But hormone therapy alone doesn’t cure prostate cancer, and many cancers become resistant to hormone therapy over time. Dr. Traci Kurtzer, a menopause specialist at the Northwestern Medicine Center for Sexual Medicine and Menopause in Chicago, agreed the push for testosterone started happening in recent years. Her patients inquire about testosterone therapy for multiple problems — to improve mood, energy, sex drive, brain fog and muscle mass. Historically, the concern for TRT was its effect on the prostate. Despite evidence that the prostate does enlarge slightly on TRT, no studies have shown any significant worsening of urinary symptoms while on therapy. Studies have also demonstrated no significant change in PSA while on therapy.
Where gaps in the evidence existed, the Panel provides guidance in the form of Clinical Principles or Expert Opinion with consensus achieved using a modified Delphi technique if differences of opinion emerged. A Clinical Principle is a statement about a component of clinical care that is widely agreed upon by urologists or other clinicians for which there may or may not be evidence in the medical literature. Expert Opinion refers to a statement, achieved by consensus of the Panel, that is based on members’ clinical training, experience, knowledge, and judgment for which there is no evidence. A large, 2010 meta-analysis of 51 studies looked at the safety of TRT. The report concluded that safety analysis of TRT is of low quality and fails to inform the public about potential long-term effects. Still think best testosterone booster for athletes [click through the next website] therapy turns guys into roid-raging gym rats?
One of the most persistent myths around TRT is that it makes men overly aggressive or “unnatural.” The reality? Access guideline recommendations, patient information, and clinical education modules for a range of endocrine topics plus dozens of interactive decision algorithms and other point-of-care tools. Everyone can benefit from an unbiased, listening ear now and then.
An additional potential benefit of this approach is that the temporary break from the side effects of hormone therapy may improve a man’s quality of life. Once starting testosterone replacement therapy, a man should have his testosterone levels closely monitored with blood work. Additional blood work is routinely checked while on testosterone therapy as well to help minimize some of the above risks. TestosteroneThe basic form of the treatment is to add more of the male hormone to the body. This can be through injections, creams, pills, or even injections under the skin. These hormones aim to raise a man’s testosterone levels to a more typical range. Recent studies had mixed findings about links between testosterone replacement therapy and increased risks of obesity, diabetes and metabolic syndrome.
By the 12-month mark, you are beginning to see optimal results and improvements in overall mood and mental health, decision making, and critical thinking. Testosterone therapy can help reverse the effects of hypogonadism, however, it is unclear whether testosterone therapy would benefit older men who are otherwise healthy. Although some men believe they feel younger and more vigorous if they take testosterone medications, there is little evidence to support the use of testosterone in otherwise healthy men. Guidelines from the American College of Physicians indicate that testosterone therapy might improve sexual function in some men, however, there is little evidence that it improves other functions, such as energy and vitality. LHRH antagonists can be used to treat advanced prostate cancer. These drugs work in a slightly different way from the LHRH agonists, but they lower testosterone levels more quickly and don’t cause tumor flare like the LHRH agonists do.
In the event these practices fail to raise a patient’s testosterone levels naturally, Dr. Muthigi says he then introduces the idea of external testosterone supplementation, or testosterone replacement therapy (TRT). Lots of things can affect testosterone levels, including lifestyle factors like diet, sleep, stress and weight. Age can too, as the glands responsible for regulating testosterone decline over time, along with certain medical conditions like diabetes and genetic disorders. Although TRT offers benefits to people with low testosterone levels, it can cause many short-term side effects. Past research found a correlation between TRT and lower urinary tract symptoms (LUTS) due to testosterone’s growth-promoting effects on the prostate. This is common among aging men who developed hypogonadism late in their life. Recent clinical trials support this theory, concluding that although TRT may help in reducing prostate inflammation, it does not lower urinary tract symptoms and may even make these symptoms worse in the long term.
The dosage and frequency of the treatment may vary depending on the person. However, these benefits were quite modest and went away with the discontinuation of TRT. Around half of the participants in the 2019 study still had bone mineral density in the ranges of osteopenia or osteoporosis while on TRT.
