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Replacement therapy, testosterone: The practice of giving testosterone to treat conditions in which the testes do not produce enough testosterone. LSA or BXO when it affects men, LS when it affects women or in referring to the disease in general. In recent years, testosterone replacement therapy (TRT) for low testosterone has gained widespread interest from aging men and acceptance from the medical community.
Testosterone replacement therapy is the hormone treatment of testosterone prescribed by a physician to counter the effects of low testosterone. The official term for this decline is late onset hypogonadism (LOH) also known as andropause.
To determine whether or not you have low testosterone, a physician will request a blood test to measure your total testosterone level. However, no absolute consensus among different medical organizations exists for the exact cutoff value.
These symptoms may be caused by an unrelated issue, so experiencing one or more of these symptoms does not necessarily mean you have low T. The ADAM Questionnaire also helps men decide if they should talk to their doctor about low testosterone. Testosterone Injections – Injectable testosterone delivers testosterone deep into the muscle via an injection.
Testosterone Implants – Implants in the form of small pellets are implanted under the skin in the fat layer by your physician.
Testosterone Lozenges – Lozenges are placed under the tongue or against the surface of your gums twice daily.
Testosterone replacement therapy in men has shown to produce numerous benefits with minimal side effects, and these benefits can be both physical and mental. Although some benefits appear in the first month of therapy, most effects begin to take place over the first few months.
Side effects of testosterone replacement therapy are generally minimal as long as testosterone is kept within the normal range. For years, physicians have worried that one of the potential side effects of testosterone replacement therapy would be the causing or worsening of prostate cancer. Interestingly, a new meta-analysis (Testosterone Replacement Therapy and Cardiovascular Risk: Advances and Controversies) in the Mayo Clinic Proceedings published during this FDA review says there is no evidence of increased cardiovascular risks in its analysis. As mentioned above, one side effect of testosterone replacement therapy is temporary infertility. Fortunately, maintaining fertility may be accomplished by also taking human chorionic gonadotropin (HCG) during testosterone replacement therapy.
It should be noted that there is not complete agreement on the threshold value of testosterone below which a man would be considered to have low testosterone. Consequently, there are some interesting questions yet to be answered regarding the definition of low testosterone and the implementation of testosterone replacement therapy in men. Should the existence of clinical symptoms of low testosterone, despite a normal level, constitute a medical diagnosis by itself? Ultimately, the diagnosis of low testosterone and the decision to pursue testosterone replacement therapy is typically considered on an individual basis rather than simply being based on numerical guidelines for generally accepted “normal” testosterone levels. For those with low testosterone, combining proper diet and exercise and good sleep with testosterone replacement therapy can make you both stronger and leaner and feel better. Testosterone Replacement Therapy (TRT) Follow-Up Care Why should you continue to follow-up with your physician throughout your course of testosterone replacement therapy? Common Testosterone Therapy Mistakes to Avoid Testosterone therapy for men with clinically low testosterone can potentially improve health and quality of life.
ADAM Questionnaire: Androgen Test Androgen deficiency is a relatively common problem in older men.

With an aging male population, less stigma, and more popular advertisement, more and more men are consulting with their physicians about testing for low testosterone and initiating TRT.
The following EMG Testosterone Section provides an in-depth review of TRT to make you a better-informed man.
In men testosterone production slowly declines after early adulthood as part of the normal aging process. Men with low testosterone and the associated symptoms may benefit from testosterone replacement therapy. Nonetheless, it is important to be aware of these potential symptoms and discuss them with your physician. Testosterone most commonly comes in one of the following forms: 1) gels, 2) injections, 3) implants, or 4) lozenges.
This form is the newest form of testosterone, so most options are available under a brand name.
They slowly deliver testosterone over the course of three to six months, so only two to four implants must be performed per year.
The lozenge is designed to adhere to the gum or inner check for a 12 hour period, after which time it is replaced. This meta-analysis is the largest to date, and it revealed no increase in cardiovascular risks in men who received testosterone. Testosterone therapy suppresses the natural production of testosterone by the testes, which also reduces sperm production. Adding HCG to TRT may sustain continued sperm production necessary for conception in patients on testosterone therapy.28-29 (For more information, see EMG’s Human Chorionic Gonadotropin and Testosterone Therapy Article). The wide normal testosterone range presents a major challenge in defining low testosterone levels. Anderson RJ, Bergman DA, Garber JR, Hamilton CR, Hershon KS, Jovanovic LG, Kleerekoper M, Mechanick JI, Palumbo PJ, Peters AL, Rettinger HI, Rodbard HW, Rubenstein HA, Seibel JA, Tourtelot JB.
Wang C, Nieschlag E, Swerdloff R, Behre HM, Hellstrom WJ, Gooren LG, Kaufman JM, Legros JJ, Lunenfeld B, Morales A, Morley JE, Schulman C, Thompson IM, Weidner W, and Wu FCW. Namiki M, Akaza H, Shimazui T, Ito N, Iwamoto T, Baba K, Kumano H, Koh E, Tsujimura A, Matsumiya K, Horie S, Maruyama O, Marumo K, Yanase T, Kumamoto Y. Coviello AD, Matsumoto AM, Bremner WJ, Herbst KL, AmoryJK, Anawalt BD, Sutton PR, Wright WW, Brown TR, Yan X, Zirkin BR, Jarow JP. This article helps you understand the benefits, risks, and side effects of testosterone replacement therapy.Testosterone Replacement Therapy - Testosterone TreatmentWe provide testosterone replacement therapy for men and women.
Here, you will learn about testosterone levels and aging, symptoms of low testosterone, as well as TRT benefits and side effects. Each form possesses different time between applications, ease of administration, and potential for side effects. Subsequently, the FDA voted to require manufacturers of testosterone to change labeling to inform of possible increased risk of heart attack and stroke with use. Fortunately, certain healthy lifestyle choices, such as weight lifting, vigorous aerobic exercises, and proper diet, may actually increase testosterone production naturally. Longitudinal assessment of serum free testosterone concentration predicts memory performance and cognitive status in elderly men. Longitudinal changes in testosterone, luteinizing hormone, and follicle-stimulating hormone in healthy older men. Prevalence and incidence of androgen deficiency in middle-aged and older men: estimates from the Massachusetts Male Aging Study. Testosterone replacement therapy in men with androgen deficiency syndromes: an Endocrine Society Clinical Practice Guideline.
American association of clinical endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hypogonadism in adult male patients.

Investigation, treatment and monitoring of late-onset hypogonadism in males ISA, ISSAM, EAU, EAA and ASA recommendations. Testosterone administration to older men improves muscle function: molecular and physiological mechanisms. Testosterone substitution of hypogonadal men prevents the age-dependent increases in body mass index, body fat and leptin seen in healthy ageing men: results of a cross-sectional study. Exogenous testosterone or testosterone with finasteride increases bone mineral density in older men with low serum levels.
Androgen and erythropoiesis: evidence for an androgen receptor in erythroblasts from human bone marrow cultures. Polycythemia as a complication of testosterone replacement therapy in nursing home men with low levels.
The short-term effects of high-dose testosterone on sleep, breathing, and function in older men.
Testosterone: its role in development of prostate cancer and potential risk from use as hormone replacement therapy. Serum testosterone and sex hormone-binding globulin concentrations and the risk of prostate carcinoma: a longitudinal study. Prostate volume in testosterone-treated and untreated hypogonadal men in comparison to age-matched normal controls. Association of testosterone therapy with mortality, myocardial infarction, and stroke in men with low testosterone levels. Increased Risk of Non-Fatal Myocardial Infarction Following Testosterone Therapy Prescription in Men. Low-Dose Human Chorionic Gonadotropin Maintains Intratesticular Testosterone in Normal Men with Testosterone-Induced Gonadotropin Suppression.
Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. Does-dependent effects of testosterone on sexual function, mood, and visuospatial cognition in older men. As with estrogen replacement therapy for women, dosing must be carefully calibrated to gain the greatest benefits without unwanted side-effects. Also, learn about different administration methods (including transdermal, injectable, implantable, transbuccal and oral forms) as well as ways to increase testosterone naturally.
Even worse, free testosterone (the active form of testosterone not bound to sex hormone binding globulin (SHBG)) declines even more than total testosterone.1-3 Free testosterone is the free, active form of testosterone in the body. Your doctor can perform simple blood tests to determine whether your testosterone levels are low or not.
On the other hand, certain poor lifestyle choices, such as smoking and heavy drinking, may actually significantly decrease testosterone. As a note, infertility is usually reversible if the testosterone dosage is either decreased or TRT is stopped all together.15 While this side effect may not concern certain men, men looking to conceive a child or remain fertile must be aware of this potential side effect. This means that one man could have a level 2-3x higher than that of another man, while both are considered normal. Additional tests of use include a measurement of LH (luteinizing hormone) levels, FSH (follicle stimulating hormone) levels, prolactin levels, and a full thyroid panel.
These include testosterone cypionate, enanthate, and undecanoate (under the brand name Aveed).

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