What is testosterone?
Testosterone is a naturally produced hormone by the body. Testosterone helps maintain men’s fat distribution, muscle strength and mass, bone density, sperm production, sex drive and red blood cell production. It may be used as replacement therapy for males who have low levels of naturally produced testosterone. The disease that affects the ability of the body to produce normal amounts of testosterone is called hypogonadism. Testosterone therapy increases the muscle mass, improve the energy level, boost the libido, sharpen the memory and concentration and improve the signs and symptom of low testosterone levels in men. It is available for use as injections, patches, pellets or gels. Prior to commencing the replacement therapy all patients need to make necessary tests in order to determine the level of testosterone and if the levels of testosterone are low determine the causes (either due to the decline of normal aging or if it is due to hypogonadism).
The symptoms of lower testosterone levels appear slowly and sometimes these might be subtle. Some of them are:
·Changes in sleep patterns like insomnia or other sleep disturbances.
·Changes in sexual function determined by decreased sexual desire, erectile dysfunction and infertility.
·Physical changes such as increased body fat, decreased bone density, swollen or tender breasts (gynecomastia) and body hair loss. Males may also experience reduced muscle bulk and strength, hot flashes and less energy than usually.
·Emotional changes such as decreased self-confidence and motivation. Males might also feel sad, depressed, irritability, have difficulty in remembering things and concentrating.
Most of the signs and symptoms of lower testosterone levels may be part of normal aging. However, there might be other factors contributing to the decrease in testosterone levels, such as medication side effects, abuse of alcohol, thyroid problems or depression. The blood tests are relevant in identifying the causes of low testosterone levels. Get informed about all potential risks to your particular medical condition and follow the therapy exactly as prescribed.
Potential risks of testosterone therapy for normal aging
Like any other replacement therapy, testosterone therapy has various risks. Generally, testosterone replacement therapy is safe and the side effects are mild and infrequent. However, risks from testosterone therapy should be considered. Some of them are the following:
·Increased risk of a heart attack;
·Sleep apnea which is a serious sleep disorder in which breathing stops and starts repeatedly;
·Acne and other skin reactions;
·Benign prostatic hyperplasia. Testosterone may stimulate noncancerous growth of the prostate and also contribute to the growth of existing prostate cancer.
·Limit sperm production or cause testicle shrinkage.
·Erythrocytosis (high blood counts). Testosterone supplements may increase the red blood cell count. It is necessary to make regular blood tests in order to track the red blood cell count and avoid the risk of erythrocytosis.
·Testosterone might also cause such side effects as rash, itching and irritation at the site where the testosterone is applied.
·Congestive heart failure. Men with existed congestive heart failure should avoid the replacement therapy due to worsening of existing condition.
Due to the various potential risks from testosterone therapy, it is important to talk to a doctor before starting to take testosterone medications. It is not advisable to treat normal aging with testosterone therapy. If there are not obvious reasons of starting to take testosterone therapy, men are not advised to follow it. Consult with a doctor about the benefits and about the risks, and if you might be susceptible to any of them due to existing medical conditions, do not start the testosterone therapy.
Forms of testosterone supplements and indications of usage
As already mentioned above, testosterone replacement therapy is available in several forms, such as:
·Gels, by this mean testosterone is absorbed directly through the skin by applying it once a day. There are gels that come in a pump that delivers the exact amount of testosterone prescribed by your doctor.
·Skin patch. Generally it is applied once a day and it is worn on the arm or upper body.
·Injections and implants. It is a very popular form of testosterone due to the fact that is can be injected directly into the muscles or implanted as pellets in the soft tissues. The body absorbs slowly the testosterone into the bloodstream.
·Mouth patch. Generally, it is applied twice a day. It is a tablet that sticks to the upper gums above the incisor and it continuously releases testosterone into the blood through the oral tissues.
Testosterone is also available as pills, however it is considered that oral testosterone may have negative effects on the liver. By using the other forms of testosterone, it gets into the blood directly without affecting the liver. However, if there are men who cannot tolerate the described testosterone supplements, they might be prescribed tablets as the easiest form of therapy.
Important things to remember about testosterone therapy
·As already mentioned, testosterone therapy helps reverse the effects of hypogonadism. However, there is no clear medical evidence about the mechanism of action of testosterone in older men who are otherwise healthy. It is considered that testosterone therapy makes men feel younger and more vigorous as they age, but it is not clear yet how testosterone may act in each patient. For example, one study has showed that healthy men who took testosterone medicines increased muscle mass but did not gain strength.
·Testosterone replacement therapy can have long-term side effects. The replacement therapy should be considered only in men who have confirmed blood tests of low testosterone. Testosterone therapy may not be right for all men. Discuss with a doctor all issues related to replacement therapy considering your particular medical condition.
·The benefits of testosterone therapy are the following: improvement in sex drive, energy level, increased bone density, muscle mass and quality of erections. Some men also report improvement in mood from testosterone replacement.
·The difference between testosterone and anabolic steroids is that testosterone replacement therapy achieves physiologic levels of hormone in the blood. Anabolic steroids also contain testosterone or chemicals that act like it. But athletes have the tendency to abuse it and often combine it with other substances that boost the overall muscle boost effect, while testosterone therapy is used to increase the levels of this hormone and contributes to improvement of some other factors already mentioned above.