Beginning at approximately 40 years of age, a man’s testosterone levels slowly decline. A condition called “andropause” develops which is similar to menopause experience by women.
Testosterone deficiency is associated with other medical conditions including obesity, diabetes, hypertension and atherosclerosis; as well as elevated levels of triglycerides, total cholesterol, and low-density lipoprotein cholesterol.
Testosterone may provide a protection against the development or progression of atherosclerosis in men. Medical evidence indicates that appropriate therapy can relieve and partially reverse the progression of these problems in testosterone-deficient men.
Hypogonadism is the medical term for low levels of testosterone in association with specific signs and symptoms, including:
- Diminished sex drive and sense of vitality
- Erectile dysfunction
- Depression and Anemia
- Heart disease or worsening lipid profile
- Reduced muscle mass and bone density
- Increased fat mass
Hormone therapy is recommended for men with symptoms of hypogonadism and low total testosterone levels or high estrogen levels. Depressed men have been found to have significantly lower testosterone levels, perhaps because an associated decrease in sexual function results in depression, irritability, and mood swings. Testosterone therapy may improve depressed mood in older men who have low levels of bioavailable testosterone.
Gradual loss of testosterone is one of the major causes of osteoporosis in elderly men. Studies have reported beneficial effects of testosterone therapy in older men, showing an increase in bone mineral density (BMD) and slowing of bone degeneration. Testosterone therapy in older men with low testosterone levels also increases lean body mass and decreases fat mass, improving physical performance and strength.
Testosterone replacement therapy has relieved symptoms and improved the quality of life for many men. TRT is well tolerated. Laboratory values and clinical response should be monitored frequently so that any necessary adjustments can be made.
- Testosterone can be replaced by either a weekly injection, a cream or a lozenge that melts under the tongue. The specific dose needed by each man can be compounded based on lab results and clinical symptoms.
- The presence of prostate or breast cancer is an absolute contraindication for androgen replacement therapy. Guidelines recommend that Testosterone replacement therapy should not be initiated in older men with PSA serum levels above the normal range.
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