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Low Testosterone
JSMPatient Highlights
Information about sexual health issues & treatments © 2010 International Society for Sexual Medicine
Short Term Therapies Testosterone injections These were originally intended to be given every two months but are now known to be safer and more effective if given every one to two weeks Pro: The least expensive alternative, particularly if you learn to give yourself the injection Con: The hormone levels go very high with each injection and gradually decline until the next. This does not replicate the normal daily rhythm of testosterone levels.
Testosterone gels Testosterone in a gel form that can be absorbed through the skin
Low Testosterone
Pro: Can be applied so that the normal daily rhythm of testosterone is restored. No need for injections or needles. Con: Hormone can be transferred to people with whom you come in contact (partners/ spouse/children) if you do not follow specific precautions. Gels can be expensive. jsm_11
1595
Testosterone patch
D
o you fall asleep right after dinner? Has your “get up and go” got up and left? Have you lost your interest in sex? Are your erections not as hard as they used to be? These are common problems that men encounter as they age that may be caused by hypogonadism, or low levels of the “male” hormone testosterone. Testosterone levels start to decline in most men by the time they are 40 and in some men this decline occurs even earlier. This change may affect your energy level, bone density, muscle mass, mood and sexual function. The good news is that these effects are potentially reversible with testosterone therapy. Restoring your testosterone level to where it was when you were younger just may help you feel young again!
What is Testosterone Therapy? Testosterone therapy is the replacement or restoration of testosterone so that the level is within a normal range for the individual patient. With treatment, the problems that are associated with low testosterone may get better or event disappear altogether.
How is Testosterone Therapy given? There are several different methods to boost testosterone levels, each of which is effective with different pros and cons.
Testosterone in a patch form that can be absorbed through the skin. Pro: Can be applied so that the normal daily rhythm of testosterone is restored. No need for injections or needles. Con: Adhesive can result in a rash causing red and itchy skin
Testosterone buccal system Testosterone in an insert that sits inside your cheek. Pro: No need for injections or skin application of medication. Con: May be uncomfortable. Has been associated with bad breath. Needs to be changed twice a day.
JSMPatient Highlights
Information about sexual health issues & treatments © 2010 International Society for Sexual Medicine
Will testosterone cause prostate cancer?
Long Term Therapies
For many years, doctors assumed that giving testosterone supplementation would increase the risk of prostate cancer and prostate enlargement. However, recent studies have shown that there is no evidence that testosterone causes prostate cancer. We do know that castrating a man will cause a prostate cancer that is already present to stop growing, and therefore there is slight but real concern that testosterone may enhance growth of an already existing prostate cancer. Although the risk of stimulating prostate cancer growth from testosterone supplementation appears to be very low it is prudent to have your doctor check your PSA and perform a prostate examination before prescribing testosterone.
Testosterone pellets
Men who have been successfully treated for prostate cancer may consider testosterone therapy but there are important guidelines and you should have an honest and frank discussion of risks/ benefits with your doctor. If you are being treated with a medication to deplete your body of testosterone it is probably not a good idea to take testosterone supplements.
If I take testosterone, will I have “Road Rage” or an increase in aggression? Many people think that taking testosterone will cause aggressive behavior and/or bulging muscles like body-builders. It is true that steroid-abusers can develop these symptoms but that is from testosterone levels that are many times higher than the normal range for adult men. Restoring testosterone to normal range should not cause bulging muscles or “road rage.” In fact, many men who are hypogonadal and restore their testosterone level to normal report that they are less moody and more pleasant to be around!
What effects will testosterone have on other parts of my body? Testosterone plays a number of very important roles in the human body for both men and women. Generally, the effects of testosterone are either neutral or even beneficial for most body systems. Specific examples of ways testosterone might benefit you include stronger bones, more muscle mass, and less fat mass. Irwin Goldstein, MD Director of Sexual Medicine Alvarado Hospital San Diego, CA, USA
Inserted under the skin every 4–6 months, these pellets dissolve slowly and release testosterone. Pro: Hormone levels remain stable for long periods, no risk of transferring hormone to others, no need to remember to take medication. Con: Not available in many countries, requires a very minor procedure to insert.
Testosterone undecanoate injections Given every 10–14 weeks Pro: Hormone levels remain stable for long periods, no risk of transferring hormone to others. Con: Not available in many countries
Warnings • When you are using testosterone supplements, your body may shut down its own production of testosterone from the testicles. This may lead to some mild shrinkage of the testicles and a halt to sperm production. These issues are normally not a problem except for men who are still interested in having children. It is therefore imperative that men who still want to have children NOT use testosterone supplements. Clomiphene citrate is an oral medication that can be used to boost natural production of testosterone without reducing sperm counts. • If you are using a testosterone gel, we recommend applying the gel before bedtime to avoid accidentally exposing your children to it and wearing a tee shirt to avoid accidentally exposing a spouse or partner. • If you shower (or swim) you should apply gel after rather than before. The gel takes several hours to be absorbed through the skin and you don’t want it to wash off.
Information about sexual health issues & treatments © 2010 International Society for Sexual Medicine
Short Term Therapies Testosterone injections These were originally intended to be given every two months but are now known to be safer and more effective if given every one to two weeks Pro: The least expensive alternative, particularly if you learn to give yourself the injection Con: The hormone levels go very high with each injection and gradually decline until the next. This does not replicate the normal daily rhythm of testosterone levels.
Testosterone gels Testosterone in a gel form that can be absorbed through the skin
Low Testosterone
Pro: Can be applied so that the normal daily rhythm of testosterone is restored. No need for injections or needles. Con: Hormone can be transferred to people with whom you come in contact (partners/ spouse/children) if you do not follow specific precautions. Gels can be expensive. jsm_11
1595
Testosterone patch
D
o you fall asleep right after dinner? Has your “get up and go” got up and left? Have you lost your interest in sex? Are your erections not as hard as they used to be? These are common problems that men encounter as they age that may be caused by hypogonadism, or low levels of the “male” hormone testosterone. Testosterone levels start to decline in most men by the time they are 40 and in some men this decline occurs even earlier. This change may affect your energy level, bone density, muscle mass, mood and sexual function. The good news is that these effects are potentially reversible with testosterone therapy. Restoring your testosterone level to where it was when you were younger just may help you feel young again!
What is Testosterone Therapy? Testosterone therapy is the replacement or restoration of testosterone so that the level is within a normal range for the individual patient. With treatment, the problems that are associated with low testosterone may get better or event disappear altogether.
How is Testosterone Therapy given? There are several different methods to boost testosterone levels, each of which is effective with different pros and cons.
Testosterone in a patch form that can be absorbed through the skin. Pro: Can be applied so that the normal daily rhythm of testosterone is restored. No need for injections or needles. Con: Adhesive can result in a rash causing red and itchy skin
Testosterone buccal system Testosterone in an insert that sits inside your cheek. Pro: No need for injections or skin application of medication. Con: May be uncomfortable. Has been associated with bad breath. Needs to be changed twice a day.
JSMPatient Highlights
Information about sexual health issues & treatments © 2010 International Society for Sexual Medicine
Will testosterone cause prostate cancer?
Long Term Therapies
For many years, doctors assumed that giving testosterone supplementation would increase the risk of prostate cancer and prostate enlargement. However, recent studies have shown that there is no evidence that testosterone causes prostate cancer. We do know that castrating a man will cause a prostate cancer that is already present to stop growing, and therefore there is slight but real concern that testosterone may enhance growth of an already existing prostate cancer. Although the risk of stimulating prostate cancer growth from testosterone supplementation appears to be very low it is prudent to have your doctor check your PSA and perform a prostate examination before prescribing testosterone.
Testosterone pellets
Men who have been successfully treated for prostate cancer may consider testosterone therapy but there are important guidelines and you should have an honest and frank discussion of risks/ benefits with your doctor. If you are being treated with a medication to deplete your body of testosterone it is probably not a good idea to take testosterone supplements.
If I take testosterone, will I have “Road Rage” or an increase in aggression? Many people think that taking testosterone will cause aggressive behavior and/or bulging muscles like body-builders. It is true that steroid-abusers can develop these symptoms but that is from testosterone levels that are many times higher than the normal range for adult men. Restoring testosterone to normal range should not cause bulging muscles or “road rage.” In fact, many men who are hypogonadal and restore their testosterone level to normal report that they are less moody and more pleasant to be around!
What effects will testosterone have on other parts of my body? Testosterone plays a number of very important roles in the human body for both men and women. Generally, the effects of testosterone are either neutral or even beneficial for most body systems. Specific examples of ways testosterone might benefit you include stronger bones, more muscle mass, and less fat mass. Irwin Goldstein, MD Director of Sexual Medicine Alvarado Hospital San Diego, CA, USA
Inserted under the skin every 4–6 months, these pellets dissolve slowly and release testosterone. Pro: Hormone levels remain stable for long periods, no risk of transferring hormone to others, no need to remember to take medication. Con: Not available in many countries, requires a very minor procedure to insert.
Testosterone undecanoate injections Given every 10–14 weeks Pro: Hormone levels remain stable for long periods, no risk of transferring hormone to others. Con: Not available in many countries
Warnings • When you are using testosterone supplements, your body may shut down its own production of testosterone from the testicles. This may lead to some mild shrinkage of the testicles and a halt to sperm production. These issues are normally not a problem except for men who are still interested in having children. It is therefore imperative that men who still want to have children NOT use testosterone supplements. Clomiphene citrate is an oral medication that can be used to boost natural production of testosterone without reducing sperm counts. • If you are using a testosterone gel, we recommend applying the gel before bedtime to avoid accidentally exposing your children to it and wearing a tee shirt to avoid accidentally exposing a spouse or partner. • If you shower (or swim) you should apply gel after rather than before. The gel takes several hours to be absorbed through the skin and you don’t want it to wash off.