Male Hormone Replacement Therapy
(HRT) for Men Suffering from Low Testosterone:
You’ve probably been hearing and reading more and more about Low Testosterone (also known as Male Menopause or Andropause). You may also be wondering if “Low T” has affected you. If so, you are not alone. Approximately 40% of men over the age of 45 have Low Testosterone. Bottom line … if you have Low T, you need to take care of it.
You can start by taking the following test, called the ADAM questionnaire (Androgen Deficiency in the Aging Male), to help determine if Low Testosterone is affecting you.
If you answer “Yes” to question number 1 or 7, or if you answer “Yes” to more than 3 questions, you may have low testosterone:
1. Do you have a decrease in libido (sex drive)?
2. Do you have a lack of energy?
3. Do you have a decrease in strength and/or endurance?
4. Have you lost height?
5. Have you noticed a decreased “enjoyment of life”?
6. Are you sad and/or grumpy?
7. Are your erections less strong?
8. Have you noticed a recent deterioration in your ability to play sports?
9. Are you falling asleep after dinner?
10. Has there been a recent deterioration in your work performance?
To find out if you have Low Testosterone, or if you would benefit from Testosterone Replacement Therapy (TRT) call us at 586-992-8300 or email us at email@example.com to set up an appointment and testing.
The Facts About Low Testosterone (Low T):
Your body started making Testosterone in high quantities when you were a silly, active, growing kid. It is not really your whole body that makes your Testosterone; it is actually made in your testicles. So your testicles are what make your male hormones.
Your testosterone overload made you foolish when you were a young man. It stimulated your sex drive when you started dating. It led to your self-confidence, energy, manliness, drive, competitiveness, facial hair, and shaped your male features as you grew up.
As time goes on, you may experience a decline in your production of testosterone. It is not clear why we were designed to stop making so much testosterone after maturing, but it happens.
Symptoms of Low T Include:
- Loss of muscle
- More difficulty with erections
- Lower sex drive
- Less competitive edge
- Minor depression
A blood test to measure your testosterone, as well as your other related hormones, is most frequently done as a simple blood test. If your testosterone is low, you can be prescribed Testosterone Replacement Therapy (TRT).
Usually, you can sense something has changed, and you don’t know what it is. A simple blood test will tell you if you have Low T.
Fortunately, it is very simple. First, we do a blood test. If the test reveals that you have Low T, we advise you take Testosterone replacement. You are replacing what nature took away from you.
There are numerous medical conditions that may cause low testosterone. However the most common causes remain normal aging and your own personal genetics. For example, if you have a family history of adult onset diabetes, you are at personal risk for developing low testosterone at a younger age. In some cases, the onset of low testosterone can be delayed by diet and exercise, and you should do that. And if your testosterone is borderline low, and you are overweight and do not exercise, changing your lifestyle can boost your levels at least for a period of time.
If you have low testosterone you are more at risk for prostate cancer, premature heart disease, diabetes, obesity, Alzheimer’s, erectile dysfunction, poor sex drive, minor depression, and loss of muscle mass.
Since your body is supposed to make testosterone in the first place, the risks are limited, and can be reviewed at your office visit. Most side effects of TRT are from taking too much, or not enough, so this is monitored with a blood test. It is not safe if you have active prostate cancer. Men with preexisting heart disease need to be carefully monitored when starting TRT.
This is a very important question. Low T is a disease; just as much as heart disease, diabetes, Parkinsonism, depression, obesity, erectile dysfunction, and other “age” related diseases are diseases. Yet, they all have this in common: Men with Low T have an increase in heart disease, diabetes, Parkinsonism, depression, obesity, erectile dysfunction, and other “age” related diseases.
There are side effects with too much Testosterone, but too little Testosterone is much more dangerous.
Men with the lowest Testosterone have the most prostate cancer. We cannot say that restoring Testosterone can prevent cancer. But Testosterone does not cause cancer. Men get prostate cancer. Period. It happens. Men with the Lowest T get the most aggressive prostate cancers. Men with normal T get the least cancers.
More energy, less depression, less fat, more sex drive, harder erections, more edge, less tiredness. Are other side effects possible? Yes. But with monitoring of your T level, it is generally not an issue. If you cannot commit to communicating with our practitioners 1-2 times per year, you are not a candidate.
Testosterone replacement has been shown to improve men’s energy, libido, erectile firmness, and decrease body fat. It is also known to help combat minor depression, elevate mood, increase bone density (resulting in less broken bones) and improve muscle mass. It has also been shown to be beneficial for memory, cardiac (heart) performance, and may be preventative of heart disease and can be helpful for reversing early stages of adult onset diabetes. (There is some recent controversy over heart disease and testosterone replacement for men with existing heart disease).
The most common methods are through a topical cream rubbed into your skin, or by weekly injections (that you do by yourself at home). In general, we prefer compounded Testosterone, as it is much more effective at getting a physiologic level (that is a youthful, optimal) level of testosterone in your body vs the much weaker drug forms. The Bio-identical (meaning exactly the same as your body makes) form of testosterone in a cream is about 10 times stronger than the common drug forms available. This allows you to much better control your ability to get a testosterone level that you had when you were younger.
The shots are for men who want to take a shot once a week and not have to remember to apply cream twice a day. The cream is for men who don’t want shots and can remember to apply a cream twice a day. No judgment, no perfect solution, just two main options.
Usually about 2-4 weeks. Your blood will be tested to see how much testosterone is needed to get your body to healthy, youthful levels of testosterone.
Most men will take it forever. If you have low testosterone, in most cases it is permanent. So the solution is permanent as well.
Insurance typically covers the blood work and office visits. Many carriers will not cover the cost of testosterone replacement beyond that. The Testosterone will generally cost you about $1.50 to $4 a day or roughly as much as a cup of coffee a day. When you are feeling better, having more sex drive and firmer erections, more energy, more muscle and less fat: You will agree better outlook on life is worth the price of a Starbucks (and just coffee; no fancy, odd named coffee look-a-like’s). For what it does, you can justify the cost of testosterone replacement. If you want your insurance to cover it, ask your family doctor to prescribe you the ineffective drugs to deal with the symptoms of Low T.
In the early stages of low testosterone, exercise and healthy diet can give some benefit. So that is step one. Additionally, there are some medical conditions and drugs that lower testosterone, so your doctor will evaluate you for that. Some success may be seen with using testosterone boosters (such as HCG or Human Chorionic Gonadotropin), but these generally are not as effective as just simply replacing your diminished testosterone.
It is optimal to restore not just to a “normal” lab value, but an ideal level. Typically, most men will feel their best with a testosterone level in the range of 600-900 ng/dl. The range a laboratory will report as normal is generally 280-1000 ng/dl. Men with a testosterone level of 290-400 would be “normal” based on a doctor lab report, but that would be physiologically low for most middle aged men. In other words, the testosterone level that is average for an 80 year old man may make a 45 year old man feel … old. But it would be reported as “normal” for a man. So, it needs to be reviewed with respect to age and symptoms.
TRT, or Testosterone Replacement Therapy is restoring your testosterone to normal levels. Steroid Abuse is when men take drugs that are designed to copy the effect of testosterone’s actions (or just massive doses of testosterone) on muscle development in order to create large, unnatural muscles. Steroid abuse is unsafe, leads to serious side effects (including premature death) and is illegal.
Well, this is a medical website, so we have to say the typical answer of “it depends”. But it can happen at any age. Most Male Menopause, Andropause, or Low Testosterone occurs in men ages 38-60. It can occur earlier or later. It is not universal at a young age; however it is almost universal as men age.