Several of my older male patients have expressed the desire to try hormone (testosterone) replacement.  Perhaps you’ve been considering the same. Like my patients, you may have tried the more natural, gradual methods of boosting testosterone levels by diet, exercise, stress reduction, and avoidance of environmental, or, xenoestrogens.

Although most of my patients who try natural testosterone enhancement report that those measures have helped, they may not have been enough to boost testosterone levels high enough to relieve their particular symptoms. The same may be true for you, and like my patients, you may now want to try direct testosterone supplementation through your doctor.

In order for you to make an informed decision, here are the pros and cons that I explain to my patients about male hormone replacement.  Let me say this first, however. I will be referring to this particular type of male hormone replacement as clinical male hormone replacement going forward, unlike the natural methods mentioned above that you can do yourself, these are methods that are prescribed and monitored by a doctor in a clinical setting.

Male Hormone Replacement

The Pros:

Recent studies have shown that men who have low testosterone can benefit from replacement of testosterone as it can reduce their risks of heart disease and diabetes.  In addition, other studies have shown that testosterone replacement helps relieve symptoms of “andropause”, or middle-age hormone decline, which is very similar to a woman’s menopause.

Andropause symptoms can include weight gain – especially belly fat,  high “bad” LDL cholesterol, high blood pressure, insomnia, irritability, depression, low sex drive, memory problems, to name a few.  German researchers even claim that low testosterone levels can increase a man’s risk for premature death from cardiovascular disease and cancer.

In the above studies, men of ages under 57 to over 63 were treated with testosterone replacement by long-acting injection every 3 months. The results were that they fared very well. They decreased their LDL “bad”cholesterol, increased their HDL “good” cholesterol and lost their belly fat, decreasing their waistline/pant sizes by several inches!  In addition, there were no adverse effects reported.  Many of my patients have expressed concern about the safety of clinical male hormone replacement, given the recent headlines about the dangers of hormone replacement in women. It’s important to note that clinical hormone replacement with testosterone in men is not fraught with the same risks as hormone replacement with estrogen in women.

The Cons:

While testosterone injections have been shown to be beneficial in helping resolve the symptoms associated with decreased testosterone levels, and have so far shown no adverse effects, they are not without concern. Simply put, the long term effects of clinical testosterone replacement in men is just not known because not enough studies have been done on the subject.

Some researchers are concerned that increasing testosterone levels higher than usual levels may raise blood pressure and create kidney function damage in men. Other researchers wonder whether it will lead to prostate disease as higher testosterone levels have been associated with prostate cancer and/or prostate enlargement (benign prostatic hyperplasia).  Similarly, men who have existing prostate disease, high blood pressure or kidney disease, should probably not undergo clinical male hormone replacement. Yet, your doctor will be able to make the final decision on whether it is safe for you to try it.

It’s crucial, however, if you do undergo clinical testosterone replacement, that you be monitored regularly and carefully with prostate specific antigen tests, kidney function studies, blood pressure monitoring and blood hematocrit levels.

What’s Available For Clinical Male Replacement Therapy?

If you’re ready to try testosterone replacement via injection or another doctor-prescribed method, here are your options:

1.  Oral route (pills or cheek placement): Most pills are really not that effective and not prescribed within the United States as they can be toxic to the liver.  The only pill form that is an exception to this is the testosterone undecanoate form which is absorbed by the lymphatic system, rather than the liver, but must be taken 4 times a day. However, it too is not available in the United States at this time.

2.  Injections: The most commonly prescribed form of male HRT. These include cypionate and Sostenon 250, et al. Usually given every 2-3 weeks, it can also be done by self-injection though you might not want to.  Side effects can include pain and bleeding at the site of injection, bursts of testosterone out of normal range right after injection and low levels right before a scheduled injection.  It is felt that 200 mg every 2 weeks is a good dosage to avoid the highs and lows of testosterone levels with injections. Costs are about $30 a month.

3.  Gels: These include AndroGel, AndroDerm, Axiron and are gel/liquid forms that are rubbed into the skin usually at bedtime. The biggest drawback of these is that of transference of hormone to another person if the gel has not completely been absorbed out of the skin before close contact with another person. Must be kept away from children and pregnant women. Axiron is applied under the arms and may help avoid the transference issue.

4.  Patches/Transdermal: Testosterone delivered daily via the skin through patches. Thought to without the side effects of injectable testosterone. Side effects can include reaction dermatitis to the patch itself.  In addition, they’re costly – (up to $200 a month).

There you have the basics of male hormone replacement that can be prescribed by your doctor.  As my patients know, I always recommend that they try the natural methods of boosting testosterone levels for a good amount of time and see how they feel. However, if you are like those patients who feel that their symptoms are not relieved by natural methods and you wish to try the stronger, clinical route of testosterone replacement, do contact your doctor who can address your specific testosterone issues directly.

Stay Well,

Mark Rosenberg, M.D.

Natural Health News

Types of Testosterone Replacement, http://www.medscape.com/viewarticle/543997_7

Testosterone Replacement – Is It Safe? http://men.webmd.com/news/20040223/testosterone-replacement-therapy-is-safe?page=2

Photo Credit: iimcs.org