If you want to save money from your spending budget, start by identifying priorities with your health. If you find yourself spending more and more on supplements because they don’t seem to be getting any results, you may be experiencing testosterone deficiency. So what exactly is testosterone deficiency?
The administration of testosterone is the most common treatment prescribed by medical practitioners to men suffering from testosterone deficiency. It helps in improving sexual function, muscle strength, bone density, and men’s overall sense of well being, and can be administered transdermally, orally, or through injection.
Testosterone deficiency has become quite common among men in the United States. This is mainly because a major part of the population is above 50 years of age, and it is an established fact that testosterone levels decrease with increasing age. Moreover, a high prevalence of morbidities, such as metabolic syndrome, cardiovascular disease, and diabetes, has been observed in men, who have low testosterone levels. Testosterone deficiency, also known as Hypogonadism, affects about 40% men who are aged 45 or above, but only 5% of them are diagnosed with the condition and given proper treatment .
Although there are some discrepancies, testosterone therapy has been considered as an effective and safe treatment for hypogonadism for over 7 decades. However, in the past several years, many researches and studies have contributed to improve our understanding of hypogonadism and diseases caused because of it.
Hypogonadism is quite common in men, but its diagnosis is tricky. However, after it has been confirmed that the patient is suffering from testosterone deficiency and exclusion of contraindications and any other reversible causes to the use of testosterone has been done, testosterone replacement therapy may be the best option of treatment for them. There are several methods of performing this therapy including oral testosterone (testosterone undecanoate), transdermal testosterone (gels or patches), and injectable testosterone esters. After the therapy, a standard monitoring plan should be followed to ensure that there are no adverse side effects and whether there is any need for further procedures or alternate treatment.
Men suffering from conditions such as erectile dysfunction, fatigue, mood changes, depression, reduced libido, poor memory and concentration, low energy, decreased muscle strength, infertility, and reduced volume of ejaculated sperm most probably have lower levels of testosterone. You should get tested for free and total testosterone levels and the results of the tests will aid in elucidating the serum concentrations of luteinizing hormones, and will also help in determining whether the level of testosterone deficiency is primary or secondary.
The major causes of testosterone deficiency are pituitary and/or hypothalamic failure and testicular failure. The latter is also known as primary hypogonadism, while the former is categorized as secondary hypogonadism. There is another type which is age-related dysfunction, and men suffering from this type of testosterone deficiency exhibit the symptoms of both primary and secondary hypogonadism.
Primary hypogonadism is mostly caused by vanishing testicle syndrome, myotonic dystrophy, Klinefelter syndrome, and chemotherapy- or radiation-induced induced hypogonadism. The causes of secondary hypogonadism are divided into congenital causes and acquired causes. Congenital causes include idiopathic hypogonadotropic hypogonadism (IHH) and Kallmanns syndrome. Acquired causes include pituitary tumors, hematochromatosis, and adult-onset IHH.
These symptoms can cause significant general health concerns and adversely affect the overall quality of life.
Despite the increasing number of cases of hypogonadism, it is a difficult task for medical practitioners to accurately diagnose this deficiency and its level. The diagnosis, to some extent, is dependent upon low serum testosterone levels and the presence of clinic symptoms . Men with testosterone deficiency might not exhibit clear enough signs and symptoms, upon which it could be established that they require treatment. Moreover, men having relevant symptoms but with close to normal levels of testosterones are usually not recommended to opt for therapy or any other treatment for boosting testosterone levels, as excess levels of testosterone can also have side effects.
To accurately diagnose whether hypogonadism is primary or secondary, medical practitioners have categorized the symptoms of testosterone deficiency as nonsexual and sexual. The most common nonsexual symptoms include depressed mood, poor concentration, fatigue, and decreased energy. Nonsexual symptoms also include physical signs such as decreased muscles mass, reduced bone density, anaemia, and increased fat mass. Comorbid conditions like obesity and increased waist circumference are also the nonsexual signs of testosterone deficiency.
The most common sexual symptoms of hypogonadism include erectile dysfunction, difficulty achieving orgasm, and decreased libido.
Many clinical studies and large scale researches have been conducted on testosterone deficiency and have shown that hypogonadal men who undergo testosterone replacement therapy have peripheral body fat, improved sense of wellbeing, and reduced blood sugar and insulin resistance. As discussed above, there are many methods of administering testosterone for the treatment of hypogonadism such as oral testosterone, transdermal testosterone, and injectable testosterone esters. These modes of delivery have their own perks, but patients can go with whichever method suits them the best.
Medical practitioners have to study the physiology of the patients and adjust the dosage of testosterone accordingly. Sometimes, there may be need to switch to a different delivery method as there are chances that the blood levels of the patient are not appropriate or the current delivery method could lead to side effects such as polycythemia.
Following are the common testosterone replacement therapy administration methods along with their recommended regimens.
- Tablet – Take testosterone undecanoate (80 mg) two times a day during or after meals.
- Gel – Apply testosterone gel (5 to 10 g) daily.
- Patch – Apply one or two testosterone patches (5 mg) onto the upper arm, thigh, or back. Make sure you don’t apply the patches near or on the pressure areas.
- Injection – Administer testosterone cypionate or enanthate (75 to 100 mg) weekly, or increase the dosage to 150 to 200 mg and administer it every other week.
Cautions and Considerations
For patients receiving testosterone treatment with certain diseases, it is imperative that they take precaution and know about special considerations. Men diagnosed with prostate cancer should avoid testosterone replacement therapy as it can cause the tumor growth to accelerate. However, men who have been cured of prostate cancer in the past and have clear signs of testosterone deficiency can opt for this treatment after consulting with an urologist or oncologist.