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Testosterone Replacement Therapy

Testosterone is an important hormone for a wide range of issues in Men as well as Women. At Optimal Family Health we offer testing, treatment and advice for testosterone issues for Men and Women of all ages.

What is Low Testosterone?

Testosterone is a chemical produced by the testicles. It is the main sex hormone that controls male puberty during the teenage years.

However it is also important in other roles such as:

  • Sex Drive (in Men & Women)
  • Maintaining Erections
  • Muscle Bulk
  • Blood and Bone Maintenance
  • Mood & Energy Levels

If your Testosterone is low, this can lead to:

  • Low Interest in Sex (in Men & Women)
  • Erection Problems – Difficulty initiating or maintaining.
  • Lower Muscle Mass, Increased Fat Gain
  • Low Mood
  • Poor Concentration and Irritable.
  • Poor Energy Levels
  • Reduced Body Hair
  • Fragile Bones

What causes Low Testosterone?

Older Age – In men testosterone peaks in the twenties and then gradually falls from thirty years onwards.

Stress – Any mental stress will lead to a temporary drop in testosterone. Long term stress, especially sleep deprivation, shift-work, frequent air travel, long working hours will lead to a ‘testosterone burn-out’.

Illness – Nearly any illness can cause a fall in testosterone. If the illness is severe or lasts a long time, the testosterone may remain at a low level and not recover. Typical examples include long term injuries, recurring infections and liver/kidney failure.

Obesity – Increased fat, especially abdominal obesity (‘pot belly or ‘beer belly’) can lead to low testosterone and high oestrogen.

Drugs & Alcohol – Drugs especially those used in cancer treatment and steroids can lead to a low testosterone. Long term alcohol use has a similar effect, as well as typically increasing likelihood of obesity.

How do I test my Testosterone Levels? 

The best way to test your testosterone is to test your levels in the morning. Your doctor may order some of the the following tests as well:

Free Testosterone – This is the ‘active’ testosterone level in your blood at the time of blood taking.

Total Testosterone – This testosterone is ‘non-active’ and fluctuates less during a day than Free Testosterone.

SHBG – This is a protein that binds to sex hormones such as Testosterone.

DHEA – This is a pre-cursor of Testosterone.

Oestrogen – This is typically seen as the ‘female’ sex hormone. If this is too high this can produce similar symptoms to low testosterone.

Prolactin – This hormone is produced in the brain and can also produce similar symptoms to low testosterone.

Types of Testosterone Replacement Therapy? 

If your Testosterone is low and you are suffering from symptoms you may benefit from Testosterone replacement therapy.  It is available in several forms:

  • Gels & Creams: Testosterone is absorbed directly through the skin when you apply the gel or cream once a day.
  • Oral Medication: Medication can be used to stimulate the Testes to produce testosterone and reduce Oestrogen levels.
  • Testosterone Injections: Typically these are injected into the buttock as it is a large muscle. Injections can last from 2 weeks to 12 weeks depending on the type used.
  • HCG Injections – In some cases HCG injections has been used to stimulate the testes to produce testosterone.
  • Vitamins & Supplements – There are supplements and herbs which support Testosterone production too.

Who should not take Testosterone Replacement Therapy? 

Men who have or have high risk of the following should avoid Testosterone supplementation:

  • Prostate or Breast Cancer
  • Severe Urinary Symptoms
  • Sleep Apnoea
  • Heart Failure

What are the Side-Effects of Testosterone Replacement Therapy? 

In general, testosterone replacement therapy is generally safe as long it is monitored on a regular basis and kept within the normal range. It is associated with some side effects especially if above the normal range, including:

  • Skin Changes – more Oily Skin and Acne. Skin irritation from injections or creams.
  • Prostate – Increase risk of abnormalities
  • Breast Enlargement
  • Mood – Increased Aggression and Irritability
  • Blood Clots – Increased chance of heart attack and stroke.
  • Testicles – Decreased testicle size and sperm count.
  • Cholesterol – Increase blood levels.
  • Sleep Apnea – This may worsen.

Testosterone Replacement Therapy Vs. Performance-Enhancing Steroids 

Some people especially body-builders or athletes take a form of testosterone or related products specifically to improve their athletic performance.

Testosterone replacement Therapy only achieve physiologic (natural) levels of hormone in the blood. The testosterone forms some athletes use illegally are significantly much higher doses, combined (“stacked”) with other substances that boost the overall muscle-building effect. Their testosterone levels are typically a lot higher than the ‘normal range’ expected for their age.