Testosterone therapy for men
Testosterone therapy uses the male hormone testosterone to treat symptoms of low testosterone level.
Testosterone replacement therapy; Androgen therapy; Androgen replacement therapy; Testosterone deficiency - replacement
TESTOSTERONE AND YOUR BODY
Testosterone is a hormone made by the testicles in men. It is the most important androgen (male) hormone in the body. Androgens like testosterone are often called steroids or anabolic steroids
Testosterone is important for:
- Keeping bones and muscles strong
- Making sperm
- Maintaining sex drive
- Making red blood cells
- Feeling well and having energy in general
As you become older, testosterone levels slowly drop. This can lead to signs and symptoms, including:
- Low sex drive
- Problems having an erection
- Low sperm count
- Sleep problems such as insomnia
- Decrease in muscle size and strength and in bone density
- Increase in body fat
- Trouble concentrating
WHO SHOULD TRY TESTOSTERONE THERAPY?
To help assess if testosterone therapy is right for you, your doctor will likely do the following:
- Measure your testosterone levels one or more times.
- Make sure there are no other causes of your symptoms. These include side effects from medicines, thyroid problems, depression, or over-using alcohol.
If your testosterone level is low, your doctor will discuss the risks and benefits of testosterone therapy and how this therapy may help you.
You should understand that many of the symptoms of a low testosterone level are thought to be a normal part of aging.
HOW IS TESTOSTERONE THERAPY GIVEN?
The medicine used is man-made testosterone. It can be given as:
- Gel applied to the shoulders, upper arms, or abdomen daily
- Solution applied to the armpit
- Skin patch, applied to the body or the scrotum, used daily
- Patch-like material, applied to the upper gum twice a day
- Injections, most often given every two or three weeks
- Implants, placed underneath the skin, which last 4 to 6 months
Talk with your doctor about which form of testosterone is right for you.
RISKS AND SIDE EFFECTS
Before taking testosterone, discuss these risks with your doctor:
- Increase in red blood cell count, which can lead to stroke and blood clots
- Acne or oily skin
- Worsening of sleep apnea
- Breast enlargement
- Water retention
- Sometimes good cholesterol (HDL) can decrease
Testosterone therapy may cause growth of the prostate gland. Discuss with your doctor the following:
- You need to have a PSA blood test to screen for prostate cancer before starting.
- You cannot take this therapy if you have had prostate cancer.
- Symptoms caused by an enlarged prostate may become worse.
Pregnant or breastfeeding women, as well as children, should avoid contact with this medicine. Follow package instructions about other precautions for the type of testosterone you are using.
WHEN TO CONTACT A MEDICAL PROFESSIONAL
It is important to have regular checkups with your health care provider when taking testosterone therapy. If you have side effects, call your health care provider.
Bhasin S, Cunningham GR, Hayes FJ, et al. Testosterone therapy in adult men with androgen deficiency syndromes: An Endocrine Society Clinical Practice guideline. J Clin Endocrinol Metab. 2010;95:2536-2559.
Swerdloff RS, Wang C. The testis and male sexual function. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 242.