Testosterone replacement therapy, also called androgen replacement therapy, is approved to treat male hypogonadism.
Testosterone replacement therapy, also called androgen replacement therapy, is approved to treat male hypogonadism (low testosterone or “Low T”), a condition in which the body fails to make enough hormones because of a problem with the testicles, pituitary gland, or brain. Men use testosterone products — such as patches, gels, pills, injections, or creams — to help with fatigue, erectile dysfunction, and loss of sex drive.
Testosterone therapy is intended to treat male hypogonadism (low testosterone or “Low T”), a condition in which the body fails to make enough hormones because of a problem with the testicles, pituitary gland, or brain. A number of prescription testosterone products are available to treat hypogonadism. Testosterone products come in different forms, including gels, injectable solutions, patches, pills, and pellets implanted under the skin.
Once a patient starts testosterone therapy, the patient usually undergoes lifelong treatment. Doctors will monitor the patient’s hormone levels every six months to a year. Depending on the patient, the checkups may be more frequent.
Fast Facts: Use of Testosterone Therapy Over the Years
- American men spend $2 billion on testosterone each year
- Four times as many men used testosterone products in 2014 than in 2000
- In 2013, 2.3 million Americans were being treated with testosterone therapy
- In 2011, nearly one in 25 men in their 60s were taking testosterone
- Prescription sales of testosterone increased from $18 million in 1988 to $1.6 billion in 2011
What Is Testosterone Replacement Therapy?
TRT or androgen replacement therapy (ART) is a treatment that doctors give to males who have testosterone deficiency and are showing symptoms of hypogonadism.
Taking prescription testosterone helps restore the levels of this hormone in the blood, reversing the symptoms of low testosterone. People who take it may notice improvements in alertness, sexual function, energy, mood, and overall well-being.
Who is a testosterone replacement therapy for, and how does it work
Doctors prescribe TRT to males with hypogonadism. To receive a definitive diagnosis, blood tests must show that a person has low testosterone levels, which the American Urological Association notes as being below 300 nanograms per deciliter (ng/dl). The individual must also have other symptoms, such as fatigue, breast growth, and sexual dysfunction.
However, doctors do not usually recommend TRT as the first course of action for low testosterone levels, even for males who show such symptoms.
If other conditions or medications cause testosterone levels to drop, doctors usually treat the underlying condition before recommending TRT.
How To Get TRT
TRT is only available with a prescription. If a person presents with symptoms consistent with low testosterone levels, a doctor will only provide a prescription after taking a thorough medical history and performing physical and lab exams.
As hormone levels fluctuate depending on activity levels, diet, and the time of day, doctors usually take a blood test before noon on 2 consecutive days. They may sometimes also ask for imaging studies and additional tests, such as tests for luteinizing hormone and follicle stimulation hormone, to determine the cause of the low testosterone levels.
Types of Testosterone Products
Testosterone can be administered in a skin patch, skin gel, pill, or cream form — or as an injection, a solution applied to the armpit or a patch, or a buccal system applied to the upper gum or inner cheek.
While many testosterone products are available only with a prescription, some drug stores and health food stores sell them over the counter. A few of these products also claim to be all-natural.
Gels (Androgel and Testim)
Testosterone gel is a prescription medication applied directly to a man’s skin — on the shoulders and upper arms and/or abdomen, depending on the brand. Testosterone gel can inadvertently transfer from your body to others and can lead to serious health reactions. To avoid such contact, apply testosterone gel to clean, dry, intact skin that will be covered by clothing. Wash your hands right away with soap and water after applying. Once the gel has dried, cover the area with clothing and keep it covered until you have washed the area well or have showered.
Injections (Depo-Testosterone)
First approved in 1979, Depo-testosterone is one of the older drugs of its kind on the market. It’s a liquid and is designed for injection deep into the gluteal muscle. The active ingredient, testosterone cypionate, is a white or creamy white powder mixed with other ingredients to make a solution. The drug is available in two strengths, 100 mg, and 200 mg.
Patches (Androderm)
Testosterone transdermal patches, including Androderm, come as patches to apply to the skin. Patches work best when applied around the same time each night and are left in place for 24 hours. Testosterone patches are meant to be worn at all times until replaced with new patches. Androderm patches should be changed every 24 hours. The old patch should be removed before applying the new one. You should apply the patches to different spots each night and wait at least seven days before re-using a spot.
Capsules (Methyltestosterone and Android)
The testosterone capsules Methyltestosterone and Android have been discontinued but have been used in men and boys to treat conditions caused by lack of the hormone, such as delayed puberty, and in women to treat breast cancer that has spread to other parts of the body. Methyltestosterone is a man-made form of testosterone. It can affect bone growth in boys who are treated for delayed puberty.
Boosters (Testofen)
Manufacturers of testosterone boosters like Testofen have touted their products as means to increase muscle mass, strength, and sex drive in men. Among the most popular testosterone boosters are products that contain some combination of Tribulus Terrestris, DHEA, zinc, and d-aspartic acid. These ingredients have been associated with a number of side effects, including aggressiveness, breast enlargement, cholesterol changes, prostate problems, and an increased risk of cardiovascular disease.
Makers of testosterone products use two types of hormones:
Bioidentical Hormones AndroGel and a number of other products contain bioidentical hormones. Scientists create bioidentical hormones in a lab to chemically match the hormone naturally made by the body. In theory, this results in fewer side effects.
Synthetic HormonesSynthetic hormones are altered from the original chemical makeup, so they do not match those made by the body. These types of drugs typically have more side effects.
Recent Clinical Trials
Researchers for a year studied the effect of testosterone treatment on cognition, bone health, anemia, and cardiovascular health in 788 men aged 65 or older who had low testosterone levels that couldn’t be explained by anything other than age.
According to the findings, reported in February 2017 in JAMA and JAMA Internal Medicine, testosterone treatment did not have an effect on memory or cognitive abilities, though it appeared to increase hemoglobin levels in men with anemia and improve bone density. In addition, a clinical trial found one year of testosterone treatment in men aged 65 or older with Low T was associated with a significant increase in coronary artery plaque, a risk factor for heart disease.
For any concerns contact our qualified experts here.