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Testosterone Replacement Therapy: What You Need to Know

Testosterone Replacement Therapy: What You Need to Know


Testosterone is what gives men their characteristics - deep voices, facial and body hair, large muscles, production of sperms, and high libido. It is also known to increase bone strength and density, while also taking care of the heart. 


However, with age, testosterone levels in men begin to decline. A study showed that low levels of testosterone were present in 20% of men above 60 years of age, 30% of men above 70 years, and 50% of men above 80 years of age. 


Extremely low levels of testosterone may sometimes cause long-term effects on the body. It can lead to erectile dysfunction, lowered sex drive, tiredness and fatigue, and weakened bones (which may translate to a condition called osteoporosis). 


But there are ways in which one can manage their testosterone levels.  Here is everything you need to know about testosterone and testosterone replacement therapy.


What Medical Conditions Can Cause Low Testosterone in Men?



Testosterone levels are generally at their highest during adolescence and early adulthood. With age, typically after 30, testosterone levels decline by approximately 1% every year. It is important to consult a doctor to know what might be the real reason. 


Here are some of the reasons why your testosterone levels might be low:


  • Primary Hypogonadism

It is a condition in which the body is unable to produce normal amounts of testosterone due to a problem with the testicles or the pituitary gland that controls the testicles. This can be caused due to multiple reasons like:

    • Inherited Conditions:

      • Undescended testicles: When the testicles fail to descend from the abdomen before birth
      • Klinefelter’s syndrome: A condition in which a man is born with three sex chromosomes: X, X, and Y
      • Hemochromatosis: Too much iron in the blood causes testicular failure or pituitary damage
  • Types of testicle damage that can lead to primary hypogonadism:

    • Physical injury to the testicles: Injury must occur to both testicles to affect testosterone levels
    • Mumps orchitis: the testicles may get injured due to a mumps infection 
    • Cancer treatment: Radiation or chemotherapy may also damage testicles
  • Secondary hypogonadism

When there is damage to the pituitary gland or the hypothalamus, one may develop secondary hypogonadism. These parts of the brain control hormone production by the testes and any damage to it may result in lower production of testosterone.

Inherited or disease conditions in this category include:

  • Pituitary disorders caused by drugs, kidney failure, or small tumours
  • Kallmann syndrome, a condition connected to abnormal hypothalamus function
  • Inflammatory diseases, such as tuberculosis, sarcoidosis, and histiocytosis, which can impact the pituitary gland and the hypothalamus
  • HIV/AIDS, which can affect the pituitary gland, hypothalamus, and testes

Acquired circumstances that can lead to secondary hypogonadism include:

  • Normal ageing: Aging affects production and response to hormones.
  • Obesity: Excess body fat may affect the production of hormones.
  • Medications: Certain pain medications and steroids may affect the function of the pituitary gland and hypothalamus.
  • Concurrent illness: The reproductive system may temporarily shut down due to emotional stress or during recovery from an illness or surgery.


What Lifestyle and Diet Choices Can Lower Testosterone Levels in Men?



Certain lifestyle choices like alcoholism and smoking are known to contribute to low levels of testosterone. However, a healthy diet is key to maintaining testosterone levels in your body. Here are 6 foods that can lower your sex drive.


Do You Need Testosterone Replacement Therapy?



You may feel tired or drained often, and it may just be due to work stress or age. However, for some, it may also be a case of low testosterone. If your test results show very low levels of testosterone, your doctor may suggest testosterone replacement therapy (TRT).


What is Testosterone Replacement Therapy?


Testosterone Replacement Therapy (TRT), also known as Androgen Replacement Therapy (ART) is a hormone replacement therapy used to counter low levels of testosterone in a man. TRT is advised only when you’ve been diagnosed with hypogonadism.

You may have multiple questions if you’ve been advised TRT or are planning to consult your doctor regarding the same. Here are some of the top questions about TRT answered.


Is Testosterone Replacement Therapy Safe?

Like any other treatment method, there are a few side effects involved in TRT. Some of them are:

  1. Acne
  2. Breathing disturbances while sleeping
  3. Breast swelling and tenderness
  4. Ankle swells
  5. Long-term users may have an increased risk of cardiovascular problems like heart attacks and strokes
  6. May stimulate the growth of prostate cancer cells

However, most of the times, the benefits outweigh the potential risks, making TRT a choice for many men who are suffering from Hypogonadism.


Can Testosterone Replacement Therapy Make Me Feel Energetic?



Abnormally low levels of testosterone might need TRT to boost hormonal levels. This can make you feel energetic and bring back your sex drive as well.  However, during treatment, the body stops making testosterone, and stopping the therapy can present big differences since testosterone production isn’t fully recovered.


How is TRT done?


TRT can be administered in multiple ways and your doctor will recommend based on your lifestyle and medical needs. Testosterone Replacement Therapy methods include:

  1. Oral medications
  2. Intramuscular injections
  3. Topical creams
  4. Transdermal patches

Consult your doctor to know more about each of these methods in detail to know which one is best suited for you.


How long do I have to take TRT for?


TRT is not a cure for your low levels of testosterone. So you will have to keep taking it indefinitely. However, testosterone replacement therapy can be taken in microdoses as well to take in only some amounts of testosterone for physical changes.


Testosterone Replacement Therapy has been a long-standing treatment method for hypogonadism. However, if only low levels of testosterone is your concern, try changing your lifestyle and diet to help boost testosterone levels naturally. 



Medanta Medical Team
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