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Testosterone Replacement Therapy In Malaysia

What is testosterone?

Testosterone is the hormone produced primarily by the testicles in males, responsible for the development of male sexual characteristics. In men, testosterone is thought to regulate a number of functions alongside sperm production.

These include:

  • Sex drive
  • Bone density or mass
  • Fat distribution
  • Muscle size, strength and mass
  • Facial and body hair
  • Red blood cell production
  • Sperm production : Without adequate amounts of testosterone, men become infertile. 

Despite being a male sex hormone, females also produce testosterone, however only in smaller amounts. Testosterone contributes to sex drive, bone density, and muscle strength in women. However, an excess of testosterone can also cause women to experience male pattern baldness and infertility.

What are the signs and symptoms of low testosterone levels?

This is called Testosterone Deficiency Syndrome (TDS) or Androgen Deficiency. Men may have many signs and symptoms as they age. Some that might occur as a result of lower testosterone levels which include:

1. Changes in sexual function

  • Low sex drive 
  • Fewer spontaneous erections 
  • Infertility
  • Erectile dysfunction

2. Physical changes

  • Increased body fat
  • Reduced muscle bulk and strength 
  • Decreased bone density
  • Swollen or tender breasts (gynecomastia) 
  • Body hair loss is possible
  • Fatigue

3. Emotional changes

  • Decrease in motivation or self-confidence. 
  • Sad or depressed 
  • Trouble concentrating or remembering things.
  • Irritability

Some of these signs and symptoms can be also caused by other medical problems., including medication side effects, thyroid problems, diabetes and depression. It’s also possible that these conditions cause low testosterone levels.Thus, it is important to do a blood test to diagnose a low testosterone level.

How Common is Low Testosterone in Men?

In men, Testosterone levels gradually decrease as a man ages about 1% a year after age 30 or 40. About 4 in 10 men suffer from hypogonadism by the time they reach 45 years old. The effects of gradually lowering testosterone levels as men age is known as late-onset hypogonadism. Hypogonadism hampers the ability to produce normal amounts of testosterone.

Additionally, Testosterone deficiency is more common in men who have diabetes or who are overweight. In one research study, 30% of overweight men had low Testosterone levels, compared to only 6.4% of those with normal weight. In another study, 24.5% of men with diabetes had low Testosterone levels, compared to 12.6% of those without diabetes.

What are the options for Testosterone Replacement Therapy 

American College of Physicians guidelines indicate that testosterone therapy might improve sexual function and help reverse the effects of reduced testosterone production especially in patients with hypogonadism or Testosterone Deficiency Syndrome.

Testosterone replacement therapies are available in several forms.

All can improve testosterone levels such as:

1. Gels

Androgel comes in packets of clear testosterone gel. Testosterone is absorbed directly through the skin when you apply the gel once a day. Natesto is a gel applied inside the nose.

2. Injections

Testosterone can also be injected directly into the muscles which has to be administered by a medical professional. It could be given every 2-3 weeks or months depending on its type and the severity of your conditions.  Your body slowly absorbs the testosterone into the bloodstream. 

3. Pills

Testosterone pills are simple, painless and convenient and taken on a daily basis. Since testosterone is oil soluble, thus for the testosterone to be well-absorbed into the system,  the pills need to be taken with a meal containing oils. 

4. Skin patch (transdermal) 

Androderm is a skin patch that’s applied on the arm or upper body once daily. 

5. Mouth patch

Striant is a tablet that sticks to the upper gums above the incisor. It is applied twice a day, it continuously releases testosterone into the blood through the oral tissues.

Androgel

Androgel (testosterone gel) are controlled substances, available by prescription, used to treat adult males who have low or no testosterone due to certain medical conditions.

Prior to initiating AndroGel, confirm the diagnosis of hypogonadism by ensuring that serum testosterone has been measured in the morning on at least two separate days and that these concentrations are below the normal range.

How to use

Androgel 1% should be applied once daily to clean, dry, intact skin of shoulders, upper arms, and/or abdominal area only. The dose should be titrated based on the serum testosterone concentration. Additionally, serum testosterone concentration should be assessed periodically. 

Do not apply Androgel  to any other areas of the body, such as your penis, scrotum, chest, armpits (axillae), knees, or back. After applying the gel,  you should wash your hands and the application site with soap and water after the gel has dried up to prevent transferring the gel to someone else.  You should also avoid showering, swimming, or bathing for at least 5 hours.

What is testosterone gel, and how does it work (mechanism of action)?

Androgel is a gel containing testosterone which belongs to a class of drugs called androgens. Testosterone is the major male sex hormone responsible for the normal growth and development of the male sex organs and secondary sex characteristics.The FDA approved Androgel in February 2000 to supplement or replace natural production of testosterone and reverse symptoms of low testosterone levels. 

What are the side effects of testosterone gel?

The most common side effects of Androgel are:

  • Headache,
  • Increase blood pressure,
  • Acne,
  • Application site reactions (for example, itching, blisters, and redness),
  • Increased serum prostate specific antigen (PSA) levels or increase prostate size.

Next read: Testosterone – What types of treatments are there?

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