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Testosterone – What Types of Treatments Are Available?

Do you feel your energy levels, sex drive, and mood have gone down the drain. Even the junk in pants is always facing down. Maybe this is due to your male hormones? Did you know that the symptoms for low testosterones are very subtle! It’s hard for one to notice but your partner just might. 

What is testosterone?

Testosterone is a hormone. It’s made by the bodies of both men and women. It plays a role in puberty and fertility. It also affects sexual desire. In men, most testosterone is made in the testes. In women, most testosterone is made in the ovaries.

Men have higher levels of testosterone than women. It’s thought that testosterone greatly influences the development of many characteristics considered to be male traits. It helps increase muscle bulk, bone mass, physical strength, and the amount of body hair.

The levels of testosterone in your body are constantly changing in response to your body’s needs. However, the overall level of testosterone in your body changes throughout your lifetime as well. It usually decreases, particularly for men aged 30 years and older. For some men, these levels can become too low and cause unwanted effects that have them looking for ways to increase their testosterone levels.

SUBTLE SYMPTOMS OF LOW TESTOSTERONE

The symptoms of low testosterone are sometimes obvious, but they also can be very subtle. Testosterone levels decline naturally in men as they age over decades. But certain conditions can also lead to an abnormally low level.

Symptoms of low testosterone include:

  • Changes in sexual function – This includes reduced sexual desire, fewer spontaneous erections, such as during sleep and infertility.
  • Erectile dysfunction
  • Fatigue and poor energy level
  • Decreased muscle mass – you may notice you are saggier than before.Various physical changes are possible, including increased body fat, reduced muscle bulk and strength, and decreased bone density. Swollen or tender breasts (gynecomastia)
  • Body and facial hair loss
  • Difficulty concentrating
  • Depression
  • Irritability
  • Low sense of well-being – Low testosterone can contribute to a decrease in motivation or self-confidence. You might feel sad or depressed, or have trouble remembering things.

If you have been facing any of the above symptoms, do make an appointment with us and get yourself checked! 

WHAT TO EXPECT?

In the clinic, you will be asked a series of questions. You will then be required to do some hormonal testing and the prices may vary depending on the package. 

Once your report is back and if total testosterone levels are normal (greater than 12), you would  not be diagnosed with (TDS). However, if the values are borderline below 12, a repeat testosterone level may be performed for confirmation. 

Despite repeating and the numbers are still low, further comprehensive tests would also be undertaken These include FSH, TSH, LH, Prolactin– (hormones produced by the pituitary gland), a complete blood count, SHBG, cFT or cBAT, Ferritin (iron capacity in the blood), PSA (prostate specific antigen) for prostate disease. (Yup, too many alphabets, visit us for a detailed explanation) 

Depending on the results of the comprehensive tests, one would then be given a diagnosis of hypogonadism. There are two basic types of hypogonadism:

  • Primary. 

This type of hypogonadism is also known as primary testicular failure. Issues originating from a problem in the testicles.

  • Secondary. 

This type of hypogonadism indicates a problem in the hypothalamus or the pituitary gland, the parts of the brain that signal the testicles to produce testosterone. The hypothalamus produces gonadotropin-releasing hormone, which signals the pituitary gland to make follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Luteinizing hormone then signals the testes to produce testosterone. Hence the reason for the full hormonal testing. 

WHAT TYPES OF TREATMENTS ARE AVAILABLE?

There are few different types of testosterone preparations available. However, oral testosterone preparations have not been used for treatment of hypogonadism because they can cause serious liver problems. Also, they don’t keep testosterone levels steady.

Other preparations you might choose that are available in our clinic, depending on convenience and cost includes:

  • Gel (AndroGel)

There are several gels and solutions available, with different ways of applying them. As for AndroGel, you rub the testosterone into your skin on your upper arm or shoulder.

Your body absorbs testosterone through your skin. Don’t shower or bathe for several hours after a gel application, to be sure it gets absorbed.

Side effects include skin irritation and the possibility of transferring the medication to another person. Avoid skin-to-skin contact until the gel is completely dry, or cover the area after an application. If unwanted exposure took place, wash the exposed area well with plenty of soap and water right away. 

  • Injection. 

Testosterone undecanoate (Nebido) is given by deep intramuscular injection, typically every 10 weeks. The injection interval should be within the recommended range of 10 to 14 weeks. Careful monitoring of serum testosterone levels is required during maintenance of treatment. It is advisable to measure testosterone serum levels regularly. 

The most frequently reported undesirable effects during treatment with Nebido are acne and injection site pain. 

Testosterone therapy carries various risks, including:

  • Increased production of red blood cells
  • Acne
  • Enlarged breasts
  • Sleep disturbances
  • Prostate enlargement
  • Limited sperm production

TESTOSTERONE AND FERTILITY

Since testosterone replacement therapy may reversibly reduce spermatogenesis, it is not suggested for patients that are trying for a baby or planning to have a baby in the near future. 

If a pituitary problem is the cause, pituitary hormones can be given to stimulate sperm production and restore fertility. A pituitary tumor may require surgical removal, medication, radiation or the replacement of other hormones.

There’s often no effective treatment to restore fertility in a man with primary hypogonadism, but assisted reproductive technology may be helpful. This technology covers a variety of techniques designed to help couples who have been unable to conceive.

Some may ask if testosterone therapy promotes youth and vitality? Testosterone therapy can help reverse the effects of hypogonadism, but it’s unclear whether testosterone therapy would benefit older men who are otherwise healthy. Although some men believe they feel younger and more vigorous if they take testosterone medications, there’s little evidence to support the use of testosterone in otherwise healthy men. 

So which is the best for you? Well the only answer to that question is to find out your current hormonal levels. Come and get tested! 

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