Testosterone Replacement Therapy: Indications and Features

Testosterone is the main male hormone, the functions of which go far beyond maintaining normal sexual and reproductive ability. It affects the metabolism, the state of muscle and bone tissue, and the work of the endocrine glands and internal organs. Lack of testosterone leads to a serious deterioration in the health and well-being of men, causing impotence, obesity, reduced physical strength, and many other problems.

The only way to cope with the symptoms and return the person to a fully active life is testosterone replacement therapy. Next, let’s talk about the features of prescribing and taking such drugs and the nuances and side effects that may occur during treatment.

When are testosterone preparations prescribed?

Testosterone therapy is indicated for men who have symptoms of androgen deficiency and laboratory-confirmed low levels in the blood. The most common causes that cause an imbalance of hormones in the male body and require correction:

  • congenital hypogonadism, including Kalman’s syndrome, Klinefelter’s syndrome;
  • age-related androgen deficiency, which occurs in all men after 50-55 years;
  • violations of hormone production after testicular injury, orchiectomy, autoimmune diseases;
  • diseases of the pituitary and hypothalamus, causing a deficiency of gonadotropic hormones.

Like any hormone therapy, testosterone intake has a number of strict contraindications. Absolute limitations are malignant tumors of the prostate and breast, decompensated heart failure, and polycythemia. In the presence of benign prostatic hyperplasia, the appointment of a hormone is possible if the expected benefits of its use outweigh the risks. This point should be discussed with the doctor individually, taking into account the characteristics of the man’s health.

Types and results of testosterone therapy

For hormone replacement therapy, there are different dosage forms, among which the doctor chooses the most suitable for a particular patient. The main options for the introduction of testosterone:

  • oral – taking pills;
  • transdermal – using patches that are attached to the skin;
  • intramuscular – by injection;
  • implantation – the use of subcutaneous implants of prolonged action;
  • buccal – application of testosterone to the buccal mucosa.

A man notices the first effects of using testosterone after a few weeks. The patient’s mood improves, energy and physical endurance increase, and cognitive functions are activated. Gradually, sexual desire and potency are restored, and the frequency and quality of erections improve, so the man again receives vivid emotions from sexual life.

With prolonged low testosterone therapy services, changes occur throughout the body. The level of visceral fat reduces, and at the same time, muscle mass grows, which benefits the metabolism. After 6-12 months of therapy, hemoglobin and erythrocyte levels improve, bone density increases and osteoporosis vanishes.

Monitoring men who take testosterone

Hormone therapy can produce cellular changes in the blood, toxic effects on the liver, gynecomastia, and other adverse effects; thus, it should only be used under the guidance of a doctor. Another side effect of treatment might be an expansion of the prostate gland, a hormone-dependent organ.

To minimize side effects and avoid complications, a man needs regular health monitoring by a doctor. In the first year of taking testosterone, visits to the doctor are planned every 3 months; in subsequent years, in the absence of complications, it is enough to visit a doctor every 6-12 months.

Examination by an andrologist is supplemented by a number of instrumental and laboratory studies, such as:

  • clinical blood test;
  • biochemical blood test with determination of lipid profile;
  • examination of prostate-specific antigen (PSA) levels;
  • digital prostate examination and ultrasound;
  • densitometry;
  • a survey about the quality of sleep, polysomnography for suspected obstructive sleep apnea syndrome.

If, according to the results of the diagnosis, the doctor sees a sharp increase in hematocrit, an increase in the level of PSA, and other undesirable consequences, the issue of reducing the dose, changing the drug, or conducting alternative therapy is considered.