Testosterone replacement therapy (TRT) is a great treatment option for men with hypogonadism – a condition in which the body fails to produce enough of the hormone testosterone.
Hypogonadism can be a result of either illness or as part of normal aging.
Whether or not men with hypogonadism should receive TRT remains debatable. This is mainly because hypogonadism is still not fully understood and also because TRT may lead to other health risks in some cases. Nevertheless, TRT is considered a revolutionary treatment for men having suboptimal levels of a very important male hormone.
What does it mean to have low testosterone?
According to Abraham Morgentaler, MD, the Director of Men’s Health Boston with over 20 years of experience in treating male hypogonadism, The Endocrine Society considers low testosterone levels to be a total of testosterone (T) below 300ng/dl.
However, he also warns that there is no definitive agreement on what constitutes normal T levels. The situation is further complicated by the fact that half of the circulating T is not available to the cells due to testosterone binding to a glycoprotein called sex hormone–binding globulin (SHBG).
Luckily, we’re now able to measure total free testosterone levels which is a precise indicator of the biologically available levels of T in a man’s blood. Other than testing for blood testosterone levels, doctors also look for symptoms of hypogonadism because some men don’t develop problems from having low T levels and treatment may not be needed in such cases.
Is TRT successful?
Just a little over 15 years ago, TRT was not as successful as it is today because the available formulations were not efficient in reproducing the pattern at which T is naturally secreted by the body. These therapies have resulted in either too low or too high T levels the following administration.
Nowadays, the situation is quite different as TRT is efficient enough to provide men with ideal levels of T similar to those naturally produces by the testes according to an article published in the Current Pharmaceutical Design.
Today’s TRT involves either injection, topical gels, and patches with the latter being the best treatment option for achieving a uniform level of blood T for men receiving treatment for low testosterone. Because of the hypothalamus and the pituitary gland release hormones that stimulate the testes to produce T at daily intervals, it’s always best to mimic the natural way T is released in the human body.
Which men are candidates for TRT?
Men who present with the symptoms of male hypogonadism such as a low sex drive, erectile dysfunction, infertility, central obesity, osteoporosis, loss of muscle mass, and who are tested for low testosterone levels are usually candidates for TRT.
The reason why men develop TRT are many, and the underlying causes should also be looked into before suggesting TRT. For instance, some men may develop hypogonadism due to pituitary tumors and treatment of these tumors usually result in the improvement of T levels.
On the other hand, older men usually have lower T levels than they did in their youth and whether or not T would benefit them is a matter of debate. These men also worry that TRT may put them at risk of developing prostate cancer. Although this idea may seem logically plausible, Dr. Morgentaler states that there is no real evidence to support such claims.
What are the benefits of TRT?
Just like estrogen provides a protective effect on women’s general health status, so does testosterone on men. Dr. Morgentaler believes that the therapeutic effect of TRT will be recognized in the near future not for just improving the patient’s well-being but also in protecting the patient against heart disease and all-cause mortality.
Men receiving TRT may see improvements in their overall functioning and feelings of well-being. Their energy levels may improve, their sex drive may rise, and their body composition may also improve. These benefits are best achieved by consulting a medical professional licensed to treat men with hypogonadism, but there are also claims that natural nutraceuticals may also do the trick. However, men should be aware that these products are not regulated and pose a health hazard in some cases according to a recent study published in the Journal of Dietary Supplements.
Most men will experience a decline in their T levels with age, and although this decline is completely normal, it can and does cause uncomfortable symptoms in some men.
Furthermore, men with illnesses that affect the functioning of their reproductive system and testosterone production may greatly benefit from TRT. Most treatment options today are both safe and effective in restoring normal T levels when administered by a certified physician.
On the other hand, men wishing to boost their T levels with alternative methods may find herbal supplements beneficial as some studies found that herbs and other plants have the potential to stimulate sex hormone production in some cases.