Testosterone Therapy Options Replacement And Stimulating

Hormone therapy with testosterone is prescribed to men with the onset of andropause – a natural process of extinction of reproductive functions. The onset of symptoms associated with a decrease in the level of male hormones becomes the reason for the use of various drugs. Lack of endogenous (intrinsic) testosterone during this period worsens the quality of life, leading to health problems.

Reasons for Testosterone Decrease

A gradual drop in testosterone levels is a natural process associated with the extinction of reproductive function. Changes begin after 45 years, when there is a decrease in the concentration of testosterone in the blood. In response to low hormone production, the pituitary gland activates: the production of luteinizing hormone (LH) increases, and the effect on the testicles increases. Ideally, such a scheme would lead to a natural increase in testosterone levels, but with the onset of andropause, the system crashes.

According to statistics, almost half of men aged 45-55 years have some symptoms of testosterone deficiency.

Experts say that the main problem of adropause is not a low level of testosterone at all. The reason for poor health lies in the imbalance of all hormones and, in particular, the ratio of testosterone and estrogen. In young men, estrogen is produced in small concentrations. The conversion of testosterone to estrogen increases with age. Studies show that estrogen levels in men aged 54 years and women in 59 years are approximately the same.

The lack of testosterone not only enhances the production of estrogen, but also stimulates the attachment of the female hormone to specific receptors in all organs and tissues. And if in youth estrogen went to maintain anabolic processes, then with age the body ceases to cope with such a load.

Excess estrogen and a lack of testosterone in the complex lead to symptoms of andropause.

Indications for testosterone therapy

Hormone therapy is prescribed in such situations:

  1. Natural andropause, with severe symptoms of testosterone deficiency.
  2. Pathological conditions at any age, in which there is an imbalance of hormones (diseases of the pituitary gland, hypothalamus, etc.).

The reason for the appointment of testosterone therapy may be the appearance of such symptoms:

    • fast weight gain;
    • decreased performance;
    • impaired attention and memory;
    • the appearance of hot flashes;
    • headaches and dizziness;
    • insomnia.

At the same time, there are disorders in the sexual sphere:

    • decreased libido;
    • lack of orgasm;
    • violation of erection and ejaculation;
    • loss of ability to conceive a child.

A progressive decrease in testosterone leads to the appearance of various pathologies from the internal organs and the musculoskeletal system. The following symptoms occur:

    • urination disorders;
    • decrease in bone density (osteoporosis) and the appearance of back pain;
    • increase in blood pressure;
    • heart rhythm disturbance.

Unpleasant manifestations of andropause in combination with low levels of progesterone become the reason for hormone therapy.

Read: “Natural Ways to Boost Testosterone”.

Testosterone Therapy Options

There are two methods of treatment:

  1. Hormone replacement therapy (HRT).
  2. Stimulating therapy.

Hormone replacement therapy

A well-known method used in medicine since the middle of the last century. And while the first synthetic testosterone preparations had a large number of side effects, modern drugs are much better tolerated by patients.

The principle of action is the introduction of testosterone into the body, which will compensate for the deficiency of its own hormone and thereby eliminates the unpleasant symptoms of male menopause.

Testosterone preparations are used in various forms:

Oral means

    • Easy to use.
    • Effective only in mild andropause.
    • Valid for 4 hours.
    • They are prescribed several times a day, which makes these funds not the most convenient for continuous use.
    • Contraindicated in some diseases of the gastrointestinal tract.

Injection Forms

    • The best option in the presence of clinically pronounced symptoms of andropause.
    • Valid for a long time: from 1 to 3 months.
    • The effect of the use of the drug is noted after 3 days.
    • Do not affect the digestive tract, do not have a hepatotoxic effect.
    • May lead to a sharp jump in hormone levels after withdrawal.
    • After training, the patient can independently inject the drug.

Transdermal preparations

    • Presented in the form of adhesives.
    • They do not require special skills during installation: just follow the instructions.
    • They act throughout the day, creating the optimal level of hormones in the blood.
    • They require regular replacement.
    • Well tolerated and rarely lead to side effects.

Subcutaneous

    • Installed by a doctor: an implant is inserted under the skin, after which the wound is sutured.
    • Effective and relatively safe (possible complications after surgery).
    • Valid for 6 months, ensuring uniform release of the hormone.
    • Replace on time.
    • In the Russian Federation are not officially registered.

Side effects

Modern hormonal drugs are well tolerated by patients, however, when using large doses, side effects may develop:

    • a temporary decrease in the synthesis of endogenous testosterone;
    • swelling and weight gain;
    • deterioration of the skin (acne);
    • alopecia (baldness);
    • atrophy of testicles.

Studies conducted by German scientists have shown that prolonged and / or uncontrolled use of testosterone drugs increases the risk of developing vein thrombosis of the lower extremities and pulmonary embolism. There was also a connection between taking high doses of the hormone and increasing the frequency of cardiovascular disease in men.

HRT is strictly contraindicated in cancer of the prostate and breast.

Stimulant therapy

A relatively new treatment used to achieve andropause. Its essence lies in the use of drugs that stimulate the production of testosterone. During therapy, the concentration of the hormone reaches an optimal level, unpleasant symptoms disappear, and the risk of developing serious diseases is reduced.

For stimulating therapy in men, drugs based on chorionic gonadotropin (CG) are used. This substance activates spermatogenesis and triggers the production of endogenous testosterone. The drug is administered intramuscularly once a week. Therapy begins with small doses of the hormone (about 500-1000 units). With good tolerance, the dosage of the drug is gradually increased. The course of treatment lasts at least 12 months. After cancellation of CG, its effect lasts up to six months.

To determine whether this method of therapy will be effective, it is necessary to conduct a test: the patient is administered 1,500 units of the drug for 3 days, after which testosterone levels are measured. The concentration of the hormone should increase by 50% or more. In the absence of effect, testosterone replacement therapy is indicated.

Treatment is contraindicated in prostate cancer and malignant breast tumors.

Comparison of therapies

Comparative characteristics of substitution and stimulation therapy are presented in the table:

Sign Replacement therapy Stimulant therapy
Operating principle The introduction of testosterone and maintaining it at the right level in the body Stimulating testosterone production
Benefits High efficiency
    • Prolonged effect.
    • Positive effect on the production of your own sex hormones.
    • Minimum effect on spermatogenesis (does not interfere with sperm production, does not affect the size of the testicles)
disadvantages
    • Sudden changes in the concentration of the hormone in the blood are possible, which is poorly tolerated by patients.
    • A large number of other side effects.
    • Reversible inhibition of spermatogenesis and a decrease in testicle size during therapy
Possibility of an allergic reaction
Release Forms Oral, injectable, subcutaneous, transdermal agents Injection form
Action duration Depends on the form of release (from 4 hours to 3 months) 2-3 days
Efficiency A large selection of drugs allows you to choose the best option Some patients do not respond to stimulant medications.

Read: Gonadotropin Stimulating Therapy

The final choice of the method of therapy will depend on the condition of the man, the presence of concomitant pathology and individual tolerance of certain drugs. It is strongly not recommended to take any hormonal drugs without a doctor’s prescription.