Low Testosterone Levels | Treatment & Hormone Replacement Therapy

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Aug 7, 2014/ 0 Comments / in Low T (Low Testosterone) / by
Low Testosterone Levels | Treatment & Hormone Replacement Therapy

Low Testosterone Levels Treatment & Hormone Replacement Therapy

Testosterone is indeed the most important male sexual hormone that is required for the development and maintenance of primary and secondary male sexual characteristics. According to latest estimates reported by CDC (Centers for Disease Control and Prevention), roughly 5 million adults in America are currently living with clinically low testosterone levels.

Normal testosterone levels are required for several biological activities; such as:

  • It maintain normal libido and sex drive (interest and enthusiasm to engage in physical sexual contact).
  • Testosterone is required to achieve and maintain normal erection and ejaculation.
  • Functional serum levels promote protein synthesis and normal metabolism to alleviate  fatigue, depression and anger.
  • It helps in maintaining the classic male traits like male-pattern hair growth (beard, moustache, scalp hair), strong muscular build and high bone density and muscle mass.
  • Testosterone also strengthens the leg and hand musculo-skeletal architecture.

Depending upon the cause of low testosterone secretion, a number of testosterone treatment therapy options are available:

  • Hormone replacement therapy.
  • Lifestyle or dietary modification.
  • Supplements.

Hormone Replacement Therapy for Low Testosterone Levels:

The aim of hormone replacement therapy is to maintain normal serum of testosterone levels in the body to alleviate the symptoms of andropause (Andropause Wiki Page). Most popular options are:

Low Testosterone Levels Treatment & Hormone Replacement Therapy Image

Low Testosterone Levels Treatment & Hormone Replacement Therapy

  • Oral formulation of testosterone are less effective (due to weaker concentration and metabolism in the body as compared to gels, patches, and injections). Serious adverse effects are a concern when used in high concentration.
  • Implantable testosterone pellets can be placed during the procedure, under the buttocks’ skin. At one time, several pallets can implanted that serves as a depot testosterone source and gradually release recommended quantities of testosterone over a period of 3-4 months. Once all these pallets are used up, another procedure is needed to replace the pellets.
  • The less expensive option available is deep muscle injections. These injections are administered after every 7-22 days. After the administration of injection the level of testosterone is higher for 2-3 days and gradually declines until it is time for the next injection.  These injections are quite painful and between the injections the level of testosterone fluctuates significantly.
  • Application of gel and patches is done on the skin on the daily routine basis. These gels or patches can be applied on the scrotum, thigh, upper arm, abdomen and back. Their application is easy and doesn’t cause the fluctuation in the testosterone levels as in case of injections. The testosterone is quickly absorbed by the skin and is stored and released gradually in the blood. However some common side-effects and concerns associated with gels and patches are; blisters, itching and irritation. In addition, the risk of missing the patch is high in hot humid weather due to sweating. It must be carefully noted that children and women must not touch that area of the skin where gel or patch is applied to minimize the risk of testosterone transfer.

It is highly recommended to keep up with your periodic follow-up visits. Immediately report to your healthcare provider if you are experiencing:

  • Breathing or respiratory difficulty.
  • If you experience persistent or frequent erections.
  • Any other discomfort or concern that may require a dose adjustment.

According to a latest report published in the Journal of Sexual Medicine (1), investigators reported that long-acting testosterone replacement therapy can significantly improve the quality of life and sexual dysfunction as evidenced by the results of clinical trial that was conducted in 199 men over a period of 30 – 52 weeks. Report concluded:

“TU (long- acting testosterone) significantly improved all domains of the IIEF (International Index of Erectile Function) and patient reported quality of life at 30 weeks and more significantly after 52-week open-label extension. Improvement was most marked in less obese patient and those without coexisting depression”

Risks & Concerns Associated With Testosterone Level Replacement Therapy

  • Personal history of prostate or breast malignancy is a contraindication to testosterone replacement therapy.
  • Individuals who have moderate dysfunction of liver, kidney may experience severe side-effects with hormone replacement (and hence existing renal or hepatic dysfunction is a relative contraindication to the therapy).
  • Long term use of testosterone replacement therapy may lead to enlargement of prostate or breast tissues in male subjects.

Males receiving testosterone replacement therapy require more frequent screening for prostate cancer via PSA and rectal examination.

Testosterone is a hormone of primary significance that is required for the development and maintenance of male adulthood. The hormone replacement therapy may not be a suitable option for every male; therefore pros and cons should be measured before choosing testosterone replacement therapy.

Lifestyle & Dietary Modifications:

Low Testosterone Levels Treatment & Hormone Replacement Therapy Image

Low Testosterone Levels Treatment & Hormone Replacement Therapy

Intake of healthy diet that is rich in essential fatty acids is fairly helpful in maintaining normal testosterone levels. This is mainly because research and clinical studies indicate that malnutrition or chronic stress (emotional, physical or nutritional) can affect the normal functioning of all endocrine glands.

  • Incorporate exercise and other healthy physical activities.
  • Perform yoga, meditation or other stress relieving activities.
  • Consume a balanced diet and maintain your body weight in normal limits. Obesity is a huge preventable risk factor in the pathogenesis of hypogonadism.

According to a latest research published in the peer reviewed Journal of Strength & Conditioning Research (2), investigators suggested that supplementation of Conjugated Linoleic Acid serves as a building material that significantly increases the testosterone levels if coupled with resistance or strength training exercises.

Herbal Supplements to Boost Testosterone Levels

Most popular and recommended herbal/ nutritional supplements that may improve the secretion of testosterone levels and possibly improve sexual dysfunction are:

  • Yohimbe
  • Fennel
  • Valerian Root
  • Horny Goat weed
  • Gingko Biloba

If you are considering hormone replacement therapy, it is mandatory to consult with your healthcare provider regarding herbal supplements to prevent the risk of drug-drug interaction.

References:

Hackett, G., Cole, N., Bhartia, M., Kennedy, D., Raju, J., & Wilkinson, P. (2013). Testosterone Replacement Therapy with Long‐Acting Testosterone Undecanoate Improves Sexual Function and Quality‐of‐Life Parameters vs. Placebo in a Population of Men with Type 2 Diabetes. The journal of sexual medicine, 10(6), 1612-1627.
Macaluso, F., Morici, G., Catanese, P., Ardizzone, N. M., Gammazza, A. M., Bonsignore, G., … & Di Felice, V. (2012). Effect of conjugated linoleic acid on testosterone levels in vitro and in vivo after an acute bout of resistance exercise. The Journal of Strength & Conditioning Research, 26(6), 1667-1674.