There have been no well-designed studies evaluating the risk of long-term dependence on testosterone replacement therapy (TRT). It is important to recognize that several reliable sources rule out the risk of experiencing profound withdrawal symptoms or unwanted long-term dependence. The prescribing information for each of the testosterone gel supplements is reassuring: “Drug dependence has not been documented in people using therapeutic doses of anabolic steroids for approved indications (see prescribing information, paragraph 9.3, on the respective commercial websites). However, to date, there have been no well-designed studies evaluating the risk of long-term dependence on testosterone replacement therapy (TRT).).
As the adage goes: “The absence of evidence does not constitute proof of absence. If a man's testosterone is below the normal range, it's best to repeat it one more time to be safe before starting testosterone therapy, often keeping it indefinitely. There is a kind of testosterone trap. Men start with testosterone replacement and feel better, but then it's hard to stop doing it. During treatment, the body stops producing testosterone.
Men often feel a big difference when they stop treatment because their body's testosterone production hasn't recovered yet. A low testosterone level alone doesn't need treatment. Testosterone replacement therapy can have side effects and the long-term risks are unknown. Only men with symptoms of low testosterone and blood levels who confirm that this is the cause of the symptoms should consider testosterone replacement. Talking to your doctor is the only way to know if testosterone therapy is right for you.
Testosterone replacement therapy (TRT) involves an injection, patch, or gel of the hormone testosterone to bring the level back to normal. Testosterone is produced in the testicles (the sexual organs of men) and is responsible of masculine traits. Testosterone replacement therapy for women Testosterone decreases in women as they age, especially after menopause, but most of the time, TRT isn't necessary. If a woman complains of low libido and wants that to change, experts often recommend excluding other causes first, for example, looking at current medications, such as SSRIs (taken for depression) or relationship problems.
Synthetic testosterone for women is only authorized in Australia. In other countries, testosterone is administered to women in an unauthorized manner, usually at one-tenth of the dose given at men. Women who have taken testosterone generally report an increase in sexual desire. There doesn't seem to be any benefit for women when it comes to energy, mood, or bone health.
You may confuse low testosterone levels (low testosterone levels) with erectile dysfunction. While erectile dysfunction (ED) can be a symptom of low testosterone, and having low testosterone levels can reduce libido, some people with low testosterone have no problem achieving an erection, while others have erectile dysfunction with normal testosterone levels. If your doctor suspects that your testosterone levels are low, he or she will do a blood test, probably first thing in the morning. You may need to have your blood drawn more than once and at different times of the day, as testosterone levels change. Once you receive the results, your doctor may order other tests to rule out other reasons why you have low testosterone levels.
Its levels rise and fall during the day. Testosterone levels are highest at 8 in the morning. Especially for older men, you'll want to have your level measured in the morning, as the decrease is more noticeable if blood is drawn at that time. A nurse or technician will draw blood from a vein in your arm and collect it in a small test tube. They will send it to you for analysis. There are three types of blood tests to measure testosterone.
It measures both testosterone bound to blood proteins and testosterone not bound to proteins (called free testosterone). Most testosterone is bound to proteins; proteins control the amount of active testosterone in the body and prevent tissues from using the hormone right away. This measures the amount of free testosterone in the blood. It is given to diagnose certain medical conditions. This is a skin patch that is placed on the arm, upper body, or other place where you are not likely to sweat or pressure (for example, when you lie on it).
The patch is applied once a day between 8 p.m. You'll need to choose a different location to apply it each time. Wait 7 days before returning to a place you were already using. It can come in an aluminum package or in a pump or swivel bottle. Testosterone is absorbed directly through the skin when the clear gel is applied once a day.
It is usually rubbed on the shoulders, upper arms, or thighs, according to the instructions for the medication. Allow the gel to dry before you put your clothes on it. Be careful not to let children or their loved ones touch the treated area or unwashed clothing that has been in contact with the gel, as testosterone may transfer to them. A type of gel is applied to the inside of the nose using a dosing pump.
It is usually applied three times a day to each nostril, with an interval of 6 to 8 hours. Do not blow your nose or smell for 1 hour after using this nasal gel. It may look like a pill, but it sticks to the top of the gums. Apply this patch by pushing it against the gums and to the left or right of the front teeth. Keep it in place by also pushing it from the outside of your mouth. The patch continuously releases testosterone into the blood through oral tissues.
Change it after 12 hours and change it on the other side of your mouth. A nurse or technician can give you testosterone as an injection directly into a muscle. You can also learn how to give yourself the injection yourself at home. You will be shown what parts of your body you can use for the injection site, since they need to be rotated. The injection is usually given once a week.
A healthcare provider inserts these pellets under the skin (usually in the buttock area) every 3 to 6 months. To do this, they make a small incision in the skin and use a special instrument to implant 10 testosterone granules. The body slowly absorbs testosterone into the blood stream. Why not just a simple testosterone pill? Oral testosterone has been around since the 1980s, but it wasn't popular because it can cause liver problems. However, there are now some new pills (Jatenzo, Tlando and Kyzatrex) that don't pass through the liver and carry testosterone directly into the blood, just as skin patches, gels and other treatments do.
The pill is usually taken twice daily with food. One downside is that these pills are expensive and may not be covered by insurance, unless you've tried other treatment methods and haven't been successful or have had negative side effects. Men also often report an improvement in their mood from TRT. Whether these effects are barely noticeable or represent a significant increase depends on the person.
Karen Herbst, MD, PhD, endocrinologist, specializes in testosterone deficiency. He estimates that approximately 1 in 10 men are ecstatic about their response to testosterone therapy, while roughly the same number doesn't notice much. Usually, most have positive, but variable, responses to testosterone replacement. The prostate grows naturally under the stimulation of testosterone.
In many men, prostates grow larger as they age, squeezing the tube that carries urine (urethra). The result is difficulty urinating. This condition, benign prostatic hypertrophy, may worsen with testosterone treatment. This condition may worsen with testosterone replacement.
It can be difficult for men to detect it on their own, but their partner who sleeps frequently may notice. A sleep study (polysomnography) may be needed to make the diagnosis. Some studies show that testosterone may increase the risk of deep vein thrombosis and pulmonary embolism, a potentially life-threatening clot in the lungs. Congestive heart failure: Usually, men with severe congestive heart failure should not take testosterone replacement medications, as this can worsen the condition.
As with any medication, the decision whether the potential benefits outweigh the risks is up to you and from your doctor. Side effects of testosterone replacement therapy However, the study also found that men taking TRT had more cases of irregular heartbeats, blood clots in the legs or lungs, and kidney problems than men who received the placebo. At this time, the warning label remains. Some bodybuilders and athletes illegally take anabolic steroids to build muscle mass or improve their athletic abilities.
The word anabolic refers to bodybuilding tissue. These steroids usually contain testosterone or chemicals that act like testosterone. So how is this different from TRT? You can also become addicted to anabolic steroids, even if they don't cause any side effects. You need a prescription from your doctor to access testosterone.
However, even if your doctor finds that your testosterone levels are low, he or she may recommend that you first try other remedies (for example, losing weight or seeing a psychologist for depression) before prescribing testosterone. Taking the medication is often a lifelong commitment (unless your low testosterone is due to a medical condition), so you'll need to be monitored continuously by a doctor. They'll also do a physical exam and ask you if you have symptoms of low testosterone before they prescribe anything to you. Testosterone replacement therapy clinics Over the past 15 years or so, many clinics have sprung up that specialize in TRT.
Some experts warn against them because they say that the doctors who administer them often prescribe too much testosterone and are often not specialists in urology or endocrinology (the study of hormones). Some of these clinics accept insurance, while others only accept cash. Before going to a testosterone replacement therapy clinic, do some research to find a reputable clinic. Once you start testosterone therapy, can you stop it? You can stop doing it, but symptoms of low testosterone levels are likely to return.
In one study, 151 men were followed up for 6 months after stopping testosterone replacement therapy. The researchers found that in 92 patients (61%), the effects of TRT did not continue, but they did in the other 59 patients (39%). The researchers found that people in the second group had been receiving TRT longer than those in the first group (10.7 months), compared to people who wanted to stop taking testosterone, they didn't stop taking it all at once. Talk to your doctor so you can gradually stop taking the habit. As long as you're taking TRT, your body stops producing testosterone, so you'll want to give it time to produce its own male hormone again. Testosterone replacement therapy costs Many clinics and doctors offer testosterone replacement therapy, but you may not need it.
Before prescribing testosterone, your doctor should check your testosterone levels and make sure that your low testosterone level isn't due to something else, such as an illness. If your levels are low due to age, you don't need TRT. If you start with TRT, you're likely to continue for life. Many men who take it find many benefits.
What Happens to Your Body When You Start Testosterone Replacement Therapy? How long can you continue with testosterone replacement therapy? If you stop taking TRT, symptoms of low testosterone often return, so you may need to keep taking the medication for life, unless you decide you don't want to continue receiving treatment. In some studies, a relationship was found between TRT and increased blood pressure, while in others, no effect was seen or a relationship was observed with a decrease in blood pressure. The effect on blood pressure may depend on your own health, whether you have heart disease or high blood pressure, and the amount of testosterone you take. A common concern among patients undergoing TRT is that their natural testosterone production may be completely interrupted once they start treatment.
However, this isn't necessarily true, as the body continues to produce LH even during treatment. On rare occasions, excessive psychotic symptoms, libido and aggression have been described, in addition to physical and psychological dependence and withdrawal syndromes during treatment with testosterone (306, 307), although the validity of testosterone or causes are uncertain. Kenny et al204 found no significant changes in behavior, function, depression, or cognitive performance after 12 weeks of testosterone replacement in men with low testosterone levels and early-to-moderate cognitive impairment. However, symptoms such as decreased libido and sexual desire, forgetfulness, memory loss, anemia, difficulty concentrating, insomnia, and decreased sense of well-being are more difficult to measure and differentiate from hormone-independent aging.
Whether this is a true form of hypogonadism or a decrease in serum testosterone associated with the progressive accumulation of health problems with aging (95, 9) is still hotly debated, but rather regardless of the aging process itself. Over the past two decades, there has been accumulating evidence of rapid androgen responses, dependent or independent of the androgen receptor, that occur at the cellular level and organic. Testosterone replacement may be effective in reversing age-dependent changes in body composition and associated morbidity. Even if only a small percentage prove to be susceptible to long-term dependence, the men affected could represent a very large population, in absolute terms.
Since the clinical manifestations of testosterone deficiency do not occur at a definitive threshold value of circulating testosterone, but vary depending on the target organ, associated symptoms and underlying conditions, it is even more complicated to establish a time course, since the reversion of these deficiency symptoms does not only depend on the return of serum testosterone to normal. However, a healthy level for you depends on your age, lifestyle, and level of bioavailable testosterone (free testosterone that your body doesn't use for daily functions).The above results call for a well-designed study showing the time needed to restore androgen-dependent function with optimal circulating testosterone for that specific androgen-dependent function. The risks of testosterone replacement therapy depend on age, life circumstances, and other medical conditions. In addition to the temporal evolution of the action of testosterone on androgen-dependent biological variables, table 1 presents an indication of the quantitative changes associated with the administration of testosterone.
Before starting treatment, after 3 months, a digital examination of the rectum should be performed and the PSA level determined and then in accordance with the guidelines for the detection of prostate cancer, depending on the patient's age and race.
