Bioidentical Hormones for Men
Testosterone is the only hormone used in men with pellet therapy. Several pellets are placed under the skin, lasting five to six months. This is a great long-term solution for men who find they must stay on testosterone replacement therapy continuously. We utilize blood tests to monitor patients and to help determine the initial dose of testosterone. Men often report improvement in mood, cognition, improvement in lean body mass, loss of body fat, and improvement in sexual desire and function. Men with diabetes may notice that with the weight loss that occurs with bioidentical testosterone replacement therapy, their need for insulin or diabetes medications can decrease over time. Testosterone therapy can also decrease the risk for osteopenia and osteoporosis.
When is testosterone hormone replacement therapy indicated in men?
Men can experience decreases in testosterone as early as their 30′s. The symptoms may not be as significant until the 40′s, 50′s or even 60′s. At LiveAgelessly, we treat symptomatic patients with hormonal decline, regardless of age. Hypogonadism is a clinical condition in which low serum levels of testosterone are found in association with specific signs and symptoms that may cause Erectile Dysfunction (ED).
Why is testosterone hormone replacement therapy indicated in men?
Population-based studies done in the last 10 years indicate that a low testosterone level is associated with an increase in the risk for developing type 2 diabetes, metabolic syndrome, heart disease and even a reduction in how long a man lives.
Low testosterone may be a predictive marker for those at high risk of cardiovascular disease. When testosterone is low there can be negative effects on the cholesterol causing a low HDL (the good cholesterol), an elevated LDL (bad cholesterol) and elevated triglycerides.
Low testosterone is also associated with increasing levels of fibrinogen, a protein made in the liver that increases the clotting in blood. Low testosterone at the same time increases another protein in the blood called plasminogen activator inhibitor-1 (PAI-1) which inhibits clots from breaking down. PAI-1 is primarily produced by cells lining blood vessels. The combination of elevated proteins that increase clot formation and another that stops them from breaking down is a not a good environment inside blood vessels. Excessive levels of fibrin from fibrinogen will lead to a clog like effect inside of blood vessels which can also cause a flaccid penis. This explains why there is increased risk for heart disease with low testosterone, especially when there is abnormal cholesterol levels mixed with elevated proteins that create an inflammatory response in the body.
Cardiovascular disease is the number one killer of men and women. Low testosterone can increase one’s risk for cardiovascular disease, type 2 diabetes and metabolic syndrome. Metabolic syndrome is a combination of medical disorders that when occurring together, increase the risk of developing cardiovascular disease, diabetes and an almost 50% increase in mortality over a seven year period. Testosterone decreases the expression of inflammatory markers. Studies in men have proven that testosterone replacement reduces cardiovascular risk by reducing insulin resistance, lowers cholesterol and improving control of blood sugar in type 2 diabetes. Testosterone will increase lean body mass and with a good diet and exercise program cardiovascular risks can be decreased.
Signs and symptoms of low testosterone (Andropause)
Andropause is caused by declining testosterone levels. Men may experience diminished libido, erectile dysfunction (ED), difficulty in achieving orgasm, diminished intensity of experience of orgasm, diminished sexual penile sensation, impaired cognition, diminished muscle mass, decreased bone density leading to osteopenia or osteoporosis, and an increase in central body fat. Other symptoms such as forgetfulness, difficulty concentrating, insomnia and a decreased sense of wellbeing are also sometimes present.
Diagnosing low testosterone in men in the Henderson/Las Vegas area
Low testosterone levels when combined with several of the symptoms of deficiency of testosterone is also known as andropause. The diagnosis of andropause includes demonstration of a low total or free testosterone and clinical symptoms of ED, decreased muscle mass and strength, increased body fat, breast enlargement, hot flushes, sleep disturbances, decreased bone mineral density and osteoporosis, hot flushes, decreased vitality, and decreased intellectual capacity (poor concentration, depression, fatigue).
Testosterone Deficiency Questionnaire for Men
- Do you have a decrease in libido or sex drive?
- Do you have a lack of energy?
- Have you noticed a decreased “enjoyment of life”?
- Are you sad and/or grumpy?
- Are your erections less strong?
- Are you experiencing a decease in ability to perform sexually?
- Have you noticed a recent deterioration in performance where you feel that you’re getting less done or achieving less?
- Are you falling asleep after dinner?
- Are you experiencing an increased need for sleep?
- Are you experiencing reduced muscular and physical strength?
- Are you having excessive sweating with unexpected or sudden episodes of sweating?
- Are you experience joint and muscular pain?
Benefits of testosterone replacement therapy
- Improved sexual desire and function
- Improved mood, energy and quality of life
- Weight loss regardless of exercise, results are best with healthy diet and exercise
- Change in body composition and improve muscle mass and strength
- Enhanced cognitive function with improved brain concentration and memory
- Less agitation or irritation with a better response to stressful events
- Improved fat and sugar metabolism
- Increases in coronary blood flow in patients with coronary heart disease and beneficial effects on blood vessel function and coagulation. The net effect is a reduction in risk of clotting and improvement in circulation.
- Testosterone is also been shown to increase the ejection fraction of the heart, meaning more blood is pumped with each beat.
- Increased bone mineral density with decreased risk for osteopenia and osteoporosis
Studies have proven that testosterone replacement therapy reduces insulin resistance and improves blood sugar in diabetic men, insulin resistance is improved and body fat is also reduced. Together these improvements resulted in overall reduction in cardiovascular risk.
Risks of testosterone replacement therapy
Though rare, risks relating to testosterone replacement therapy in men do exist. Testosterone may stimulate growth of already existing prostate cancer and male breast cancer. Testosterone can increase estradiol levels and this can stimulate breast tissue to grow, a condition called gynecomastia. Gynecomastia is completely avoidable by using estrogen blocking agents and monitoring hormone levels.
Men who are trying to have a child should not use testosterone due to it causing testicular atrophy and infertility. If childbearing is not an issue then this would not be a concern. It is reversible if therapy is stopped.
In rare cases testosterone may cause or exacerbate sleep apnea. Testosterone does not cause prostate cancer. Liver cancers have occurred when testosterone was used at super physiologic levels, however it also has not been proven that testosterone replacement when used in therapeutic doses can cause the development of cancer.
Testosterone replacement therapy, if done correctly, provides more benefits than risks.