course of testosterone treatment. Hormone replacement therapy with testosterone preparations. Restoring optimal testosterone levels

A failure in the production of androgens leads to serious complications in the male body, which is why hormone replacement therapy for men can be a lifesaver for them. But for many, this issue is considered controversial, because the artificial introduction of hormones can be dangerous. To hormone therapy for men was not so frightening, you need to understand it in detail.

Hormone deficiency: causes and when therapy is indispensable

Hormone therapy for men over 40 is an almost natural process, but sometimes even younger people may need such treatment. Aging is not always the cause of a decrease in testosterone production by the endocrine glands. Any injury to the testicles can lead to this deficiency. Oncological pathologies and / or a number of genetic diseases contribute to this. No less dangerous is an excess of iron in the body, which will suppress testosterone. Improper functioning of the pituitary gland, a number of drugs, chronic diseases, including alcoholism and smoking, inhibit the production of vital androgens.

Important! If there are symptoms of androgen deficiency, men under 40 should undergo an appropriate examination, and after 40 - do it regularly, even if there is no clinical picture of testosterone deficiency.

Hormone replacement therapy for men can be prescribed only after diagnosing the amount of hormones in their blood. This analysis is true and accurate. When he confirms androgen deficiency and the absence of an oncological neoplasm in the prostate gland, treatment will be prescribed that increases their level. The exclusion of oncology is mandatory because androgen deficiency is often the beginning of the development of carcinoma. And if testosterone therapy is carried out, the patient may become worse.

Alarming bells for men should be the following signs of testosterone deficiency in the body:

• sexual desire is reduced or completely absent;
• frequent manifestations of loss of strength;
• depressive state;
• reduced growth;
• aggression and irritability, which was not there before;
• erection problems;
• excess weight gain;
• constant desire to sleep after dinner;
• enlargement of the mammary glands;
• osteoporosis and anemia;
• cholesterol plaques.

Any of the symptoms is dangerous, but if 3 or more are found, then going to the doctor should become a mandatory item for the man in the plan for tomorrow. Often, such therapy is resorted to when diagnosed with:

1. Primary and secondary hypogonadism.
2. Cryptorchidism.
3. Decreased erectile function, libido.
4. Androgen deficiency associated with age-related changes.
5. Gynecomastia.
6. Obesity that cannot be cured by traditional methods.

Testosterone Therapy: A Brief History

Testosterone Therapy in men was carried out at the dawn of the last century. But its positive results were confirmed only 40 years later. At the same time, the side effects of such therapy were much worse than its positive effect. Synthetic testosterone of those times had only a tablet form. After taking them, androgen metabolism occurred in the liver, where most of it was destroyed. This led to a strong effect on the liver of carcinogens and toxins. The organ was irretrievably destroyed, which was the reason for the ban on such treatment in many countries. But with the advent of analogues of the drug, but without such terrible side effects, this ban was lifted. Often these drugs are used by athletes, which is prohibited by a number of prestigious competitions, and this is what causes public scandals and showdowns.

The introduction of androgens into the body of a man: methods

In our time, there are the following forms of introduction of androgens into the male body:

Oral

Where is a tablet or capsule with the active substance used. The tablet form is the very first form in the treatment of testosterone deficiency. Many appreciate it for its ease of use and relatively low price when compared with other methods of androgen administration. It is the tablet form of testosterone that is most often counterfeited or produced in clandestine factories, which leads to serious health problems. Commonly used licensed drugs:

• Andriol 150-200 mg every day;
• Striant 30 mg three times a day;
• Proviron or Vistimon 30-80 mg every day.

Ying injection

Doctors believe that thanks to her, testosterone enters the body naturally and smoothly. The two types of testosterone most commonly used are enanthate and cypionate. Literally 100 mg of these drugs provide a weekly supply of androgen in a man. This number is individual, so someone will need a dosage higher, and someone lower. Anything above 200 mg of replacement therapy becomes a bodybuilder's steroid cycle. Usually, the weekly dosage is divided into 2 equal parts and administered at regular intervals, which allows you to maintain a stable level of the hormone in the blood. The injections are subcutaneous, not intravenous. Commonly used injections:

• Delasteril 200-400 mg once a month, divided into equal doses;
• Nebido 1000 mg once every 90 days;
• Sustanol 250 mg every 7-14 days.

transdermal

Represented by patches, gels and creams. Gels and creams make the flow of testosterone into the body smooth and gradual. However, doctors argue that the effectiveness of this form of its introduction is less effective. Difficulties may arise with application, because the skin must be clean (preferably immediately after bathing), it is forbidden to train for some time after that so as not to sweat or swim. The smeared area of ​​the skin should not be touched by others, especially children and women, since androgen is dangerous for them. For effectiveness, the skin must be lubricated at least 2-3 times a day, which significantly complicates the usual layout of life. Cream and gel are applied without rubbing. Most often in Russia, the Androgel drug is used, because it is sold in pharmacies without a prescription and it needs from 25 to 100 mg every day. Other transdermal agents:

• patches Androderm and Testoderm should be applied every day at a maximum dosage of 7.5 mg;
• Andromen cream is used daily at 15 mg;
• gel Andraktim, its dosage is determined individually.

Subcutaneous

Where is the implant used for these purposes. Few decide to implant the implant, and doctors do not consider it appropriate. But in some cases, especially with secondary hypogonadism, this is indispensable. More often hormone replacement therapy for men over 50, and the drugs to solve it are a testosterone implant at a dosage of 1200 mg, which is placed for six months.

The introduction of androgens: what to choose?

Tablets are recommended if the level of deviation androgens insignificant from the norm. With serious pathologies, even a large dose of the drug will be ineffective. It is recommended to give preference to Andriol, since with it the main metabolism of testosterone takes place outside the liver, thereby not affecting it in any way. The drug penetrates into the bloodstream as quickly as possible and raises androgens to the proper level. But because of this, it also quickly leaves the body, which causes it to be taken 3-4 times a day.

The man was diagnosed with low testosterone. Replacement therapy should not only raise its level, but also not harm the body. Therefore, many doctors prefer to use the injection method of administering the drug. Testosterone ester, like Omnadren or Sustanol, when it enters the circulatory system, will reach its maximum concentration on the second day. Within a couple of weeks, its level will gradually decrease, reaching a minimum.

A man will feel an incredible rise in both well-being and mood, as well as sexual desire. But the lower the concentration testosterone in the blood, the worse the condition, so by the end of the injection period there will be a decline. It is because of such recessions that patients do not want to use this form of androgen administration. However, their availability and low cost, with excellent efficiency, often tilt the scales of the choice of funds in their favor.

With the introduction of the Nebido drug on the market, it was possible to avoid frequent jumps, because it is an injection with a prolonged action. One dose of the drug is enough for 3-4 months, which means that the decrease will be gradual and without an acute difference in sensations. It has been clinically proven that this medicine does not cause hepatotoxic and hepatocarcinogenic effects in the body.

More and more men are choosing to use testosterone patches or gels. With them, hormones in the blood quickly reach the required level, and the liver is not exposed to their harmful effects. There is no need to change them several times a day, and they can also be adjusted independently. Side effects are not pronounced, but the price for them is above average. It is impossible to put an implant in our country, because certification has not been passed for any of them.

When is replacement therapy prohibited?

Doctors share contraindications hormone therapy for men into absolute and relative.

The first ones include:

1. Oncological neoplasm in the prostate gland, because hello to its growth.
2. An oncological neoplasm in the mammary gland, which is rare in men, but hormonal treatment will also provoke tumor growth.

Relative contraindications:

• snore;
• gynecomastia;
• polycythemia;
• problems with removing fluid from the body;
• puffiness;
• enlarged prostate;
• disruption of spermatogenesis.

According to relative contraindications, the doctor will determine the degree of deterioration of the patient's condition with the effectiveness of hormone treatment. Usually these conditions can be moderated if they are acted upon in a complex way.

Complications

Not worth to hormone therapy be treated negligently, because if the dosage indicated to the patient is exceeded, side effects will not be long in coming. The physiological parameters of the whole organism will be violated, which will lead to:

• the inability of the body to produce androgens on its own;
• swelling and fluid retention;
• covering the skin with acne and seborrhea;
• baldness and hair loss throughout the body;
• testicular atrophy;
• inhibition of sperm production.

problems with excessive androgen levels most often occur with young people who are passionate about sports and the physical ideality of the body. It is they who abuse testosterone-containing drugs, which negatively affects their health. This is not a joke, and the selection of such a remedy should be carried out only by a doctor and strictly for medical reasons.

Testosterone is a male sex hormone. However, its functions are not limited to the control of the reproductive system. This hormonal substance improves the body's susceptibility to oxygen, helps the central nervous system, regulates cholesterol and blood sugar levels. Therefore, if androgen deficiency is detected, HRT (hormone replacement therapy) is prescribed. In addition to drugs, exogenous testosterone can be obtained from healthy drinks and foods.

Who is Testosterone Treatment for?

A decrease in testosterone levels in men over 40 is a natural process of aging. But sometimes the inhibition of the production of androgenic hormones is activated by genetic diseases, oncological neoplasms, and testicular injuries. In addition, diseases associated with smoking, the use of alcohol and drugs lead to early aging and a decrease in the synthesis of hormonal substances. In this case, exogenous testosterone replacement therapy should be carried out after getting rid of the original ailment.

Separately, it should be said about the increased production of the protein SHBG (globulin that binds sex hormones). It binds testosterone into stable compounds that circulate through the bloodstream and do not react to target tissues. In addition to globulin, hormonal imbalance during normal androgen synthesis causes an excess amount of estrogen. Then HRT (hormone replacement therapy) is useless without inhibition of SHBG and estrogen.

To assess the hormonal background, a patient of any age must pass a whole series of blood serum tests, namely:

1. Blood test (clinical, biochemical, metabolic).
2. Testosterone (total, free, bioavailable).
3. Estradiol, globulin.
4. FSH (follicle stimulating hormone).
5. LH (luteinizing hormone).
6. DHT (dihydrotestosterone).

The entire series of tests must be taken in the morning and checked every six months to understand how successfully testosterone replacement therapy is being carried out.

Method of drug administration

Testosterone therapy can be administered in several ways: injection, oral, subcutaneous, and transdermal. For each age and condition of the body of a man, doctors individually select the method of administration of the exogenous drug and its dosage. But there are also general norms of treatment, that is, the elimination of a deficiency of sex hormones.

To determine the pathology, a man needs to pass a whole series of blood serum tests.

Each method of replacement therapy has its advantages and disadvantages.

• Pills

Oral drugs have a mild effect. Therefore, they are recommended for men who have a slight testosterone deficiency. Such HRT (hormone replacement therapy) is preventive in nature and is aimed at preventing the development of diseases associated with a lack of androgens in the body. Separately, it is worth noting the tablets that are not swallowed, but laid on the cheek. Their advantage is the gradual release of exogenous testosterone and low traumatism of the mucosa of the digestive tract. And the disadvantages include cases of damage to the gum tissue of the elderly.

• Solutions for injections

The positive aspect of testosterone replacement therapy, carried out by injection, is the direct entry of exogenous hormone into the body without irritation of the mucous membranes of the stomach and intestines. For intramuscular injections, oil preparations are used, which slowly break down into elements, due to which the same level of testosterone in the blood is maintained. Subcutaneous injections are often the choice of men who require lifelong HRT (hormone replacement therapy). Thus, they avoid numerous muscle punctures, especially painful after the age of 50 years.

• Transdermal gel

Exogenous testosterone can enter the body by applying a special gel to the skin. This type of replacement therapy is very popular among the stronger sex due to its ease of use and dosing flexibility. There are certain rules for the use of such drugs. So, you need to apply it on clean skin and after that do not sweat for half an hour (do not exercise). Make sure that during the first hour after spreading, other people do not touch this place, especially children, pregnant women, and the elderly. Also, to eliminate androgen deficiency, you can’t rub the affected area yourself.

When applying the gel to the skin, you can not sweat for half an hour.

• Testosterone patch

Another modern method of testosterone replacement therapy is the fixation of a special patch. The first generation of such preparations was intended for gluing to the scrotum, since through this place the body can absorb the maximum dose of exogenous hormone. The new generation of patches can be applied to the back, thighs, arms, abdomen. The main thing is that the skin is clean, dry and devoid of hair. This convenient tool allows you to quickly replenish testosterone deficiency and ensure its constant level throughout the day. Despite the apparent harmlessness of the sticker, the uncontrolled use of such HRT (hormone replacement therapy) can have severe negative consequences for the body.

• Subdermal implants

This type of HRT (hormone replacement therapy) is very popular with many men suffering from testosterone deficiency. It is a capsule sewn under the skin in the navel area, gradually releasing exogenous male sex hormone into the body. Due to the continuous action of the drug, the androgen level remains constant for six months after the procedure. At the same time, the incision is so small that the scar is invisible even in the summer. The disadvantages of such replacement therapy are the possible displacement or expulsion of the capsule, as well as cases of bruising and hematomas in the implantation zone.

Despite the fact that all funds can be bought at the pharmacy without any problems, it is strictly forbidden to prescribe substitution therapy for yourself. An excess of testosterone is just as dangerous as a deficiency of the hormone. Remember that with age, its natural level decreases, so all patients need to do a new test twice a year to control HRT (hormone replacement therapy).

With the help of a subcutaneous implant, testosterone levels can be maintained for up to six months.

When absolutely contraindicated

Hormone replacement therapy is absolutely contraindicated for patients of oncology clinics, as it can activate tumor growth. Intensive treatment of testosterone deficiency is prohibited for men over 45 years of age who have had cases of sleep apnea, epilepsy, migraines. In addition, an androgen replacement drug is not administered for the following ailments:

1. Bronchial asthma.
2. Inflammation in the pelvic area.
3. Heart and kidney failure.

>If all the necessary diagnostic studies are completed before starting HRT (hormone replacement therapy), the specialist will draw up an effective treatment regimen to maintain the level of the sex hormone within the normal range.

However, each organism reacts to therapy individually, and what worked at forty years old no longer has power at sixty. What side effects can be observed with HRT (hormone replacement therapy) in young men and in old age?

Adolescents may notice precocious puberty, excessive sexual desire, hypersensitivity of the nipples and penis. Elderly men are characterized by a violation of the mineral and water balance, which is expressed by puffiness, obesity, and swelling of the extremities. Therefore, in the treatment of testosterone deficiency, one should not only fix the level of exogenous hormone, but also monitor changes in one's well-being and consult a doctor in time if health deteriorates to correct hormone replacement therapy.

Testosterone is one of the main hormones in the human body. It can be found both in the blood of men and women. A deficiency of this hormone can occur for various reasons and lead to serious consequences, since the work of not only the sexual sphere, but also other body systems is disrupted.

A decrease in testosterone can also occur for physiological reasons, as a result of the aging of a man's body. Therefore, many men suffer from overweight precisely because of the decrease in the level of this hormone. Testosterone deficiency can lead to cardiovascular disease. The process of reducing testosterone levels begins after the age of thirty, and with a decrease in the amount of the hormone, libido also decreases.

In order to find out the level of the hormone in the blood, it is necessary to take a blood test, this must be done in the morning on an empty stomach. It is during these hours that the level of the hormone in the body is maximum.

Low testosterone levels can be returned to normal, and replacement therapy will help with this. There are preparations containing testosterone synthesized artificially. All men who have crossed the age limit of fifty years must be prescribed an examination in order to determine the level of testosterone in the blood. With its deficiency, the necessary treatment is prescribed.

Testosterone deficiency can also be detected in fairly young men. Normal hormone synthesis can be disrupted by smoking and regular consumption of alcoholic beverages. Constant stress and a sedentary lifestyle lead to the same result.

If there are symptoms of testosterone deficiency in the body, treatment is prescribed only after a comprehensive examination, which should exclude the presence of a malignant tumor of the prostate. With this disease, treatment with drugs that have testosterone in their composition is prohibited. All men with a history of malignant neoplasms indicated, such treatment is not carried out.

Taking hormonal pills with these pathological changes in the patient's body will lead to a sharp deterioration in his health. Therefore, without the availability of all laboratory data and MRI data, treatment is not prescribed.

What are the signs of testosterone deficiency in a man's body?

• Weakening of sexual desire.
• Decreased body tone.
• Frequent and prolonged depression.
• Changes in the patient's behavior.
• Erectile dysfunction.
• Drowsiness.
• Weight gain.
• Breast growth.
• Decrease in the level of hemoglobin in the blood.
• Increase in blood cholesterol levels.

It is believed that if a man reveals at least three symptoms from the above list, he should consult a doctor for treatment.

HRT

Men who have been diagnosed with testosterone deficiency should undergo regular medical examinations and take medications. During the course of replacement therapy, testosterone levels should be monitored.

Testosterone replacement therapy in men can only be carried out after consultation with the attending physician. He also determines the required dose of the drug. The effect of preparations containing testosterone becomes externally noticeable only after the required level of the substance in the blood is reached.

Treatment of testosterone deficiency can take place using injections, tablets, special gels and patches. A new treatment method has recently been developed. With it, special implants containing crystalline testosterone are inserted under the skin of the patient in the abdomen. Dissolving, the crystals provide a constant supply of the hormone into the blood. The effect of such an implant is designed for six months. HRT with testosterone is carried out for life.

Some drugs used to treat hormone deficiency are hepatoxic and their use is restricted or even banned in some countries. This is another argument in favor of the fact that treatment should be prescribed only by a doctor. The patient cannot be aware of all the characteristics of hormonal drugs, and making a decision on self-treatment can be harmful to his health.

Injectable forms of testosterone analogues include Testosterone cypionate, Testosterone enanthate. These two drugs are administered at 200-400 mg once every three to four weeks. These injections should not be used to treat heart failure, kidney or liver disease. In case of lung diseases, preparations containing an analog of testosterone are allowed to be taken, but with extreme caution and under strict medical supervision. A contraindication to treatment with these drugs can be diabetes mellitus, and acute urinary retention, which manifested itself against the background of inflammation of the prostate.

Hormonal tablet forms: Fluoxymesterone, Methyltestosterone. Both of these drugs are hepatoxic. They are forbidden to appoint patients with diseases of the liver and kidneys. The daily dose of Fluoxymesterone can reach up to 20 mg, for Methyltestosterone - up to 30 mg.

Subcutaneous forms of drugs include implants. 1200 mg of the drug is sewn under the skin, the effect of which lasts about six months.

Transdermal forms act through the skin. These include Testosterone gel and Testosterone patches. Indications and contraindications for these drugs are the same as for tablets and injections.

Treatment of testosterone deficiency began in the forties of the last century. During this time, many preparations with its content have been created. With each time, synthetic testosterone is more and more similar in its characteristics to the one that is present in the human body.

Taking hormonal drugs can improve the quality of life of a man, prolong his youth, as evidenced by the reviews of many patients. Some of these drugs are used not only for medicinal purposes. Sometimes athletes take these drugs in order to improve their athletic performance. But again, this must be done under the strict supervision of doctors.

Severe androgen deficiency can develop in men for various reasons and at any age.

Testosterone replacement therapy is prescribed to restore the functioning of the endocrine system of the male body and improve the quality of life.

A decrease in the concentration of testosterone in the blood serum negatively affects the functioning of various organs and systems of the male body. The process of testosterone decline occurs slowly and begins to develop after 30 years. By the age of forty, many men become overweight, their belly begins to grow and their sexual desire decreases. Testosterone deficiency in men leads to the development of cardiovascular disease and osteoporosis. Testosterone replacement therapy enables men suffering from male hormone deficiency to avoid negative consequences.

The only way to find out about the lack of a male hormone in the blood serum is to measure its level in the blood. To find out its exact amount, several samples are taken. Blood is taken for analysis from 8 to 9 in the morning, when it is at its highest level. With properly selected doses, after long-term use of androgen hormone, the health of men with symptoms of testosterone deficiency improves. They restore their weight, their blood pressure normalizes, libido and potency return.

Why does testosterone deficiency occur?

Decreasing testosterone levels don't always happen naturally over the years. There may be various reasons for the decrease in its production by the endocrine glands. Injury to the testicles can lead to a lack of male hormone. The cause is genetic diseases and the development of oncological neoplasms. Excess iron in the body suppresses the production of testosterone by the endocrine system. Pituitary dysfunction and the use of various hormonal drugs can cause a developing deficiency. Chronic diseases associated with alcoholism, nicotine addiction and drug use lead to early aging of the body and a decrease in the production of androgenic hormone.

When to Start Testosterone Treatment

All men with symptoms of androgen deficiency, and the elderly after 50 years of age, are recommended to conduct a diagnostic examination for hormonal levels in the blood serum. The test results give true information about the production of hormones in the body. Replacement therapy is prescribed in the presence of symptoms of androgen deficiency, tests confirming an insufficient amount of testosterone in the blood, and in the absence of malignant tumors in the prostate gland. Laboratory diagnostics should exclude or confirm the presence of prostate cancer. With a lack of testosterone, the likelihood of developing carcinoma of this male organ increases. For men with a history of cancer, the administration of testosterone preparations is contraindicated. Therapy will worsen the patient's condition. After collecting all the necessary information, testosterone preparations are prescribed.

Symptoms of androgen deficiency syndrome are:

1. Prostration.
2. Decreased stamina and performance.
3. Decreased growth.
4. Prolonged depression.
5. Increased irritability.
6. Erectile dysfunction.
7. The need for an afternoon nap.
8. Increase in body fat mass.
9. Growth of mammary glands.
10. Anemia.
11. Osteoporosis.
12. Cholesterol increase.

If there are 3 or more symptoms in history, then you should consult a doctor for examination.

How to properly conduct testosterone therapy

Replacement therapy with testosterone preparations should be carried out only as prescribed by a doctor and under constant medical supervision. The uncontrolled use of hormonal drugs leads to addiction of the body, which reduces the natural production of testosterone by the organs of the endocrine system. The most common hormonal treatment option has become the intramuscular administration of preparations containing the hormone.

In addition to injections, there are other types of administration of hormonal drugs into the human body. Preparations containing testosterone, manufacturers produce in the form of tablets, gels and patches.

Pharmaceutical companies offer crystalline implants for use, which are inserted under the skin by making an incision in the abdomen. This drug, dissolving, provides a uniform release of testosterone for about six months. An implant is placed and removed surgically.

Replacement therapy using various types of preparations containing testosterone lasts for life. The effectiveness of treatment can be seen after the body accumulates the desired concentration of testosterone and the symptoms of androgen deficiency are eliminated. If you take testosterone under medical supervision, then the therapy will be safe. It allows men of any age with androgen deficiency to maintain health by leading an active lifestyle.

Hypogonadism Therapy

Male hypogonadism is a functional failure of the testicles. The development of the disease is accompanied by a low level of testosterone in the blood serum and characteristic clinical manifestations.

The causes of the development of the disease can be testicular injuries or disorders of the hypothalamic-pituitary system. Developmental pathologies can be genetically determined. Treatment of the disease involves the mandatory use of testosterone replacement therapy.

Signs of hypogonadism often begin their development in boys in childhood. If the developing disease is not treated, then the adolescent will begin to delay the development of secondary sexual characteristics. Adult males with hypogonadism have underdeveloped muscles, a high pitched voice, small scrotum and testicles.

They have a small penis, sparse hair on the pubis and in the armpits. Growth of the mammary glands and eunuchoid body composition may be observed.

Hormone replacement therapy for this disease is recommended from adolescence and continues for life, because androgen deficiency will accompany a man suffering from hypogonadism throughout his life.

There are various methods for eliminating testosterone deficiency in this disease, which the doctor uses during treatment.

Replacement therapy in the elderly

Hormone replacement therapy in older men is carried out to improve the quality of life. More and more men, having crossed the 40-year mark, want to look young and strong. They do not accept old age and agree to substitution therapy if there are indications for use.

The main goal is to reduce the symptoms of age-related androgen deficiency. Such men are recommended to wear patches, intramuscular injections, gels and capsules for suturing.

Studies have shown that such therapy leads to a decrease in blood cholesterol, reduces the risk of heart attacks and cardiovascular diseases.

Side effects of replacement therapy

Therapy with testosterone preparations can lead to the development of side effects. Skin that becomes oily develops acne. Careful hygiene should be observed during treatment. Using lotions with alcohol, hard brushes for the body, gels for oily skin will help to eliminate the development of acne.

There may be fluid retention in the body due to urinary retention, an increase in the size of the testicles. All these phenomena indicate an excess of the hormone. Therapy with testosterone preparations will be temporarily canceled if the doctor detects the development of side effects. With the normalization of the condition, testosterone treatment continues, but the doctor reduces the dose of the administered drug.

Therapy results

When carrying out testosterone replacement therapy, the conditions that develop with various somatic diseases improve. A decrease in the signs of male hormone deficiency occurs in men of different ages. A month after the start of replacement therapy, there is an increase in resistance to stress, an increase in exercise endurance and a decrease in cholesterol levels, which is required to produce testosterone. Replacement therapy has a positive effect on the cardiovascular system. It reduces the symptoms of heart failure in elderly patients, normalizes blood pressure, and reduces the number of angina attacks. Numerous studies have shown that testosterone therapy improves myocardial contractility and accelerates its recovery after a heart attack.

Hormone replacement therapy helps many men cope with inferiority complexes, find the joy of fatherhood, and stop the onset of old age. If there are any symptoms of male hormone deficiency in the body, you should consult an andrologist for advice and treatment.

Most men with low testosterone levels report improvements in energy, sexual arousal, and mood after testosterone therapy. If testosterone is not enough, why not replace it? Don't be in a hurry. In fact, people with low testosterone do not need treatment.

Substitution therapy has side effects, and what benefits it brings and how much it can threaten health is unknown. Only men with symptoms of low testosterone and blood tests showing it to be a problem should consider therapy. Only in consultation with a doctor can you determine that this therapy is right for you.

Testosterone replacement therapy - video

Hidden symptoms of testosterone deficiency

Symptoms of testosterone deficiency are sometimes obvious, but can be difficult to discern. Testosterone levels in men generally decrease with age, but they can also decrease due to various conditions.

• weak sexual excitability (libido);
• erectile disfunction;
• fatigue and lack of energy;
• decrease in muscle mass;
• hair loss on the face and body;
• depression;
• distraction;
• irritability;
• deterioration in health.

If a man has these symptoms and the test shows low testosterone levels, the doctor may prescribe treatment. Millions of men with relevant symptoms but normal test results therapy is not recommended. It is also not suitable for men whose testosterone levels decline with age.

Types of testosterone preparations

• patches (transdermal type): "Androderm" - a patch that is attached to the arm or torso, is taken once a day.
• gels: "Androgel" and "Testim" - bags with a transparent gel. Testosterone is absorbed into the skin, applied once a day. "Androgel", "Aksiron" and "Fortesta" are also available in the form of aerosols, which makes it convenient to take the daily dose prescribed by the doctor. "Natesto"-gel is applied to the surface of the nasal cavity.
• absorbed in the mouth: "Striant" - a small tablet, attached to the upper gums over the incisors for resorption. It is taken twice a day and restores testosterone levels in the blood for a long time.
• injections and implants: testosterone is also injected directly into the muscles or implanted in small granules into the soft tissues of the body. Gradually, it is absorbed into the blood.

Why not just take a testosterone pill? Some experts believe that these forms of drugs adversely affect the liver. All other forms - patches, lozenges, injections - deliver testosterone directly into the bloodstream and bypass the liver.

What are the benefits of testosterone therapy?

What can you expect from testosterone treatment? It is impossible to say for sure, because the body of each person has its own characteristics. Most men note improvements in potency and energy. Testosterone also increases bone hardness, muscle mass, and, in some people, insulin sensitivity. Men also report an uplift in mood after replacement therapy. These changes are pronounced or barely noticeable - they are very individualized.

About one in ten men are enthusiastic about therapy, and about the same number say almost nothing. Most of the reviews are generally positive, with little variation from each other.

What are the dangers of testosterone therapy?

Side effects of replacement therapy are mainly rashes, itching, or irritation where testosterone enters the body.

However, there have been cases of heart attack or seizures associated with the use of testosterone drugs. Experts emphasize that the benefits and harms of long-term therapy are unknown, since large-scale clinical studies have not yet been conducted. Testosterone therapy can lead to:

• benign prostatic hyperplasia (BPH): the prostate enlarges under the influence of testosterone. In most men, it increases with age, impinging on the urethra, leading to trouble urinating. So, BPH can worsen due to testosterone therapy.
• prostate cancer: Testosterone may contribute to the development of prostate cancer. Most experts recommend screening for cancer before starting replacement therapy. Men with prostate cancer or elevated levels of prostate specific antigen (PSA) should not be treated.
• temporary cessation of breathing during sleep (apnea): this problem can also develop and intensify under the influence of testosterone. It will be difficult for the man himself to identify it, but the person sleeping with him can tell about it. To make a diagnosis, a sleep study (polysomnography) is needed.
• Blood clots: The Food and Drug Administration reports that testosterone replacement drugs are dangerous because they can cause blood clots. This develops the risk of deep vein thrombosis, pulmonary thromboembolism (its life-threatening blockage). The drugs can also cause blood clots due to polycythemia, an increase in the volume of red blood cells in the blood, which also develops under the influence of testosterone. Now this applies even to men who do not suffer from polycythemia.
• heart failure: testosterone therapy is also not recommended for men with heart failure, as it can only worsen the condition.

It will be years before large laboratory studies give results and answer the question of what are the benefits and what are the harms of testosterone replacement therapy. As with any treatment, it is up to you and your doctor to decide if a therapy is worth the risks it poses.