314 testosterone replacement therapy - Dr. Sharmila M., Sexologist, Hyderabad
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testosterone replacement therapy

This article discusses the causes and symptoms of low testosterone, treatment of testosterone deficiency and side effects of testosterone replacement therapy.

Testosterone is a hormone produced by the testicles and is responsible for the proper development of male sexual characteristics. Testosterone is also important for maintaining muscle bulk, adequate levels of red blood cells, bone growth, a sense of well-being, and sexual function.

Inadequate production of testosterone is not a common cause of erectile dysfunction; however, when ED does occur due to decreased testosterone production, testosterone replacement therapy may improve the problem.

What Causes Low Testosterone?

As a man ages, the amount of testosterone in his body naturally gradually declines. This decline starts after age 30 and continues throughout life. Some causes of low testosterone levels are due to:

  • Injury, infection, or loss of the testicles
  • Chemotherapy or radiation treatment for cancer
  • Genetic abnormalities such as Klinefelter’s Syndrome (extra X chromosome)
  • Hemochromatosis (too much iron in the body)
  • Dysfunction of the pituitary gland (a gland in the brain that produces many important hormones) or hypothalamus
  • Inflammatory diseases such as sarcoidosis (a condition that causes inflammation of the lungs)
  • Medications, especially hormones used to treat prostate cancer and corticosteroid drugs
  • Chronic illness
  • Chronic kidney failure
  • Cirrhosis of the liver
  • Stress
  • Alcoholism
  • Obesity (especially abdominal)

What Are the Symptoms of Low Testosterone?

Without adequate testosterone, a man may lose his sex drive, experience erectile dysfunction, feel depressed, have a decreased sense of well-being, and have difficulty concentrating.

What Changes Occur in the Body Due to Low Testosterone?

Low testosterone can cause the following physical changes:

  • Decrease in muscle mass, with an increase in body fat
  • Changes in cholesterol levels
  • Decrease in hemoglobin and possibly mild anemia
  • Fragile bones (osteoporosis)
  • Decrease in body hair
  • Changes in cholesterol and lipid levels

The only accurate way to detect the condition is to have your doctor measure the amount of testosterone in your blood. Because testosterone levels fluctuate throughout the day, several measurements will need to be taken to detect a deficiency. Doctors prefer, if possible, to test levels early in the morning, when testosterone levels are highest.

Note: Testosterone should only be used by men who have clinical signs and symptoms AND medically documented low testosterone

Testosterone deficiency can be treated by:

  • Intramuscular injections, given anywhere from two to ten weeks apart
  • Testosterone gel applied to the skin or inside the nose
  • Mucoadhesive material applied above the teeth twice a day
  • Long-acting subcutaneous pellet
  • Testosterone stick (apply like underarm deodorant)

Each of these options provides adequate levels of hormone replacement; however, they all have different advantages and disadvantages.

Who Shouldn’t Take Testosterone Replacement Therapy?

Men who have prostate cancer or breast cancer should not take testosterone replacement therapy. Nor should men who have severe urinary tract problems, untreated severe sleep apnea or uncontrolled heart failure. All men considering testosterone replacement therapy should undergo a thorough prostate cancer screening – a rectal exam and PSA test, prior to starting this therapy.

What Are the Side Effects of Testosterone Replacement Therapy?

  • Acne or oily skin
  • Mild fluid retention
  • Stimulation of prostate tissue, with perhaps some increased urination symptoms such as a decreased stream or frequency
  • Increased risk of developing prostate cancer
  • Breast enlargement
  • Increased risk of blood clots
  • Worsening of sleep apnea (a sleep disorder that results in frequent night time awakenings and daytime sleepiness)
  • Decreased testicular size
  • Increased aggression and mood swings
  • May increase risk of heart attack and stroke

Laboratory abnormalities that can occur with hormone replacement include:

  • Changes in cholesterol and lipid levels
  • Increase in red blood cell count
  • Decrease in sperm count, producing infertility (especially in younger men)
  • Increase in PSA

If you are taking hormone replacement therapy, regular follow-up appointments with your doctor are very important.

If you feel the above symptoms of low testosterone please consult a sexologist or an andrologist at the earliest.

Dr. Sharmila Majumdar

doctorsharmila
Dr. Sharmila Majumdar is the First Female Sexologist in India, who specializes in Female & Male Sexual Dysfunction & Mental Health. Her professional experience comprises of National and International Consultations, co-authoring a Medical Handbook on “Male Infertility and Andrology”, Journal Publications, Presentations as a guest faculty at National & International Conferences on Sexology, Endocrinology, Gynecology & Psychology. She is also a Guest lecturer in several medical colleges in India. Dr. Sharmila Majumdar has also won an award for the best Presentation in Female Sexual Dysfunction in the National Conference of Sexology in 2008. She is also a columnist in leading local newspapers. She is a guest editor and a contributor in several medical portals and magazines. Dr. Sharmila Majumdar has rich experience of 11 years in the area of Sexual & Mental Health. She has successfully treated hundreds of patients globally. Her primary motto is optimal Sexual & Mental Health in Men and Women. She is up-to-date with the latest advancement in the emerging field of Sexual & Mental Health for the well-being of her patients. She strongly believes in the right to Physical, Sexual and Mental wellness. DR. SHARMILA MAJUMDAR IS AVAILABLE FOR CONSULTATION AT AVIS HOSPITAL, SEXUAL & MENTAL HEALTH CLINIC, HYDERABAD – 500033, TELENGANA, INDIA

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