HORMONE REPLACEMENT—MEN

Hormone Replacement with testosterone address the age related decline in bioavailable testosterone. Starting already in the twenties, Testosterone declines about 10% every decade. The ubiquitous exposure to xenobiotics like plastics, Bisphenol-A, flame-retardants and pesticides that act as ”endocrine disruptors,” accelerates the process. This environmental exposure is also seen as the reason why Testosterone levels in men have been declining worldwide - about 1% per year since the 1980s. 

 

Low testosterone can lead to a variety of symptoms:

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• Loss of muscle mass and strength

• Increase in body fat 

• Low libido

• Erectile dysfunction and loss of morning erections

• Fatigue and loss of vitality 

• Indecisiveness, mood swings and depression 

• Low concentration and cognition

• Osteoporosis

• Anemia

• Loss of body hair     

 

 

Testosterone can be easily measured through a blood test for total and free/bioavailable testosterone. The lab should include the adrenal hormones DHEA and Pregnenolone, which are precursors to testosterone, and a PSA test to check the prostate. 

 

Testosterone Replacement therapy is integrated into a comprehensive nutritional and lifestyle program that addresses diet, exercise and stress. Like every medical treatment, testosterone replacement therapy needs to be evaluated regarding its potential risks and benefits. Testosterone does not increase prostate cancer risk, but is contraindicated in men who do have prostate cancer, as well as in men who have a genetic tendency for increase blood clotting. Despite many studies showing the opposite, the FDA concluded that there is a small possibility of an increased cardiovascular risk (myocardial infarctions and strokes). 

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Testosterone Deficiency is treated by weekly intramuscular injections or by daily skin applications. Men need to be aware that creams and gels can be transferred to children and partners through skin contact. 

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Testosterone replacement can cause the following adverse effects: 

• Elevated Estrogen 

• Oily skin or Acne

• Hair loss

• Overproduction of red blood cells 

• Fluid retention

• Worsening of sleep apnea

• Testicular shrinkage

• Benign prostatic hypertrophy

 

After initiating therapy, we repeat a lab test to ensure the Testosterone level is in the therapeutic range and that there is no elevation of estrogen, dihydrotestosterone or red blood cells.

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In younger men with low testosterone, we focus on increasing the body’s testosterone production by addressing sleep deprivation, stress, nutritional deficiencies, and endocrine disruptors.

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