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Testosterone therapy: Potential benefits and risks as you age

I’ve referred many patients to see a therapist whose concerns resolve without testosterone therapy. A nasal testosterone gel has now been FDA-approved in the United States. The gel must be applied three times daily, which many patients find inconvenient. Testosterone cypionate and enanthate injected IM are absorbed slowly, and hence, they can be given less frequently, although weekly injections are optimal to minimize supernormal levels. The distribution between free and bound forms depends on the amount of this testosterone-estradiol binding globulin in the plasma.

This enzyme, which is found in testicular, adrenal, and prostate tumor tissues, is necessary for the body to produce testosterone. Treatments that block the production of androgens throughout the body, known as androgen synthesis inhibitors. Like ADT, androgen synthesis inhibitors prevent androgen production by the testicles; unlike ADT they also prevent androgen production by the adrenal glands and prostate cancer cells. Even though only small amounts of androgens are produced outside the testicles, the low levels that are still produced can be enough to support the growth of some prostate cancers. The second-generation drugs bind to and block the androgen receptor more strongly and specifically than the first-generation drugs (6). Darolutamide is the only androgen receptor blocker that does not cross the blood-brain barrier in humans, which may result in fewer central nervous system–related side effects.

Some experts recommend checking a peak testosterone level 2 days after an IM injection.[3] Checking levels should usually wait for 30 days after starting therapy to allow for full therapeutic stabilization. If a supernormal level is found, a smaller dosage is suggested. Then, the process is repeated until optimal levels are achieved. This will include a blood test taken in the morning between 7 and 9 a.m., during which your testosterone levels are typically the highest, along with a complete hormone lab workup if needed, he says. “If men harbor any of the hallmark symptoms of low T and hypogonadism, I advise they meet with an andrology specialist for a thorough history and physical exam and to have their testosterone levels checked,” says Dr. Muthigi.

Brantley Scott Chair in Urology at Baylor College of Medicine in Houston, Texas. If your hormones decrease faster, or you’ve reached an age where your levels have dropped below a certain level, you start to see the effects. Some doctors advise androgen deprivation (orchiectomy or an LHRH agonist or antagonist) plus an anti-androgen for initial hormone therapy for advanced prostate cancer. Studies have suggested this may be more helpful than androgen deprivation alone.

I think that testosterone replacement therapy for [patients with] prostate cancer has to be individualized. It has to be based on numerous factors such as comorbid conditions, life expectancy, Gleason score, pathology, and severity of symptoms. It is important that everyone understands the potential risks and benefits prior to starting [patients] on therapy. It is important to discuss the AUA guidelines, particularly since the risk-benefit ratio is still unknown, and we need more studies.

Harvard Health emphasizes that TRT should be tailored to the individual and revisited frequently to minimize risks and optimize outcomes. Endocrine Society is a global community of physicians and scientists dedicated to accelerating scientific breakthroughs and improving patient health and well being. For 100 years, the Endocrine Society has been at the forefront of hormone science and public health. Read about our history and how we continue to serve the endocrine community. An increase in PSA level greater than 25% or 1.4 ng/mL within any 12-month period should be repeated and, if confirmed, considered suspicious. The FDA discontinued testosterone solutions in 2017 due to the high incidence of abuse by athletes and bodybuilders. Injections of testosterone are also common and may be ideal for those who don’t eat breakfast, have absorption issues or have personal concerns surrounding gels and transference.

Here is how to take a cautious approach to testosterone therapy. People can take trt and sperm count, politecnicotafalla.educacion.navarra.es, orally, via intramuscular injections and implants or transdermal patches, mouth patches, and topical creams or gels. Severe lower urinary tract symptoms include urinary frequency and urgency.

Dr. Amy Voedisch, an OB-GYN at Stanford Medicine in Palo Alto, California, has noticed a dramatic rise in recent years in middle-age women asking for testosterone therapy. Because patients are often prescribed testosterone gels, pellets or pills through med-spas and telemedicine, there could be even more women taking the hormone than realized, Dunsmoor-Su said. In the U.S., prescriptions for testosterone increased nearly 50% between 2013 and 2023, according to recent data from the health technology company IQVIA. Doctors say interest in the hormone isn’t being driven only by men, but also by women in their 40s and 50s. Your provider will likely have you get a blood test to check your testosterone level. These include medicine side effects, thyroid problems, or depression.

Previously, interest in testosterone therapy rarely came up in appointments, she said. While the treatment may have an impact on muscle strength and how people feel, LaPook said there is limited evidence on the extent of potential benefits and potential dangers. Testosterone replacement therapy, which involves taking manufactured forms of testosterone, has surged in popularity. Prescriptions for the treatment rose from 7.3 million in 2019 to more than 11 million last year. “Injections of hCG are sometimes used as an alternative to testosterone products in men for low testosterone and to help improve fertility.”