Testosterone replacement therapy (TRT) can help improve the symptoms of low testosterone due to male hypogonadism. Because of this risk of polycythemia, men undergoing TRT should not only have their complete blood count (CBC) monitored during their therapy, but should also have a baseline CBC drawn before testosterone therapy is initiated. Taken together, there has been consistent rejection that TRT causes development of prostate cancer in men, however administration of TRT for hypogonadal men previously treated for high-risk prostate cancer should be taken with caution. For men who have previously undergone definitive treatment for prostate cancer, the usage of TRT is becoming more accepted. For premalignancy, prostatic intraepithelial neoplasia (PIN) appears to be a risk factor for developing prostate cancer, however this association has been mostly demonstrated for high-grade disease.26,27 There is a lack of long-term data on the use of TRT in men with PIN. Swerdloff RS, Wang C. The testis and male hypogonadism, infertility, and sexual dysfunction. Male menopause; Andropause; Testosterone deficiency; Low-T; Androgen deficiency of the aging male; Late-onset hypogonadism TRT may relieve or improve symptoms in some men. The medicine used is man-made testosterone. These include medicine side effects, thyroid problems, or depression. You will also be checked for other causes of your symptoms. If any of these symptoms are bothering you, talk with your provider. Historically, testosterone was used in combination with estrogen and progesterone, hormones that decline with age. Food and Drug Administration (FDA), but the agency has never approved testosterone for women. Contrary to popular perception, testosterone isn’t simply a male hormone. Some symptoms may be a normal part of aging. Some men with low testosterone do not have any symptoms. Certain health conditions, medicines, or injury can lead to low testosterone (low-T). Schedule a video consultation with a licensed provider who will personalize your treatment based on your health goals. Such content is not intended to replace an evaluation with a qualified healthcare professional of your choosing and is not intended as medical advice. Acne and oily skin are among the most commonly reported side effects, driven by increased androgen activity at the skin level. Men on TRT are already managing an active hormonal environment, and introducing another precursor hormone adds variables that need monitoring. Because DHEA is upstream of both testosterone and estrogen, adding it can shift hormonal balance in directions that are not always predictable. Neither of these replaces sleep hygiene, but they can support it. This GABAergic activity may contribute to a calming or anxiolytic effect in some individuals, which could support the transition into sleep. DHEA also appears to interact with GABA receptors in the brain, the same receptors targeted by many anti-anxiety and sleep-aid medications, through its conversion to neurosteroids like allopregnanolone. Any man who has a comorbidity that precludes TRT should be informed of all risks. The Baltimore Longitudinal Study of Aging reported the incidence of hypogonadism as 20% in men over 60 years of age, 30% in men over 70 years and 50% in men over 80 years of age. Testosterone has many beneficial effects, including increasing bone strength and density, inducing hematopoiesis, driving sexual function and libido, providing a cardioprotective effect and increasing muscle strength. Men on TRT should be monitored for side-effects such as polycythemia, peripheral edema, cardiac and hepatic dysfunction. The benefits seen with TRT, such as increased libido and energy level, beneficial effects on bone density, strength and muscle as well as cardioprotective effects, have been well-documented. If you have low testosterone, TRT may help restore your ability to have healthy erections and can boost your sex drive. TRT, when given to appropriately selected patients with vigilant monitoring as outlined in this review and in Table 1, can bring improvements in quality-of-life, energy level, libido, muscle mass, cognition and bone density. Well-known to many prescribers of TRT is a risk of water retention and/or edema. For people who want that deeper context, Humanaut Health's Advanced Health Check is the most relevant internal resource for understanding how diagnostics shape interpretation. That is why good hormone care depends on more than a screenshot of a lab result. In transdermal therapy, timing matters differently. One reason lab conversations around TRT become confusing is that testosterone values are not independent of timing. This means women's TRT targets should not be "as high as possible while feeling good." The better standard is "the lowest effective exposure that stays within the female physiologic range and supports the specific symptom target under monitoring." In younger men, some authors have argued that a one-size-fits-all cutoff may miss clinically relevant low values when symptoms are present.
