If A Man Is Taking Testosterone And Wants To Have Children What Are His Options
He should consult with a male reproductive specialist. Men should avoid testosterone treatment until they are done trying to have their own biological children. If a man has a pituitary disorder that is causing the low testosterone, then he can be treated with a pituitary hormone that will increase his T level without disrupting sperm production. When he is done having children, he can take testosterone to treat his low T level directly.
What Are The Side Effects Of Testosterone Replacement Therapy
In general, testosterone replacement therapy is safe. It is associated with some side effects, including:
- 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 abnormalities
- Breast enlargement
How Do I Talk To My Doctor
Talking about low testosterone with anyone can be intimidating, and even awkward, so it can be hard to know where to start the discussion with your doctor. It is important to remember that this is a common condition in older men and your doctor has a lot of experience in this area. There is nothing to be embarrassed about and speaking with your doctor openly and honestly about your concerns is the first major step towards feeling like yourself again. If you don’t know where to begin, to get some tips on opening the conversation with your doctor.
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Can Low Testosterone Be Treated
Testosterone does drop with age but certain things, such as a lot of belly fat, can cause it to plummet. With it can go your sex drive and even your erectile function.
Low levels can be corrected by losing belly fat . If your doctor is seriously concerned, there are prescription anti-estrogen pills, gels, and injections that will block the effect of belly fat until its lost naturally. Dr. Mehmet Oz has plenty of health challenges that provide diet and exercise tips — even one that lets men keep the beer.
What Causes Testosterone Deficiency
Testosterone deficiency can be caused by normal ageing. However, there are many other different causes of testosterone deficiency. Some causes of testosterone deficiency can be inherited. Testosterone deficiency may be present at birth or it may develop later in life.
Being significantly overweight or obese at any age may be linked to testosterone deficiency.
Temporary testosterone deficiency may be caused by a physical illness, surgery or emotional stress. The testosterone level will go back to normal once the underlying problem has been treated.
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What Is A Normal Range For Testosterone
A testosterone level test measures the amount of male hormones in the bloodstream. The results are measured in nanograms per deciliter. A healthy range for a guy is 300 to 1000 ng/dl, with around 600 being average. Anything around or below 300 is considered low by most physicians.
According to Dr. Pastuszak, most men feel better with a level of 600 or higher. Any man with a level below 600 will likely feel better with testosterone therapy and it’s worth trying out. It’s important to remember that testosterone therapy is typically considered a “lifestyle therapy” meaning you can use the treatment as long as you’d like if it helps you feel better.
Having a low testosterone level between 300 to 400 isn’t dangerous to you health. However, if a man’s testosterone drops below 300, there is an increased risk for osteoporosis and cardiovascular issues.
Should Men With Symptoms Of Low Testosterone But Without Hypogonadism Be Prescribed Testosterone Therapy
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Healthy men who complain of symptoms of low testosterone but without hypogonadism should not be routinely prescribed testosterone therapy.
The definition of male hypogonadism varies, with different experts/societies/labs having different reference ranges for total testosterone. Generally, most experts would agree that a total testosterone level less than 250 ng/dL is considered low, whereas some experts endorse a higher level of around 350 ng/dL as the lower limit of normal. There are also additional ways of assessing for testosterone status beyond measuring total testosterone: free testosterone or bioavailable testosterone can also be measured. Each test has its own set of positives and negatives ultimately, clinicians need to order the testing which they feel is most appropriate for a particular patient.
The symptoms of low testosterone are rather vague and non-specific and can be related to many other health conditions, such as obstructive sleep apnea, overweight or obesity, or a sedentary lifestyle. Evaluation of symptoms such as fatigue may note borderline-low testosterone values, and in a minority of cases, a trial of testosterone therapy may be considered, depending on the results of the overall evaluation. However, this should generally be an exception to the rule, rather than the rule.
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What You Need To Know
Testosterone is the primary male sex hormone, mainly responsible for initiating the growth of the testicles, penis and body hair. It also causes the voice to deepen and muscle mass to increase.
Depending on age and individual makeup, typical testosterone levels in adult men range widely, from 2801,100 ng/dl, according to researchers at the University of Rochester. Most adult men average about 679 ng/dl, although some researchers suggest that 400600 is optimal in healthy individuals. Testosterone decreases naturally with age, but slowly, at a rate of about 1 percent a year after age 30. Low testosterone can also be caused by tumors in the pituitary gland or testes, especially in younger men, as well as diseases such as type 2 diabetes. It also has been strongly linked to obesity.
So what are the signs of low testosterone? They include low sex drive, fatigue, loss of muscle mass, decreased bone mass, increased body fat and mood changes, including irritability or lack of focus.
Multiple studieshave found that testosterone effectively boosts libido and sexual function for older men with hypogonadism. TRT also has been linked to modest increases in bone density, muscle tone and grip strength.
“If we give someone testosterone, we are making their testicles lazy,” Akturk said. “In these patients, who have been using testosterone for five to six years, their testicles get atrophied and sometimes permanently damaged. It’s a hard thing to wean people off of.”
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Recovering Fertility After Testosterone Therapy
Regaining fertility is not guaranteed, but it is possible for some patients depending on their age and duration of testosterone use. The first step is to end any testosterone therapy and get baseline lab tests to know where your levels truly are. Often, we find that the patient’s LH production has been suppressed. In those cases, the next task is to increase it. Most patients start with Clomid. If that isn’t sufficient, we may consider hCG injections.
In rare cases when neither therapy works, we can consider increasing the FSH level as well with injections of the FSH substitute hMG. This drug is more expensive, and success is not guaranteed.
If you are concerned about low-T symptoms, or if you’ve tried therapies that didn’t work, talk with your primary care doctor or urologist. Feeling better starts with a conversation about your needs, goals, and lifestyle. Personalized care from a board-certified urologist or male fertility expert is the healthiest way to get there.
To visit with a men’s reproductive health specialist, call orrequest an appointment online.
What Are The Treatment Options
In addition to beneficial changes in lifestyle, testosterone therapy can be administered in several ways:
- Transdermal patch
- Gels absorbed through the skin
- Pellet implants
Although testosterone is available in an oral tablet, there is some concern that long term oral delivery of testosterone can negatively affect the liver. 5 The alternative delivery methods bypass the liver and release testosterone directly into the bloodstream.
Part of Dr. Kenworthyâs evaluation process is to discuss recommended treatment methods for you based on your testosterone levels and symptoms, as well as side effects and impacts of your quality of life. He works to personalize treatment to fit your medical needs and your lifestyle.
When To Seek Treatment
Dont let reduced testosterone levels ruin your health, sex life, or positive outlook. At Low Testosterone & Weight Loss Center, we have the most up-to-date treatment options available to help you deal with low testosterone. If you have any of the symptoms listed above or are concerned about your testosterone levels, schedule a consultation at one of our locations in Allen, Frisco, or Celina, Texas.
Most cases of low testosterone can be resolved, especially with early diagnosis and treatment. In many cases, a simple blood test can give us more information about your diagnosis, although it may not be effective for every patient.
Among the options available for treating low testosterone are:
- Testosterone replacement therapy, or TRT, delivered via injections, patches, gels, oral treatments, or subdermal pellets
- Erectile dysfunction medication to address symptoms
- Sleeping aids, if you’re dealing with sleep apnea
- Lifestyle changes such as exercising more, losing weight, and adjusting your diet
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What Are The Benefits Of Testosterone Replacement Therapy
Potential benefits of testosterone replacement therapy may include:
- In boys, avoiding problems related to delayed puberty
- Loss of fat
- Skin irritation
Laboratory abnormalities that can occur with testosterone replacement include:
- Increase in prostate-specific antigen
- Increase in red blood cell count
If you are taking hormone replacement therapy, regular follow-up appointments with your physician are important.
Guidelines suggest discussing the potential risk vs. benefit of evaluating prostate cancer risk and prostate monitoring. The doctor and patient will decide together regarding prostate cancer monitoring. For patients who choose monitoring, clinicians should assess prostate cancer risk before starting testosterone treatment, and 3 to 12 months after starting testosterone:
- PSA levels should be checked at 3, 6, and 12 months within the first year, and then every year after that.
- A digital rectal examination of the prostate should be done at 3-6 months and 1 year after beginning therapy, and then every year after that. This is recommended even for men who are not on testosterone replacement therapy, as an age-related prostate cancer screening. This usually begins at age 50.
- Hematocrit levels will be checked before testosterone therapy starts, and then on a regular basis to make sure red blood cell levels remain normal.
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Treatment Options For Adolescent & Young Adulthood Men With Low T
When designing a treatment plan for TRT in young adults, clinicians must understand that most exogenous T therapy will suppress spermatogenesis and decrease fertility potential . As such, identifying modifiable risk factors that may lead to hypogonadism should be an early step in patient evaluation as correction of many of the aforementioned conditions may mitigate the need for TRT. Patients with obesity, poorly controlled diabetes, or opioid usage should be counseled on weight loss, diet, exercise, and drug abuse before starting testosterone replacement therapy . Formal weight loss programs have not only shown that the percentage of weight loss correlated with increased T levels, but parameters related to fertility including sperm motility and morphology also improved . While there is evidence that T may reduce HbA1C, lower BMI, and reduce waist circumference other studies have not shown any change in HbA1C with testosterone compared to placebo .
T therapy is associated with adverse effects on the cardiovascular and hematologic systems and caution should be exercised when prescribing testosterone for clinical symptoms without truly confirmed biochemical abnormalities per guidelines . Although to date there is no knowledge on the specific use of testosterone preparations in the younger adult cohort, it is likely that this group may also be using the formulations for symptoms and signs suggestive, but not documented of androgen deficiency.
Am I A Candidate For Treatment
Testosterone testing and prescription supplements have nearly tripled in recent years. However, data indicates that many men are supplementing their testosterone without a clear indication for it.
Some studies estimate that up to 25% of men who receive testosterone therapy do not have their testosterone level tested before beginning treatment. 4
Studies also indicate that up to a third of men currently receiving testosterone therapy do not meet the criteria to be diagnosed as Testosterone Deficient. And of those who are treated with testosterone, nearly half are not getting testosterone levels checked after therapy begins. 4
As mentioned above, Testosterone Deficiency is not only low testosterone production but low testosterone levels combined with symptoms or signs associated with the low levels. You are considered a candidate for testosterone therapy only when you meet both criteria. The challenge for physicians is that the symptoms associated with low testosterone levels are very non-specific and can be manifestations of other conditions like chronic fatigue, chronic stress, or depression. 4
There are still large numbers of men who need testosterone therapy but who never receive it because of assumptions made about specific symptoms and because of inadequate diagnostics to support treatment. This is a key reason why you need a urology evaluation by a specialist like Dr. Paul Kenworthy.
Trt: The Best Treatment For Low Testosterone
Although low testosterone levels can create a wide variety of subtle or severe symptoms, theres one widely prescribed and highly effective treatment for them all: testosterone replacement therapy .
TRT has been proven to relieve symptoms of low testosterone, increasing libido and sexual function, improving mood, increasing muscle mass and bone density, and improving cognitionall of which contribute to a higher quality of life for men. While its not a cure-all, testosterone therapy may be the key to helping you regain a sense of health and wellbeing.
Testosterone replacement therapy is widely accessible across the United States and comes in a variety of preparations to suit your preference:
- Pellets: These are implanted under the skin of the upper hip or buttocks and release a steady dose of testosterone into the bodys soft tissues over a few months.
- Injections: Testosterone is typically injected into your muscle once or twice per week,, and can be done at home after instruction by your doctor.
- Patches: Applied either to a fleshy part of the body once per day, patches deliver a small dose of testosterone over the course of 24 hours.
- Gels/Creams: These topical medications are applied to the skin of the upper arm or upper chest for a daily dose of testosterone.
Testosterone Levels In Men
In healthy men, serum testosterone levels range from 300 to 1050ng/dL, peaking in the late teens and early 20s before plateauing and beginning a gradual decline at about 1-2% per year after age 30.
According to the American Urological Association , a level of at least 300 nanograms per deciliter is normal for a man.
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A Booming $38 Billion Market
Despite this, the TRT market expected to reach $3.8 billion globally by 2022, up from $2 billion in 2012 is booming. According to Global Industry Analysts, the uptick is being fueledby the growing prevalence of hypogonadism due to the increase in the aging male population. Hypogonadism is the medical term for the condition in which the testicles don’t make enough testosterone. The condition, roughly defined as having a level under 300 ng/dl, affects about 30 percent of men over age 65.
Other factors include the rising awareness of the disease, improved diagnosis rates, availability of therapies, preference for easy-to-use products and expected approval of new-generation drugs in the pipeline, said Global Industry Analysts.
Another major driver is the overprescription of TRT to young men, wooed by the promise of heightened energy, muscle mass and sex drive. Between 2003 and 2013, TRT use quadrupled in men between 18 and 45 years old, who most frequently were prescribed the medication by their doctors, outpacing prescription in older men for whom the drug is intended, according to a 2017 study in the Journal of Urology.
The industry has a “tremendous amount of conflicts of interests,” said Thomas Perls, a professor of Medicine at Boston University, who describes TRT as “disease mongering,” or “redefining a disease so that it greatly enlarges the potential population that would be interested in the drug, with the addition of mass marketing,” he said.