Understanding Low-T Treatments
Testosterone Replacement Therapy
Authored by Ryden Anderson
In our recent blow we discussed manopause, the dreaded “male menopause.” (If you’ve landed here first, you might want to check out Part 1 of this series HERE to get the skinny on manopause’s symptoms and causes.)
Also known (by doctors) as “age-related testosterone deficiency” and commonly called (by everyone else) “low T,” it’s a range of symptoms caused by declining testosterone production in males as they age. For men over 30 or 40, about a 1% decrease in testosterone levels per year is normal. But in some older men, T levels fall much faster, and causing a dramatic dip in their quality of life.
As with any medical treatment, it’s important to diagnose the problem first. If you’re experiencing symptoms of low T, Step 1 is to determine whether it’s a normal consequence of aging or a condition needing treatment. (Generally, this means diagnostic bloodwork.) And with that out of the way, let’s get to what you came here for in the first place: boosting those testosterone levels with science!
TRT: Totally Real Thing?
But that’s not what TRT stands for. TRT is short for testosterone-replacement therapy, also known as “androgen-replacement therapy.” No, not the kind of therapy where you lie on a couch and unpack that recurring dream about your mother-in-law as a burlesque dancer. (Don’t worry, dude: this is a safe space.) It’s a course of pharmaceutical treatments that fight the symptoms of low T by boosting your body’s testosterone levels, effectively tackling the problem at its source. Makes sense, right? Some of the more common outcomes of TRT are:
- better sexual function (including libido, performance, and fertility);
- improved cognition and mood;
- greater athletic endurance or stamina;
- reduced body fat; and
- increased lean muscle mass and strength.
Treatment Methods: What are your options?
Though the oldest TRT drugs first got FDA approval back in the late ’70s, the field has practically exploded in the past couple of decades: where testosterone-prescription sales were a meager $18 million in 1988, they’d increased to $1.6 billion in 2011, when nearly 1 in 25 men in their 60s was taking some form of TRT. And by 2013, 2.3 million Americans were receiving TRT—four times as many as at the turn of the century. With this boom has come a proliferation of FDA-approved drugs, and today TRT comes in myriad forms, including:
- buccal testosterone, which you put on your gums morning and night;
- injectable testosterone, which involves getting a poke every 1–4 weeks;
- an intranasal gel, which you spray up the ol’ schnoz 3 times a day;
- subdermal pellets, which go under your skin every 3–6 months;
- transdermal gels, which you spread over your soon-to-be-shredded abs or guns daily;
- a transdermal patch, which you swap out once a day; and
- a transdermal solution, which you spread on your pits every morning like deodorant.
Each of these testosterone-delivery methods comes with its own pros and cons, so the one helping your buddy Steve ditch the dad bod and get his groove back may not be ideal for you. It’s important to consider the options and find the type of TRT that best suits your own symptoms, lifestyle, and treatment goals. With so many TRT drugs on the market today, that’s a pretty dense topic in itself—and we’ll sort it all out in a future installment. But for now, if you’re considering TRT, talk to your doctor or schedule an appointment at our clinic to determine which method is right for you.
Risks of Testosterone Replacement: Will your penis fall off?
No. Well, probably not. And if it does, it’s very unlikely to be the TRT’s fault. But still, it’s important to understand that TRT isn’t a magic bullet and isn’t without risks.
For one thing, TRT may increase the risk of heart attack and stroke by contributing to the formation of blood clots. For another, it could stimulate the growth of metastatic prostate and breast cancer. So if you’re a cancer patient or survivor, or at an increased risk of those particular cancers, it’s important to talk to your doctor about the associated risks before starting TRT.
And regardless of your history with cancer, if you do undergo hormone therapy, it’s important not to avoid your doctor-recommended prostate exams. While there’s no established link between androgen therapy and prostate cancer, there is some concern that increasing testosterone levels may exacerbate the risk in patients who already have undiagnosed or subclinical prostate cancer. Listen, no one likes a finger poking around up there (well, some of us might—but that’s a whole different article. But an ounce of prevention, knowing is half the battle, early and often—all that good stuff G.I. Joe taught you back in the ’80s.
Also, there’s a link between testosterone and balding. And some patients undergoing TRT report headaches, nausea, indigestion, bloating, or leg cramps.
Contraindications: Who shouldn’t get TRT?
In addition to the populations implicated by the risks of TRT—men with a history or increased risk of breast or prostate cancer, heart attack, stroke, or embolism—there are a few other reasons you might not be a good candidate for the treatment. Messing with your body’s natural hormone levels can adversely affect fertility, so if you have hopes or plans of conceiving in the near future, your doctor may tell you to wait on TRT. Other contraindications include untreated severe obstructive sleep apnea and uncontrolled heart failure or thrombophilia. As with all courses of medical treatment, talk it over with your primary-care physician first.
But let’s say you fall into one of those camps. Don’t lose hope just yet! Making some simple lifestyle changes, which we discussed in our last post, can naturally increase your T levels. And there’s even an alternative treatment that has proved effective against manopause and is safe for many men for whom TRT isn’t a good fit. It’s called peptide therapy, and it’ll be the subject of another installment in this series.
Taking Charge of the Change: What are you waiting for?
Symptoms of low T can go undiagnosed, since the symptoms are often mistaken as the effects of “just getting older.” And yes, testosterone production naturally decreases with age, but now you know you don’t have to settle for waning energy and dwindling quality of life. Now you know better. Now you know there’s a way to feel better, live better.
Testosterone-replacement therapy can restore testosterone levels to the range found in young men. Imagine feeling as vital (and virile) as you did in your twenties—but without the roach-infested apartment, P.O.S. car, and soul-sucking, dead-end job. The best years of your life could still lie ahead. So what are you waiting for, man? Book an appointment to get your T levels checked today!