Testosterone Replacement Therapy

Testosterone is a steroid hormone that belongs to the group of androgen hormones. It is commonly known as the male sex hormone and is mainly produced by the testes. However, a small amount of testosterone is also found in women, which is released by the ovaries. The principal function of this hormone is to ensure the proper development of male reproductive organs and secondary male characteristics like deepening of voice, growth of beard and body hair. It also plays a significant role in the conversion of food into energy and so, the normal rate of growth and development depend on this hormone. Besides these, it participates in protein synthesis and affects muscle mass and bone density.

Deficiency

A deficiency of testosterone hormone can have serious consequences like underdevelopment of reproductive organs and lack of virilization resulting from pre-pubertal deficiency. On the other hand, deficiency after puberty can impair masculinization, reduce libido, facial and body hair. It can even lead to infertility. It can also cause mood disorders like depression, low level of concentration, fatigue and osteoporosis.

A deficiency of testosterone can be caused by any injury or infection of the testes, a malfunctioning pituitary gland and a damaged hypothalamus. However, the level of testosterone in the body also decreases with age, usually after 50 years. In addition, people undergoing cancer treatments like chemotherapy and radiation therapy may also experience a reduction in the level of testosterone.

Testosterone Replacement Therapy

A significantly low level of testosterone in body may require testosterone replacement therapy, where testosterone is administered either in the form of tablets, injections or transdermal systems. Tablets can be taken orally, while injections are administered into the muscle tissue. On the other hand, the transdermal system involves the use of either skin patches and ointments or gels. Testosterone patches can be worn on the scrotum, abdomen, back, buttocks or arms, while testosterone gels can be applied on shoulders, abdomen or upper arms.

Testosterone replacement therapy can be effective in alleviating the problems and symptoms associated with testosterone deficiency. It can significantly increase mental and physical energy, improve libido and muscle strength, reduce anger, depression, irritability, tiredness, nervousness and body fat.

However, before recommending testosterone replacement therapy, physicians usually evaluate the medical history of the individual and perform certain physical tests. An evaluation of medical history generally include queries like development of any abnormality at birth, the rate and extent of virilization or masculinization at the time of puberty and status of secondary male characteristics. Besides these, hormone screening is also performed to determine the level of serum testosterone or the level of testosterone in blood.

Serum prolactin level is also examined, as a high level may indicate that the pituitary gland is not functioning properly. Then, the level of serum LH or luteinizing hormone is tested as it helps in differentiating failure of the testes to produce sufficient amounts of testosterone from the deficiency resulting from the abnormality of pituitary and hypothalamus. Testosterone replacement therapy is usually suggested to individuals with low levels of testosterone snd a high level of luteinizing hormone.

Side Effects of Testosterone Replacement Therapy

There can be several side effects of testosterone therapy which include acne and oily skin, excessive growth of body hair, loss of scalp hair and worsening of sleep apnea. It can also inhibit the endogenous production of testosterone. Testosterone replacement therapy is sometimes performed on women, especially to treat post menopausal symptoms like reduction in libido. But it can produce serious side effects like fluid retention, excessive growth of body hair, enlargement of clitoris and masculinization. On the other hand, use of skin patches can cause skin irritation. Besides, long term use of testosterone replacement therapy can cause significant damage to the liver. It is also not suitable for people with prostrate cancer, as testosterone replacement therapy can worsen the disease by stimulating the growth of cancerous cells.

Therefore, one should opt for testosterone replacement therapy only under the supervision of a physician. The physician should also monitor the level of testosterone of the individuals undergoing testosterone replacement therapy at regular intervals. Awareness of the side effects or symptoms associated with the therapy, is helpful in regulating testosterone therapy.