A New Look At Testosterone Therapy In [location_name]

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Over the past ten years, testosterone replacement therapy (TRT) has gained widespread popularity in Auburn. Numerous older men have turned to TRT to normalize their hormone levels, seeking renewed energy and a revitalized sex drive.

While TRT has become widely used, it remains controversial due to uncertain benefits and potential health risks. Years ago, safety concerns were highlighted when research suggested a possible association between TRT and increased cardiovascular disease risk.

Dr. Frances Hayes, from Harvard-affiliated Massachusetts General Hospital, notes that some studies had limitations.

“For instance, in one study, TRT doses were much higher than what would usually be prescribed, and the subjects tended to be more frail, with other health problems,” she says. “Other studies showed no evidence of increased risk.”

THE LATEST FINDINGS

Recent investigations have endorsed this perspective. At the 2015 American Heart Association Scientific Sessions, a study involving 1,472 men aged 52 to 63 with low testosterone and no previous heart disease was presented.

Researchers reported no higher risk of heart attack, stroke, or death for healthy men on TRT.

A study from the August 2015 Mayo Clinic Proceedings indicated no relationship between TRT and venous blood clots among 30,000 men. “Right now, the jury is still out about TRT’s influence on cardiovascular disease,” says Dr. Hayes.

The association between TRT and other health conditions offers a varied perspective. While TRT has been linked to an increased incidence of prostate cancer in the past, a study published in the December 2015 Journal of Urology showed that exposure to TRT over a five-year period did not result in a higher risk of aggressive prostate cancer.

The long-term risks of TRT continue to be uncertain due to limited follow-up in various studies. However, this shouldn’t discourage individuals from considering TRT. It might be a suitable option for specific groups of men

Who Is a Candidate For TRT In [location_name]?

Meeting two conditions is essential for TRT prescription in Auburn: low testosterone levels (less than 600 nanograms per deciliter (ng/dL)) and the manifestation of multiple symptoms (see page 7). Dr. Hayes points out, “While low levels can exist without symptoms, if key symptoms such as fatigue and sexual dysfunction are absent, commencing TRT isn’t recommended due to ongoing uncertainties about its long-term safety.”

Testosterone levels are typically determined through a standard blood test. Due to their daily fluctuations and susceptibility to medication and diet, multiple tests are essential. Dr. Hayes states, “Around 30% of cases where the initial testosterone test shows low levels, subsequent tests reveal normal levels.”

Low testosterone levels and multiple symptoms don’t automatically mean testosterone replacement therapy (TRT) is required. According to Dr. Hayes, “Identifying the cause of declining levels allows us to address it and naturally enhance low levels.”

Take weight gain, for instance, which is frequently the main contributor to declining levels. “Weight has a larger impact on testosterone levels compared to aging. As weight increases, testosterone levels decrease,” she explains. A five-point increase on the body mass index (BMI) scale, such as moving from 30 to 35, is comparable to adding 10 years to your age concerning testosterone levels.

“Your doctor should also review any other factors that might affect levels, such as medication or medical conditions,” says Dr. Hayes. In these cases, your doctor may address the underlying condition or change your medication or dosage to one that wouldn’t affect testosterone levels.

Men also need to understand the boundaries of TRT, as it’s often seen as a panacea. “Its impact is typically not as dramatic as men imagine,” Dr. Hayes states.

Take sexual health and vitality, for example, often cited advantages of TRT. A study published in the Feb. 18, 2016 issue of The New England Journal of Medicine examined the effects of TRT on 790 men aged 65 and older. Those receiving TRT for one year, compared to those on a placebo, witnessed improvements in sexual function, encompassing activity, desire, and erectile function. Nonetheless, the group experienced only a slight mood enhancement and observed no changes in walking speed, a measure of TRT’s impact on vitality.

Using TRT

TRT is often given through gel or injection. For the gel, you apply the daily dose, about the size of a ketchup packet, to both upper arms, shoulders, or thighs. Injections are generally given into the buttocks every two weeks.

Both methods have unique merits. Gels maintain stable testosterone levels. “But you need to avoid close skin contact for a few hours, especially with women, as testosterone might cause acne or hair growth,” says Dr. Hayes.

Injections cause testosterone levels to rise to high levels for several days and then slowly decrease, creating a roller-coaster effect where mood and energy levels fluctuate.

Symptom improvement typically occurs within four to six weeks for most men in Auburn, with muscle mass gains taking up to six months.

TRT might not be needed permanently. “If the initial cause of your low testosterone is resolved, you should attempt a trial off the treatment and have your doctor re-evaluate you,” says Dr. Hayes.