A New Look At Testosterone Therapy In [location_name]
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In the last ten years, testosterone replacement therapy (TRT) has become a widely popular choice in Rochester. Many older men have turned to this therapy to replenish their hormone levels, aiming to enhance their energy and rekindle their sexual interest.
Despite its widespread use, TRT remains a controversial subject because of its unclear benefits and potential health risks. Research from years ago suggested a possible link between TRT and an elevated risk of cardiovascular disease, leading to safety worries.
Dr. Frances Hayes, a Reproductive Endocrinologist at Harvard-affiliated Massachusetts General Hospital, identifies the limitations in various studies.
“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 studies uphold this position. At the 2015 American Heart Association Scientific Sessions, a study involving 1,472 men aged 52 to 63 with low testosterone and no cardiovascular disease history demonstrated that TRT did not increase the risk of heart attack, stroke, or death in healthy men.
More findings in the August 2015 Mayo Clinic Proceedings demonstrated no connection between TRT and blood clots in veins among 30,000 men. “Right now, the jury is still out about TRT’s influence on cardiovascular disease,” says Dr. Hayes.
The connection between TRT and other health issues remains mixed. While earlier studies associated TRT with a higher risk of prostate cancer, a December 2015 Journal of Urology study found no increased risk of aggressive prostate cancer with five years of TRT exposure. This challenges conventional wisdom and warrants further investigation into TRT’s long-term effects.
The long-term risks of TRT remain uncertain due to limited follow-up in many studies. Nonetheless, TRT should not be overlooked as a potential solution, as it may be appropriate for specific individuals.
Who Is a Candidate For TRT In [location_name]?
TRT prescription in Rochester mandates two criteria: testosterone levels below 600 nanograms per deciliter (ng/dL) and experiencing various symptoms (refer to page 7). Dr. Hayes emphasizes, “While it’s conceivable to have low levels without symptoms, if crucial symptoms like fatigue and sexual dysfunction aren’t present, initiating TRT isn’t advisable due to current uncertainties surrounding its long-term safety.”
Testosterone levels are usually assessed with a standard blood test. Given the daily variations and the influence of medication and diet, multiple tests are necessary. Dr. Hayes explains, “In around 30% of cases where the initial testosterone test indicates low levels, subsequent tests show normal levels.”
Low testosterone levels and various symptoms don’t always mean immediate testosterone replacement therapy (TRT) is necessary. Dr. Hayes suggests, “By understanding the underlying cause of declining levels, we can address it and naturally enhance low levels.”
For example, improvements in sexual well-being and vitality are commonly cited as advantages of TRT. A study published in the February 18, 2016 edition of The New England Journal of Medicine involved 790 men aged 65 and older to examine TRT’s effects. Men who received TRT for one year, compared to those on a placebo, experienced enhancements in sexual function, including activity, desire, and erectile function. However, the group saw only slight improvements in mood and noticed no changes in walking speed, a gauge of TRT’s effect on vitality.
“Your doctor should also consider any additional factors that could influence levels, such as medication or medical conditions,” suggests Dr. Hayes. In such scenarios, your doctor may address the root cause or adjust your medication or dosage to sidestep influencing testosterone levels.
Men should understand the constraints of TRT, often touted as a panacea. “Its outcomes are typically not as astounding as men expect,” Dr. Hayes observes.
This is demonstrated by the frequent focus on sexual health and vitality as advantages of testosterone replacement therapy (TRT). A study outlined in the February 18, 2016 edition of The New England Journal of Medicine investigated how TRT affected 790 men aged 65 and older. Participants who underwent TRT for one year, compared to those given a placebo, experienced enhancements in sexual function, such as activity, desire, and erectile function. However, the group observed only a slight improvement in mood and detected no changes in walking speed, a measure of TRT’s impact on vitality.
Using TRT
Administering TRT is possible through either gel application or injections. Gel application involves applying a daily dose, roughly the size of a ketchup packet, over both upper arms, shoulders, or thighs. Injections are commonly administered into the buttocks every two weeks.
Both options provide unique benefits, with gels ensuring consistent testosterone levels. “However, you should be careful to avoid close skin contact for a few hours, especially with women, as testosterone could cause acne or hair growth,” Dr. Hayes advises.
After receiving an injection, testosterone levels might briefly peak before gradually declining, resulting in mood and energy variations similar to a roller-coaster.
In Rochester, many men often observe symptom relief within four to six weeks, with changes in muscle mass potentially taking three to six months.
It’s important to understand that TRT doesn’t have to be maintained indefinitely. “If the factor that caused your testosterone drop is resolved, you should try stopping the treatment and be re-evaluated by your doctor,” says Dr. Hayes.