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Testosterone replacement therapy (TRT) has seen a significant rise in popularity in recent years in Santa Monica. Countless older men have chosen TRT to restore their hormone levels, with the hope of increasing their energy and rejuvenating their sex drive.

While TRT has seen a rise in use, it remains controversial due to uncertain benefits and potential health risks. Years ago, safety concerns emerged when research suggested a possible link between TRT and a higher risk of cardiovascular disease.

Dr. Frances Hayes of Harvard-affiliated Massachusetts General Hospital points out that there were limitations in some of these 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

Latest research has upheld this view. A study disclosed at the 2015 American Heart Association Scientific Sessions involved 1,472 men between the ages of 52 and 63 with low testosterone and no history of cardiovascular disease.

Healthy men who received TRT did not have a greater risk of heart attack, stroke, or death, the study found.

Moreover, findings from the August 2015 Mayo Clinic Proceedings indicated no connection between TRT and venous blood clots in a group of 30,000 men. “Right now, the jury is still out about TRT’s influence on cardiovascular disease,” says Dr. Hayes.

TRT’s association with other health concerns presents a complex picture. While TRT has been previously linked to an elevated prevalence of prostate cancer, a study released in the December 2015 Journal of Urology found no connection between exposure to TRT over a five-year duration and an increased risk of aggressive prostate cancer.

The long-term risks of TRT continue to be uncertain due to limited follow-up in many 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 Santa Monica: 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.”

Evaluating testosterone levels commonly involves a standard blood test. Given their daily fluctuations and susceptibility to medication and diet influences, multiple tests are essential. Dr. Hayes explains, “About 30% of cases where the initial testosterone test indicates low levels show normal levels upon retesting.”

Even in the presence of low testosterone levels and multiple symptoms, immediate testosterone replacement therapy (TRT) isn’t always recommended. Dr. Hayes explains, “Identifying the root cause of declining levels allows us to address it and naturally increase low levels.”

Take weight gain, for instance, which is often the leading factor behind declining levels. “Weight has a more substantial effect on testosterone levels than 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 regarding testosterone levels.

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

Men must grasp the constraints of TRT, as many see it as a magical solution. “Its effects are usually not as dramatic as men might hope,” Dr. Hayes remarks.

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 can be administered by either gel application or injection. With a gel, you spread the daily dose, roughly the size of a ketchup packet, over both upper arms, shoulders, or thighs. Injections are typically given in the buttocks biweekly.

Each method has distinct advantages. Gels provide less variability in testosterone levels. “However, you should avoid close skin contact for a few hours, especially with women, since testosterone can cause acne or hair growth,” says Dr. Hayes.

Injections can cause a surge in testosterone levels for a few days, followed by a gradual decline, resulting in a roller-coaster effect where mood and energy levels rise and then fall.

Many men in Santa Monica feel better within four to six weeks, although muscle mass gains may take from three to six months.

Lifelong TRT might not be needed. “If the initial cause of your low testosterone levels is resolved, you should try a trial period off treatment and consult with your doctor for re-evaluation,” says Dr. Hayes.