Hypogonadism is a male condition where the testes cannot produce adequate levels of the sex hormone testosterone, sperm or both according to the Milton S. Hershey Medical Center at Penn State University. Harvard University reports that hypogonadism affects an estimated two to four million American men. Although many seniors are subject to hormone deficiencies, hypogonadism can affect men of any age, including developing fetuses and prepubescent boys. Testosterone replacement therapy is an effective medical treatment for hypogonadism. Please discuss hormone replacement therapy for hypogonadism with your doctor or endocrinologist to see if it can benefit you.
Hypogonadism
Men with hypogonadism produce little to no testosterone. According to the University of California at San Fransisco, although the discussion of what constitutes "normal" testosterone ranges varies, a testosterone level below 200 ng/dl is a clear indicator of hypogonadism. Many symptoms of hypogonadism can subtle and may not appear life-threatening, but can significantly effect your quality of life. According to Penn State University, in adult males, symptoms may include: fatigue, erectile dysfunction, loss of sex drive, infertility, decreases in hair growth, inability to build or maintain muscle and increases in body fat. Psychological symptoms such as depression and irritability can also be symptoms of a testosterone deficiency. Simple blood tests are needed to determine your testosterone levels.
What is Testosterone Replacement Therapy?
Testosterone replacement therapy is a treatment for hypogonadism that supplies your body with the testosterone that it can not produce naturally. Treatment involves administering synthetic endogenous testosterone to your body. This can be done with testosterone injections, testosterone patches or topical testosterone creams. According to Penn State University, testosterone injections are safe and effective and need to be administered about every two weeks. Topical patches or testosterone replacement creams are applied to your skin and the replacement dose is transdermally carried through your skin into the bloodstream. While this seems more desirable than injections, dosing can be less accurate and physical contact with women and children may be a concern, as you must protect them from contact with the testosterone. Testosterone replacement therapy for hypogonadism requires a prescription from an endocrinologist.
Cardiovascular Concerns
There are several cardiovascular concerns about the administration of replacement testosterone for hypogonadism. Both high and low testosterone levels are associated with an increased risk of heart disease, according to the University of California at San Fransisco. More specifically, the University of North Carolina explains that hypogonadism is associated with insulin resistance, low HDL/"good" cholesterol, high LDL/"bad" cholesterol and elevated triglycerides. Increasing testosterone and other hormone levels can potentially further increase your cardiovascular risk factors. Harvard University, however, reports that there is "no compelling evidence" that links testosterone replacement therapy to an increased risk of heart disease or prostate cancer.
Other Considerations
Testosterone replacement therapy is generally a lifetime commitment because administering external hormones to your body will shut down your natural testosterone production. You and your doctor should be absolutely certain that you are suffering from irreversible hypogonadism before opting for hormone replacement therapy. Nutrient deficiencies, other medications and lifestyle factors can also be responsible for low testosterone or symptoms of hypogonadism.
Increasing your testosterone levels will also likely increase other hormones in your body, such as estrogen and progesterone. If you are on any type of testosterone replacement therapy, it is very important to get blood tests regularly to confirm that your hormones and vitals are in their proper ranges.
References
- Penn State University: Hypogonadism
- University of California, San Fransisco: Are Higher Testosterone Levels Associated with Greater Heart Risk?
- University of North Carolina: Cardiovascular Issues in Hypogonadism and Testosterone Therapy
- Harvard University: Study of Testosterone Replacement Therapy Not Linked to Prostate Cancer, Heart Disease Risk
