Male Hormone Replacement

It is well known that women go through menopause, but what about men? Men experience something very similar, known as andropause or late-onset hypogonadism. Starting as early as 35 years old, the level of testosterone in men can start to gradually decline at a rate of 1-1.5% annually. This decline in testosterone may not effect every man, but is seen in about 39% of the male population > 45 years old. Many of the signs and symptoms of low testosterone are overlooked as signs of old age, including weakness, fatigue, decreased muscle mass and decreased bone density. Other effects of low testosterone include depression, hair loss and sexual issues, such as decreased libido and erectile dysfunction. If men start to experience these symptoms, it is important for them to talk to their physicians and get lab work done to see if their testosterone level is truly low.

Having low testosterone can greatly impact a man’s health and general well-being. Men with low testosterone are more likely to have other diseases, such as high blood pressure, high cholesterol, and diabetes. There have also been studies linking low testosterone with cognitive impairment and a higher risk of cardiovascular disease. Ideally, restoring the hormonal balance in men will not only help resolve symptoms, but also decrease their risk for concurrent diseases.

Currently there are a few different products on the market which provide supplemental or replacement testosterone. Testosterone can be injected into the muscle, applied topically to the skin by a patch (Androderm) or gel (Androgel, Testim), absorbed through the inner lining of the mouth (Striant SR), or absorbed from a pellet implanted underneath the skin (Testopel). These treatments are all FDA-approved, which means that they have gone through rigorous testing for safety and efficacy.

These conventional treatments are not the only options available. Recently bioidentical hormone replacement therapy (BHRT) has picked up popularity as a solution to resolve menopause in women. Heralded as a safer and more effective treatment compared to conventional products, BHRT is the supplementation of hormones that are molecularly identical to the hormones produced in the human body. While most studies have focused on the treatment of women with BHRT, men can also benefit. The concept of using BHRT in men is similar to the treatment of women, just with different hormones. BHRT for both men and women, are available as compounded medications produced by a compounding pharmacy. The main benefit of using compounded medications is the ability to provide individualized treatment. The strength of the medication, schedule of when to take the medication, and how the medication is administered, can all be easily customized.

In general, testosterone replacement therapy should only be started in men with reported low levels of testosterone and those experiencing symptoms. Choosing to start conventional treatments or BHRT depends on each individual’s situation. It is best to seek the advice of doctors and pharmacies who are well informed about testosterone replacement therapy, both conventional and BHRT, in order to receive the best health care possible.