Testosterone Replacement Therapy

The testicles produce a hormone that is known as testosterone and it is responsible for the proper growth and development of the male sexual characteristics. It also functions for

  • Adequate red blood cell levels.
  • The bone density.
  • Reproductive and sexual functions.
  • The maintenance of the muscle bulks.
  • Sense of well being.

What are the causes of testosterone deficiency?

As a man gets older, after the age of 30, his body starts facing declines of testosterone. These declines result in testosterone deficiencies. Reasons of these deficiencies are,

  • Any injury to the testicles
  • Infections in the testicles
  • Genetic abnormalities
  • Hemochromatosis
  • Pituitary gland dysfunction
  • Medication for cancer and other severe disease
  • Use of steroids
  • Chronic illness
  • Liver problem
  • AIDS
  • Sarcoidois
  • Depression
  • Congenital conditions
  • Alcoholism
  • Kidney failure

What are the different Symptoms of the testosterone deficiency?

The symptoms of testosterone deficiency include:

  • Depression and mood swings.
  • Erectile dysfunction.
  • Decrease in sex drive.
  • Decrease in the sense of well being.
  • Difficulty in remembering things and poor memory.

Erectile dysfunction can be commonly caused by inadequate testosterone production. If erectile dysfunction is caused by decreased testosterone production, then testosterone replacement therapy can help in the improvement of erectile dysfunction.

What are the different types of Testosterone Replacement Therapies available?

The deficient testosterone is replaced by the natural (unmodified) testosterone to the physiological levels. These replacements are done by different successful methods.

1. Implants

It is one of forms of replacement therapies in which usually three to six pellets of testosterone are subcutaneously implanted every 3 to 6 months. This may require a small, but not usually painful, surgery and it stabilizes the normal levels of the testosterone.

2. Oral Testosterone Replacement Therapy

If the unmodified testosterone is orally taken then it gets rapidly inactivated by the first pass through the liver hepatic metabolism, this makes the oral therapy an ineffective means for the delivery of unmodified testosterone. But ester testosterone gets absorbed into the lymphatic system when it is taken orally and as it gets hydrolyzed in the body, it yields natural testosterone. This makes the oral replacement active and efficient.

3. Intramuscular injections

Due to the low cost and convenience, the intramuscular injection therapy has become famous and is widely used for treatment. The testosterone esterifies at the 17β-hydroxyl group increasing the solubility of the molecules. This allows the use of injections as long acting depots. In the body these esters get hydrolyzed and release the natural testosterone. The effect of depot gets increased as the length of the ester side chain becomes larger, so that different ester testosterones get different biological lives. For example,

• Testosterone propionate require injections every 2 to 3 days
• Testosterone enanthate or cypionate require injections every 5 to 7 days.

4. Transdermal patches

Transdermal patches increase the testosterone levels to within the normal range and mimic the testosterone levels to the circadian rhythm. The scrotal patches are applied to the shaved scrotum daily and they cover the area about 40 to 60 cm2 . The advantage of these patches is that they rapidly get absorbed through the vascularized scrotal skin.

5. Transdermal gels

Theses gels have been introduced recently and are applied once every day to the upper arms and torso making the dosage low for reaching the ideal level. Gel formulation does not create irritation like the patches and they provide normal range of serum testosterone at a more stable level.