|“So, one of the things to know in this whole realm of giving testosterone is that the lab numbers, the amount of testosterone in the blood, is not the most important thing—it’s how men feel—because giving testosterone is designed to restore a better quality of life, provide energy, improve libido.”- Dr. Scholz|
All men’s testosterone decreases with age. For many men this means decreased libido, increased fatigue, and loss of muscle. Testosterone replacement therapy can give men back their quality of life.
Testosterone replacement is given through several different methods: creams, shots, pellets, and patches. The two most common approaches are shots and topical application. The dosage can be adjusted based on close monitoring and how the patient feels while on the testosterone replacement therapy.
There are four situations to consider testosterone replacement therapy:
- Aging men with low testosterone: Studies have shown that giving testosterone replacement to men with low testosterone won’t encourage prostate cancer growth in men with no known prostate cancer.
- Men who’ve received prior treatment for prostate cancer and their testosterone failed to return to pre-treatment levels: Men with prostate cancer who have low testosterone after testosterone inactivating pharmaceuticals (TIP) may be understandably nervous about receiving testosterone. But studies show that for qualified men it is safe. Think of how men on TIP can be on an intermittent schedule—once TIP is stopped testosterone levels are able to return naturally. If these men’s testosterone levels don’t naturally return, they can use testosterone replacement therapy to counteract the side effects.
- Men with advanced prostate cancer: Some studies have shown that men with advanced prostate cancer who have exhausted all options can use testosterone replacement therapy as a treatment with varying degrees of success. These men must be carefully monitored but in some cases overloading testosterone has worked to put these men back into remission. These men must be sure that the administering doctor has experience with this situation.
- Spouses (aka bioidentical hormones): As women go through menopause they lose the little bit of testosterone they have as well. Adding testosterone replacement to a woman’s health plan can help them maintain libido, improve energy and memory and even assist in weight loss.
The main concerning side effect of testosterone replacement is polycythemia, or increased red blood cell count. This can mean increased risk of heart attack and stroke. Blood levels should be checked regularly during testosterone replacement therapy. The test is called a CBC, or complete blood count, the section of the CBC that reports red blood cells is called the hematocrit. The hematocrit should be less than 50%. If it is above 50%, men should consider reducing the testosterone dose or donating blood.
Talk to your doctor about your testosterone levels and if testosterone replacement therapy is an option for you.
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The purpose of this podcast is to educate and inform. The information presented on this podcast and corresponding blog posted on prostateoncology.com/blog should not be used in place of a physician consult. Guests on the podcasts present their own opinions and conclusions, these views do not necessarily represent that of Prostate Oncology Specialists.