Testosterone Replacement Therapy (TRT)
Testosterone is a sex hormone responsible for many functions in the body. It is present in both males and females. Low testosterone affects 20% of men in their 60s, 30% of men in their 70s, and 50% of men over 80 according to a study by the National Institute of Health (NIH).
Normal Testosterone levels for men should be between 300-1000 ng/dL depending on age and the lab. Lower than normal testosterone in women can negatively impact their health.
Signs of Low Testosterone
- Sexual: erectile dysfunction, drop in sex drive (libido), infertility
- Emotional: decreased self-confidence, decreased motivation, difficulty with concentration, depressed mood
- Physical: reduced muscle strength, decreased bone density, decreased energy, increased body fat and weight gain, breast enlargement and tenderness, vaginal dryness
These signs can be caused by other medical issues as well.
Risks of Testosterone Therapy
- Decreased sperm production, shrinking of testicles
- Enlarged breasts
- Worsening of Benign Prostatic Hyperplasia or growth of existing prostate cancer
- Causing acne or other skin eruption
- Can make sleep apnea worse
- Increased red blood cell production potentially leading to blood clot
- Potentially Increased risk of cardiac disease
- Increased Aggression
Normal aging should not be treated with testosterone therapy. It is important to test for low testosterone to make sure you would actually benefit from testosterone replacement. Also, other tests may be necessary to determine if another medical condition may be responsible for causing this low testosterone. You should speak with one of our doctors to see if treatment with testosterone is right for you. Of note, the FDA has not approved testosterone therapy in females, therefore it is prescribed as off-label use.
Types of Testosterone Replacement
- Topical: Gels (Androgel, Fortesta, Testim); Patches (Androderm); Solutions (Axiron)
- Advantage: adsorbed slowly, blood level is more stable
- Disadvantage: skin irritation and rash, transference to other people, possible odor
- Injection: many formulations
- Disadvantage: discomfort with injection, levels may fluctuate
- Cheek: sticks to your gums (Striant)
- Disadvantage: irritation
- Pellets: Testopel is implanted under the skin of the buttock or hip and usually lasts 3-7 months
- Oral tablets: Andriol and Restandol
- Disadvantage: potential liver damage
- Nasal Gel: Natesto applied 3 x daily
- Disadvantage: nose bleeds
What Is Estrogen Replacement Therapy?
Estrogen replacement therapy is used to replace the estrogen that a woman’s body stops making once it reaches menopause. This medication can help alleviate various symptoms associated with menopause such as hot flashes and vaginal discomfort. It can also help prevent bone loss and reduce the risk of fracture. The dedicated doctors at DoctorMeNow can help you decide if hormone replacement therapy is right for you, and if so, which type of therapy you need.
The Basic Types of Estrogen Therapy
Depending on your individual needs, there are two main types of estrogen therapy that our doctors may prescribe:
Systemic Hormone Therapy
Systemic estrogen can come in a variety of different forms. From pills, skin patches, gel, cream, or spray, this form of hormone therapy contains a high dose of estrogen that will be absorbed by the body. This can be used to treat common symptoms of menopause such as hot flashes.
Low-dose Vaginal Products
This type of hormone replacement therapy comes in either a cream or tablet form and holds only a minimal amount of estrogen to be absorbed by the body. Because the dosage of estrogen is low, it is used only to treat common discomfort to the urinary tract and common vaginal symptoms of menopause such as dryness.
Will I Have to Take Progesterone?
For individuals who have not had their uterus removed, our team will test and go over your hormonal levels with you. This can determine whether you need a progesterone or progestin treatment. Estrogen alone can stimulate the growth of the lining in the uterus if it is not being properly balanced with progesterone. This increases your risk of developing endometrial cancer. If you have had your uterus removed by a hysterectomy, you may not need to take progesterone. It depends on your body’s hormonal development.
Risks to Estrogen Therapy?
As with all medications and treatments, there are risks involved in receiving hormone therapy. These risks include heart disease, stroke, blood clots, and breast cancer. However, you can rest assured that our team will be working very closely with you to help minimize the risk. We do this by:
- Finding the best method of hormone replacement therapy for you
- Giving you only the amount of medication that you need
- Requiring regular follow-up care
Should I Get Estrogen Replacement Therapy?
Here are some of the reasons why hormone replacement therapy may be right for you:
- You have severe hot flashes
- You are suffering from vaginal dryness, itching, burning, or discomfort during intercourse
- You are at risk for bone loss or fractures
- You are experiencing early menopause or have an estrogen deficiency
If you think that you may need hormone replacement therapy to help alleviate symptoms of menopause, the team at DoctorMeNow can help. We can set up a consultation and some tests to discuss whether hormone replacement therapy will be right for you. Contact our caring team today for more information on our practice.
