Klinik Temasya
Men's Health

Testosterone replacement therapy (TRT)

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Testosterone is a chemical hormone produced by the testis and its important to male sexual development and functions. It also help to maintain sperm production, maintain lean body mass and muscle strength, decrease body fat, bone health and stimulates a hormone called erythropoietin in the kidney that helps increase red blood cell production 

Testosterone level decrease with age. Testosterone levels begin to decline around 40 years of age and by 80 years of age, more than 50% of men will have testosterone levels in the hypogonadal range. The symptoms of low testosterone can be insidious, non-specific and may be dismissed as part of ageing process

Low testosterone cause poor energy, decrease sex drive, decrease erection, declining muscle mass and increase in fat distribution especially around the abdomen and breast area. Some men also develop psychological symptoms such as sleep disturbances, poor motivation and self-confidence and depression. Men with low testosterone also at high risk of metabolic disorders such as obesity, diabetes, high cholesterol and heart disease.

Testosterone deficiency can be diagnosed with blood test that measure level of serum and free testosterone level. Testing preferably done in the morning fasting state. Other hormone testing such as FSH/LH/estrogen/prolactin and thyroid function also needed to help with the diagnosis. As part of the work-up, baseline full blood count and PSA are also needed. Your doctor may also perform physical assessment to check your heart health, weight and BMI, blood pressure and genital and prostate assessment

Testosterone replacement therapy (TRT) is used primarily to treat symptoms of sexual dysfunction in men and occasionally in postmenopausal women to treat hypoactive sexual desire. TRT can be initiated with lengthy discussion with patient on the risks and benefits, long term issues and desire for pregnancy. Potential benefits include improved libido, increased bone mass, and improved mood and sense of wellbeing.

Testosterone can be administered by injection, patch, topical gel, pill, or implant. Side effects include acne, body swelling and water retention, breast swelling and tenderness, increase production of red blood cells ('polycythemia') which can increase risk of blood clot formation, raising level of prostate specific antigen (PSA), decrease sperm production and testicular shrinkage affecting fertility and rarely liver injury. Men on long-term use of TRT appear to have a higher risk of cardiovascular  problems, like heart attacks, strokes, and deaths from heart disease.

Testosterone replacement therapy is not a fountain of youth. Full discussion with your doctor is needed about the potential issues that may arise with short and long term use of TRT. If you have concern about your testosterone health, discussed with your doctor and get your hormone level check.

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