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    Erectile Dysfunction: Testosterone Replacement Therapy

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    How Is Low Testosterone Treated?

    Testosterone deficiency can be treated by:

    • Intramuscular injections, given anywhere from two to 10 weeks apart
    • Testosterone gel applied to the skin or inside the nose
    • Mucoadhesive material applied above the teeth twice a day
    • Long-acting subcutaneous pellet
    • Testosterone stick (apply like underarm deodorant)

    Each of these options provides adequate levels of hormone replacement; however, they all have different advantages and disadvantages. Talk to your doctor to see which approach is right for you.

    Who Shouldn't Take Testosterone Replacement Therapy?

    Men who have prostate cancer or breast cancer should not take testosterone replacement therapy. Nor should men who have severe urinary tract problems, untreated severe sleep apnea or uncontrolled heart failure. All men considering testosterone replacement therapy should undergo a thorough prostate cancer screening -- a rectal exam and PSA test -- prior to starting this therapy.

    What Are the Side Effects of Testosterone Replacement Therapy?

    In general, testosterone replacement therapy is safe. It is associated with some side effects, including:

    • Acne or oily skin
    • Mild fluid retention
    • Stimulation of prostate tissue, with perhaps some increased urination symptoms such as a decreased stream or frequency
    • Increased risk of developing prostate cancer
    • Breast enlargement
    • Increased risk of blood clots
    • Worsening of sleep apnea (a sleep disorder that results in frequent night time awakenings and daytime sleepiness)
    • Decreased testicular size
    • Increased aggression and mood swings
    • May increase risk of heart attack and stroke

    Laboratory abnormalities that can occur with hormone replacement include:

    • Changes in cholesterol and lipid levels
    • Increase in red blood cell count
    • Decrease in sperm count, producing infertility (especially in younger men)
    • Increase in PSA

    If you are taking hormone replacement therapy, regular follow-up appointments with your doctor are important.

    Like any other medication, directions for administering testosterone should be followed exactly as your doctor orders. If you are unsure or have any questions about testosterone replacement therapy, ask your doctor.

    WebMD Medical Reference

    Reviewed by Lisa Bernstein, MD on August 12, 2015
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