Erectile Dysfunction: Testosterone Replacement Therapy
How Is Low Testosterone Treated?
Testosterone deficiency can be treated by:
- Intramuscular injections, given anywhere from two to 10 weeks apart
- Testosterone patch worn either on the body or on the scrotum (the sac that contains the testicles)
- Testosterone gel applied to the skin or inside the nose
- Mucoadhesive material applied above the teeth twice a day
- Oral tablets
- Long-acting subcutaneous implant
- 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 may be right for you.
Who Shouldn't Take Testosterone Replacement Therapy?
Men who have prostate cancer or breast cancer should not take testosterone replacement therapy. All men considering testosterone replacement therapy should undergo a thorough prostate cancer screening prior to starting this therapy with a rectal exam and PSA test.
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
- 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
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.