madman
Super Moderator
Are you experiencing a low sex drive or difficulty keeping an erection? You may have other symptoms, too, like, low energy, fuzzy thinking and increased body fat with less muscle mass. When you notice these symptoms, it may be time to talk with your doctor about low testosterone treatment options. Our team of experts highlight new oral agents and other treatment options.
Here are 20 key facts from the video:
- Testosterone Deficiency: The preferred term for low testosterone is testosterone deficiency, emphasizing a hormonal efficiency rather than a temporary condition.
- Symptoms of Deficiency: Symptoms include decreased libido, weaker erections, fatigue, depression, irritability, poor memory, weak bones, decreased muscle mass, breast enlargement, increased body fat, anemia, and diabetes.
- Associated Conditions: Conditions like diabetes, sleep apnea, metabolic syndrome, COPD, kidney failure, osteoporosis, and certain treatments (steroids, opioids, HIV) can be associated with testosterone deficiency.
- Diagnosis Process: Diagnosing testosterone deficiency requires blood tests, taken twice in the morning, to confirm low levels along with the presence of symptoms.
- Treatment Thresholds: Treatment is considered when testosterone levels fall below a certain threshold, even if average levels decline with age.
- Prevalence: Testosterone deficiency affects 2% to 39% of men, depending on the study and criteria used.
- Treatment Modalities: Includes injectable testosterone, topical treatments (gels, creams), implanted pellets, oral testosterone, and intranasal sprays.
- Topical Testosterone: These can transfer to others upon contact and have good insurance coverage but carry risks of skin transference.
- Injectable Testosterone: Provides quick and controlled dosage adjustments, common formulations include testosterone enanthate and cypionate.
- Pellets and Oral Options: Pellets provide a slow-release form of testosterone, while oral options offer convenience but have been historically limited due to concerns over liver toxicity.
- FDA Approval: Recent oral testosterone options are FDA approved and avoid liver toxicity by bypassing liver metabolism through lymphatic absorption.
- Safety and Efficacy: Testosterone replacement therapy is safe for the heart when levels are restored to the normal range and may be protective in some contexts, such as prostate health.
- Risks of Treatment: Testosterone therapy can increase blood viscosity, worsen sleep apnea, cause skin issues, and potentially impact fertility and mood.
- Transference Issues: Gels and creams pose risks of transference to women and children, which can be harmful.
- Cost Considerations: While insurance may cover many testosterone therapies, out-of-pocket costs for new oral treatments can range from $150 to $185 per month.
- Monitoring Therapy: Regular blood tests are necessary to ensure testosterone levels are appropriate and to monitor for side effects like erythrocytosis.
- Effect on Symptoms: Symptomatic improvement can be expected within 3 to 6 months of starting therapy, depending on the individual.
- Fertility Concerns: Certain testosterone therapies can suppress sperm production, necessitating special considerations for men wishing to maintain fertility.
- Specific Treatment for Fertility: Medications like human chorionic gonadotropin (hCG) can be used to maintain fertility during testosterone therapy.
- Individualized Treatment Approach: Treatment plans are tailored based on patient symptoms, lifestyle factors, and specific health considerations, emphasizing a personalized approach to therapy.
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