Testosterone replacement therapy
Testosterone levels decline naturally as a man gets older. Symptoms of low testosterone may appear earlier in some men. This is called hypogonadism and the symptoms include:
Low testosterone can be confirmed with blood tests which a GP can arrange for the sex hormones testosterone, luteinising hormone (LH) and follicle stimulating hormone (FSH).
Additional tests may be needed as hormone levels vary across the day.
Treatment may not be recommended if low testosterone is diagnosed but troublesome symptoms are not being experienced.
Treating low testosterone
If low testosterone is diagnosed, the missing hormones can be replaced with hormone replacement therapy to bring the body’s testosterone levels back to normal. This should remove symptoms of hypogonadism and related sexual problems.
Testosterone replacement therapy can be given in different forms. A doctor will discuss the different options before deciding which one is most appropriate. Testosterone levels may need to be checked after treatment begins so the right dose can be given.
Testosterone replacement therapy options
Injections: Regular injections are given deep into a muscle, called intramuscular injections. Depending on the type of injection recommended, these can be every two to three weeks to every three months. These may be injected by a doctor or practice nurse, self-injected or done by a partner. Carried out correctly, these shouldn’t be too painful.
Implants: Cylindrical pellets are inserted in the abdomen, buttock or thigh by a doctor under local anaesthetic once every three to six months.
Capsules: These are swallowed on a daily basis but give a lower dose of hormones than other methods.
Patches: These work similar to nicotine patches for people trying to quit smoking and deliver testosterone gradually through the skin using a new patch each day.
Gum or buccal testosterone: Testosterone gum is put in the mouth above the front teeth.
Testosterone gel: Gel is applied to the skin, usually on the shoulder, arm or abdomen. This need to be used after showering to stop it washing off too soon.
Is testosterone therapy safe?
Like any medication, testosterone replacement therapy can cause some side effects. These will depend on the type of therapy used. For example, injections can cause bruising and patches may cause itching or irritation.
Men using testosterone replacement therapy are usually monitored for prostate cancer as the therapy could promote growth of an existing cancer.