Testosterone is a hormone that plays a vital role in the development of male reproductive tissues such as testes and prostate. It is also responsible for the development of male secondary sexual characteristics such as the growth of facial hair and deepening of the voice. In addition, testosterone plays an important role in maintaining muscle mass, bone density, and overall health.
Testosterone levels in men decline with age, and some men may experience symptoms such as decreased libido, decreased energy, and depression. Testosterone Replacement Therapy (TRT) is a treatment option for men with low testosterone levels. In this article, we will discuss how a prospective patient can legally get started with TRT.
Step 1: Identify Symptoms and Get Tested
The first step in getting started with TRT is to identify symptoms of low testosterone. The symptoms of low testosterone can include:
- Decreased libido
- Erectile dysfunction
- Decreased energy
- Decreased muscle mass
- Increased body fat
- Decreased bone density
- Depression
- Difficulty concentrating
If you are experiencing any of these symptoms, it is important to get tested to determine if you have low testosterone levels. The most common test for testosterone levels is a blood test called a serum testosterone test. This test measures the total amount of testosterone in the blood. According to the American Urological Association, a normal range for total testosterone levels in men is between 300 and 1,000 nanograms per deciliter (ng/dL) of blood (1).
Step 2: Find a Qualified Healthcare Provider
Once you have identified symptoms of low testosterone and have been tested to confirm low testosterone levels, the next step is to find a qualified healthcare provider who can prescribe TRT. The healthcare provider should be a licensed medical doctor or a physician assistant with experience in treating men with low testosterone.
It is important to find a healthcare provider who is knowledgeable about TRT and can monitor your progress and adjust your treatment as needed. The healthcare provider should also be aware of the potential risks and side effects of TRT, which we will discuss in more detail later in this article.
According to the Endocrine Society’s Clinical Practice Guidelines, TRT is appropriate for men who have low testosterone levels and symptoms that are consistent with testosterone deficiency. The guidelines recommend that healthcare providers use a combination of symptoms, such as low sex drive, erectile dysfunction, and decreased energy, along with laboratory tests to diagnose low testosterone levels.
Step 3: Determine the Best Treatment Option
There are several options for TRT, including injections, gels, patches, and pellets. Each option has its own benefits and drawbacks, and the healthcare provider can help you determine which option is best for you based on your symptoms, lifestyle, and preferences.
Injections: Testosterone injections are administered into the muscle every two to four weeks. Injections are a convenient option for men who do not want to use a gel or patch and do not mind getting an injection every few weeks.
Gels: Testosterone gels are applied daily to the skin, usually on the shoulders, upper arms, or abdomen. Gels are a good option for men who do not want to use injections and prefer a daily application of medication.
Patches: Testosterone patches are applied daily to the skin, usually on the upper arm or thigh. Patches are a good option for men who do not want to use injections and prefer a daily application of medication.
Pellets: Testosterone pellets are small, rice-sized pellets that are inserted under the skin every three to six months. Pellets are a good option for men who do not want to use injections, gels, or patches and prefer a longer-lasting treatment option.
Step 4: Understand the Risks and Side Effects
TRT can have potential risks and side effects, and it is important to understand these before starting treatment. According to the American Urological Association, potential risks of TRT include:
- Increased risk of blood clots
- Increased risk of heart attack or stroke
- Increased risk of prostate cancer (2)
- Acne and oily skin
- Enlarged breasts (gynecomastia)
Step 5: Who is a candidate for TRT?
Not all men with low testosterone levels are candidates for TRT. Before considering TRT, a healthcare provider will conduct a thorough evaluation to determine the cause of low testosterone levels and whether TRT is appropriate. According to the American Urological Association, TRT is recommended for men with low testosterone levels who are experiencing symptoms of hypogonadism and have no contraindications to treatment.
Some medical conditions may make TRT inappropriate or require careful monitoring, including prostate or breast cancer, high red blood cell count, sleep apnea, and heart disease. Additionally, men who are trying to conceive should avoid TRT, as it can decrease sperm production.
Step 6: Get a Blood Test
After consulting with a healthcare provider, the next step is to get a blood test. The blood test will measure your testosterone levels and help determine if you have low testosterone levels. According to the Endocrine Society, the diagnosis of low testosterone requires the presence of symptoms consistent with testosterone deficiency and low testosterone levels on at least two separate occasions.
The laboratory test that is commonly used to measure testosterone levels is called a serum testosterone test. The test measures the amount of testosterone in the blood. The normal range for testosterone levels in men is between 300 and 1000 ng/dL. Testosterone levels below 300 ng/dL are considered low.
In addition to measuring testosterone levels, the healthcare provider may order other laboratory tests to rule out other medical conditions that can cause low testosterone levels, such as thyroid dysfunction or pituitary gland dysfunction.
Step 7: Monitoring and Adjusting the Treatment
Once a patient has started TRT, regular monitoring is required to ensure that the treatment is effective and safe. The doctor will monitor the patient’s testosterone levels and adjust the treatment dosage if necessary. The doctor may also monitor other health parameters, such as blood pressure and cholesterol levels, to ensure that the treatment is not having any adverse effects.
Patients should also be aware of the potential side effects of TRT. Common side effects include acne, hair loss, and an increase in red blood cell count. More serious side effects can include an increased risk of prostate cancer, sleep apnea, and blood clots. Patients should report any side effects to their doctor immediately.
Conclusion
To legally get started with Testosterone Replacement Therapy (TRT), a prospective patient must first consult with a healthcare provider who has experience in diagnosing and treating low testosterone levels. The healthcare provider will ask about the patient’s medical history, perform a physical examination, and order laboratory tests to measure testosterone levels. A blood test is necessary to measure testosterone levels and help determine if the patient has low testosterone levels. The healthcare provider will work with the patient to select the appropriate treatment option based on their preferences and medical history. The goal of TRT is to restore testosterone levels to within the normal range and improve symptoms associated with low testosterone levels. The available treatment options include injections, gels, patches, and pellets, and each option has its advantages and disadvantages.