Testosterone replacement therapy in erectile dysfunction
Testosterone is a hormone produced by the testicles and is responsible for the proper development of male sexual characteristics. Testosterone is also important for maintaining muscle bulk, adequate levels of red blood cells, bone growth, well-being, and sexual function.
Inadequate production of testosterone is not a common cause of erectile dysfunction; however, when erectile dysfunction does occur due to decreased testosterone production, testosterone replacement therapy may solve the problem.
What causes low testosterone?
As a man ages, the amount of testosterone in his body naturally gradually declines. This decline starts after age of 30 and continues throughout life. Some causes of low testosterone levels are due to:
- Injury, infection, or loss of the testicles
- Chemotherapyor radiationtreatment for cancer
- Genetic abnormalities such as Klinefelter’s Syndrome (extra X chromosome)
- Hemochromatosis(too much iron in the body)
- Dysfunction of the pituitary gland (a gland in the brainthat produces many important hormones)
- Inflammatory diseases such as sarcoidosis(a condition that causes inflammationof the lungs)
- Medications, especially hormones used to treat prostate cancerand corticosteroid drugs
- Chronic illness
- Chronic kidney failure
- Cirrhosisof the liver
Low testosterone is a controversial and not enough studied problem.
What Are the Symptoms of Low Testosterone?
What changes occur in the body due to low testosterone?
Low testosterone can cause the following physical changes:
- Decrease in muscle mass, with an increase in body fat
- Changes in cholesterol levels
- Decrease in hemoglobinand possibly mild anemia
- Fragile bones (osteoporosis)
- Decrease in body hair
- Changes in cholesteroland lipid levels
How do I find out if I have low testosterone?
The only accurate way to detect the condition is to have your doctor measure the amount of testosterone in your blood. Because testosterone levels fluctuate throughout the day, several measurements will need to be taken to detect a deficiency. Doctors prefer, if possible, to test levels early in the morning, when testosterone levels are highest.
How is low testosterone treated?
Testosterone deficiency can be treated by:
- Intramuscular injections, given anywhere from two to three weeks apart
- Testosterone patch applied to the body or the scrotum
- Testosterone gel
- Mucoadhesive material applied above the upper teeth twice a day
- Oral drugs
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. All men considering testosterone replacement therapy should undergo a thorough prostate cancer screening prior to starting this therapy (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:
- Acneor oily skin
- Mild fluid retention
- Stimulation of prostatetissue, with perhaps some increased urination symptoms such as a decreased stream or frequency
- Breast enlargement
- Worsening of sleep apnea(a sleep disorder that results in frequent night time awakenings and daytime sleepiness)
- Decreased testicular size
Laboratory abnormalities that can occur with hormone replacement include:
- Changes in cholesteroland 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, consult your doctor.