Testosterone For Men

Why Do Men Undergo Testosterone Replacement Therapy?​

Testosterone is more than just a sex hormone. Men’s testosterone levels in your body may affect a variety of functions from mood and cognitive ability to cardiovascular health, muscle mass and body fat. Testosterone deficiency can leave you feeling like a shadow of your former self. With low testosterone you may experience the following:

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• Low libido

• Lethargy

• Depression

• Erectile dysfunction

• Anxiety

• Inability to gain muscle mass

 

In short, your life becomes miserable. Testosterone is the lifeblood of every man and the balance or imbalance of this hormone can have dramatic effects on your quality of life.

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Before undergoing TRT, your symptoms will need to be evaluated in a full consultation to determine what treatments and schedule is right for you, so you can tackle the ‘male menopause.’

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You can get further information on the therapies available like hormone replacement therapy and detail about the risks and benefits of each at the link below. For any further questions, don’t hesitate to get in touch with us using the form at the bottom.

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More about treating male testosterone deficiency

​Taking over the management of your hormones with male testosterone therapies your sex hormones (testosterone and oestrogen) along with your gonadotrophins (LH and FSH) operate naturally in a tightly regulated and automated process. The brain creates a feed back loop which regulates how much testosterone is released. There is an interplay between the signal from the hypothalamus, the pituitary gland, and your testes. When you start Testosterone Replacement Therapy the regulated process will still occur but to a lesser degree and you will then take over control. You and your doctor determine how much testosterone your body receives, when it receives it and how often it receives it. Normally this is all managed for you by the Hypothalamus, but because age related Andropause or adult hypogonadism has blunted the response and has lowered your normal output to an unsatisfactory level it is now up to you to manage your hormones by topping them up with balanced testosterone replacement therapy including HCG.

 

How your body regulates testosterone through the hypothalamic gonadal axis

​An analogy might be to think of your heating system. The thermostat would be the hypothalmus and pituitary gland and Boiler would be your testes. The thermostat releases a signal called gonadotrophin releasing hormones, which signals your pituitary gland (think of microprocessor in your thermostat) to release gonadotrophins (LH and FSH) which signal to the testes (boiler) to produce more testosterone and sperm for reproduction. This process keeps the testes functioning and healthy. The testes produce sperm and testosterone allowing them to maintain their size. The Leydig cells are responsible for the production of testosterone and are sensitive to the signal (LH) sent from your pituitary. Without this signal which can be blunted by taking testosterone then the Leydig cells will cease functioning causing testicular atrophy. This can be prevented using HCG or recombinant LH and FSH as an adjunct whilst on male testosterone replacement therapy.

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Age related testosterone deficiency can be described by several different terms:

• Andropause

• ManOpause

• Adult onset hypogonadism

• Male menopause

• Low T

Other Names for low male testosterone or traditional/classical hypogonadism

• Primary hypogonadism

• Secondary hypogonadism

• Idiopathic hypogonadism

 

Diagnosis for low testosterone

​When you are being diagnosed for low male testosterone the LH will be looked at to determine if you have primary or secondary hypogonadism. In secondary hypogonadism the problem is with the Hypothalamus not signalling the Pituitary Gland to release it’s signal. The downstream effect being low LH and FSH and very little testosterone being produced. Primary hypogonadism occurs when the signal from Hypothalamus or Pituitary Gland are doing their job but when it reaches the testes it’s just not switching on production of testosterone. In this case you would have an elevated LH and FSH level with little testosterone being produced. When testosterone is produced and after a certain undetermined level is reached then enzymes known as aromatase begin to convert excess testosterone into oestrogens. These oestrogens are then sensed by the hypothalmus which then stops sending its signal to the pituitary and then the body stops sending its signal back to the testes. With no signal to produce testosterone or sperm the testes will begin to atrophy. Testosterone replacement therapy without managing oestrogen and using HCG will shrink your bollocks. The degree of atrophy depends on the individual. For some it may be hardly noticeable and body may still produce some of its own testosterone albeit at a greatly reduced level which will cause sluggishness in the whole system and eventually atrophy.

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Our testosterone balancing treatments

Our doctors will order a blood test to try to determine the category of low testosterone you are suffering and come up with a treatment plan.

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Testosterone + Estrogen Control = Balanced TRT
 

The gold standard for Testosterone Replacement Therapy.
 

There have never been more options available for treating low testosterone. The goal of therapy should be to keep your body producing natural endogenous testosterone whilst topping up what you may be missing. By correctly balancing your testosterone and other hormones you will mitigate the symptoms associated with low testosterone levels. After your doctor diagnoses you for low testosterone you can set out finding the right treatment.

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What about oestrogen blockers or aromatase inhibitors, how do they make a difference?

We know that HCG signals the testes to produce keeping the circulation of testosterone flowing through signalling the testicles to “stay open for business” there will be a glut of testosterone which will most likely be converted by various tissues that contain the  aromatase enzyme.  To minimise the amount of oestrogen it’s important not to create an imbalance.  Putting the right amount of testosterone in the right conditions will provide in most cases the right amount of oestrogen.

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In some cases where dose reduction,  diet and lifestyle alone doesn’t lower oestrogen, a small tablet called an aromatase inhibitor may be prescribed. This tablet was originally designed for woman undergoing breast cancer treatment to keep the levels of oestrogen in a women’s body very low and thus preventing oestrogen sensitive breast cancer for recurring.

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In men  aromatase inhibitors also reduce the total amount of oestrogen in the body. The challenge for men is finding the right dose of testosterone so ideally no aromatase inhibitor is needed. If an aromatase inhibitor  is needed then only the least amount should be used.

Too much oestrogen, prolactin,  insulin resistance, or genetic predisposition may cause increased breast growth in men known as gynaecomastia or man boobs which may require surgical excision.

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Many of the side effects associated with male testosterone therapy can also be attributed to oestrogen. You may have too much or too little. Both can be an issue. There are even cases of men who have low testosterone and elevated oestrogen with symptoms. In these men it’s not possible to lower there oestrogen level by lowering the dose of exogenous testosterone. In these cases  aromatase inhibitors such as anastrozole in low doses may be needed for a short period of time.

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Anastrozole has a half life of around 3 days which means you can can dose less frequently and with smaller doses around 0.25 to 0.5 once per week or every 5 days if this is absolutely needed.

This is key as too much reduction of oestrogen or too little oestrogen will dampen a man’s sex drive, cause the penis to loose sensitivity, and potentially affect mood, affect insulin sensitivity, decrease fat loss, and may cause bone loss if levels are too low for too long.  It comes down to creating the right balance.​​​​​