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December 13, 2011

Understanding Hormone Replacement Therapy Men

Hormone replacement therapy and man
Image by Jason DeRusha via Flickr

Hormone Replacement Therapy Men: Pre-Treatment Phase

Do you know of a guy in his 40’s or 50’s, maybe your dad, husband or brother, who is suddenly acting oddly? It is not so him to be moody, but one day, he just started acting crabby. Although he says everything is going great in his career and his relationships, but you notice him to seem to lack energy, and acting as though depressed. He may not know it, but perhaps he is going through andropause or the male menopause. If indeed he is, he needs to see his doctor for advice and if hormone replacement therapy for men is right for him. But before that, let us first get to know what these men go through in this phase in their life so that we can better understand and relate with them.

Five of the most common symptoms that men go through when undergoing andropause are depression, fatigue, sweating and hot flashes, diminished libido and erectile dysfunction, and poor focus and memory. On top of these, other symptoms also include sleep disturbance, increase in body fat (especially around the belly) and decrease in muscle mass, osteoporosis, loss of height, and aches and pains.

Understanding Andropause

To understand our aging men better, let us first get a good grasp of what andropause is. This medical condition among older men occurs because of the natural decline of testosterone levels. Although there may be men in their 20s who experience low testosterone levels, they are not actually going through andropause but a testosterone deficiency since their meager levels are not normal. All men in their 40s or older go through the symptoms in one way or another, and at least 95 percent of men in their 50s suffer andropausal symptoms, but the symptoms vary in intensity.

The Hormone Replacement Therapy Men

There are several ways these men can adopt to alleviate the symptoms, including regular exercise, healthy diet and lifestyle, and testosterone replacement. Experts disagree on when to give hormone replacement therapy for men. For the American Society of Andrology, it should be given when both diminished levels of testosterone and clinical symptoms and signs of testosterone deficiency are observed. For the American Association of Clinical Endocrinologists, low testosterone levels are not considered normal even if it is age-related, and they espouse clinical trial of testosterone. Moreover, they also disagree on how low is low.

Hormone replacement therapy men can take testosterone replacement in various ways: oral therapy, transdermal patches and gels, injectable depots, and subcutaneous pellets. HRT is expected to alleviate the symptoms of andropause and the effects of aging. Other benefits that are linked to the treatment include improvement in the management of type 2 diabetes.

Hormone replacement therapy for men is quite safe but there may be various minor side effects, such as acne and oily skin, and more serious effects, like the worsening of sleep apnea (very rare and yet to be seen in our practice), acceleration of pre-existing prostate cancer growth in men who have gone through androgen deprivation, and elevated hematocrit level, which may necessitate venipuncture as treatment. They may also experience thinning of hair. Men undergoing hormone replacement therapy can become less fertile as testosterone therapy may suppress spermatogenesis (this can be counteracted with concomitant use of HCG). Before beginning with the treatment, health practitioners suggest prostate cancer screening using a digital rectal exam and PSA or prostate specific antigen level. While treatment is ongoing, hematocrit and PSA levels must be closely monitored.

Hormone replacement therapy men need complete understanding from their women and loved ones as they go through the symptoms of andropause and the possible side effects of HRT.

See related articles.

“Nonsexual Symptoms of Low T”

“Low Testosterone Symptoms”

“Why is Testosterone a Controlled Substance?”

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Dr. Joe Jacko


Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio. Read more about Dr. Joe Jacko

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