Hormone Replacement Therapy: Definition
When we talk about hormone replacement therapy (HRT) in men, we’re talking about testosterone. A small amount of testosterone is produced in the adrenal glands, but for men the majority of testosterone is produced in the testicles. Testosterone has both physical and psychological benefits.1
Physically, the hormone has several functions for men. Some of these functions include:2
- Male sexual development, including deepening of the voice and hair growth
- Building strong muscles
- Reproductive function and sperm production
- Maintaining and promoting the production of healthy red blood cells
- Maintaining bone density
Psychologically, testosterone also plays a big role in men’s health. Research shows that men, particularly older men, who are dealing with depression may not have optimum levels of testosterone. As well, studies indicate that older men may have difficulty concentrating and focusing due to low testosterone. Another psychological benefit of optimum testosterone in the body is that when men feel virile and have a normal libido, they feel better about themselves.3,4
As men age, sometime in their forties for most men, their testosterone levels naturally start to deplete. With hormone replacement therapy additional testosterone is provided to the body to increase the concentration of the hormone. The goal of hormone replacement therapy is to keep testosterone levels within a normal range with the intent of relieving the symptoms of a testosterone deficiency.
After starting hormone replacement therapy, men may see an improvement in their testosterone blood levels as well as increase in libido within two months.
Who Needs Hormone Replacement Therapy?
Both younger and older man who are deficient in testosterone may benefit from hormone replacement therapy. Replacing testosterone levels may help to reduce the risk of obesity, Type 2 diabetes, and heart disease.5,6
Testosterone replacement therapy may also benefit men who have been diagnosed with hypogonadism, a condition where the sex glands produce little or no testosterone.
Men who experience the following symptoms may have low testosterone levels that may benefit from HRT:7
- Erectile dysfunction
- Low sex drive and lack of interest in sex
- Decrease in muscle mass
- Facial and body hair loss
- Low energy and fatigue
- Mood swings, irritability, and depression
- Difficulty concentrating
Supporting Hormones with OTC Remedies
Hormone replacement therapy is recommended for men who have been tested and confirmed with a testosterone deficiency that puts their health at risk. Men who are experiencing some of the symptoms of low testosterone may consider taking an over the counter natural testosterone support supplement like HexoFire Delta Prime before using HRT as prescribed by a doctor.
There are a variety of natural supplements available that may help increase testosterone levels. This includes taking a zinc and Vitamin D supplement. Studies have been done on both, showing that an increase in zinc and Vitamin D levels may naturally help to boost testosterone.8,9
Other natural supplements to consider are saw palmetto and tongkat ali. Both supplements are derived from plants and have been used in traditional medicine to increase testosterone in men.10,11
Types of Hormone Therapy
There are three main types of hormone replacement therapy. Testosterone can be given through injections, using patches, and applying a gel. Each method is different in convenience, cost, and the way individuals respond to the therapy. Men are closely monitored when given HRT. Their doctor may change the type and amount of testosterone that is administered based on each individual result.
Testosterone patches adhere to the skin. This method of HRT is often used for long-term testosterone therapy. The patches are applied each day to different areas of the skin, such as the buttocks, abdomen, arms, and back. One of the side effects with using testosterone patches is skin irritation.
Intramuscular Testosterone Injections
Testosterone injections are the standard method of HRT and more cost effective than testosterone patches. The injection is intramuscular which means that the solution of testosterone is injected into the muscle of the buttock or thigh. The testosterone is then gradually released into the bloodstream. Injections are given every 2 to 3 weeks.12
Testosterone Gel (Topical)
Testosterone androgel is absorbed through the skin. The gel is applied each day to the skin on the arms, abdomen, or shoulders. If using testosterone gel, it’s important that the skin treated with the gel doesn’t come into contact with others for a few hours to avoid a potential risk of exposure.
Testosterone cream is similar to testosterone gel. The cream is applied daily to the skin on the scrotum. Although less effective, it can also be applied to skin on the back, chest, arms, and legs.
Oral testosterone uses a natural form of testosterone known as “testosterone undecanoate”. This form of testosterone can only be absorbed when it’s taken orally. This type of HRT is more expensive and less effective than other hormone therapies. It’s typically only used when men are unable to use other forms of hormone replacement therapy.13
Testosterone implants are implanted into the abdomen or buttocks. They provide testosterone that’s absorbed for about six months, at which time the implants are replaced. A minor surgical procedure is performed to insert the implants therefore this is as of yet the least common of all the hormone replacement therapies. As well, implants are not used in older men where there is the risk of prostate cancer.
Is Men’s Hormone Therapy Safe?
Testosterone hormone therapy can have side effects, both minor and severe. Minor side effects many include acne, increased urination, and fluid retention.14
More serious side effects of HRT may include:
- Decreased sperm count
- Difficulty sleeping due to sleep apnea
- Enlargement of the breasts
- Increased red blood cell count
- Decrease in testicle size
- High cholesterol count
- Enlarged prostate
- Increase risk of heart disease
At this time, the long-term effects of hormone therapy are not known.
Why You Should Talk to Your Doctor First
Talk to your doctor if you’re experiencing any of the side effects of low testosterone. Also talk to your doctor if you’ve tried some natural testosterone support supplements and are still experiencing low testosterone symptoms.
Through testing your doctor will be able to determine what your testosterone level is and whether you’ll benefit from hormone replacement therapy. To test for low levels your doctor will do a serum testosterone test. Men are diagnosed with testosterone deficiency when levels are less than 300 nanograms per deciliter. Tests results are normal when testosterone levels are between 300 to 1000 nanograms per deciliter.12
- Bassil, N. & Alkaade, S. (2009). The benefits and risks of testosterone replacement therapy: a review. Ther Clin Risk Manag. Retrieved on January 27, 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2701485/
- Bain, J. (2007). The many faces of testosterone. Clin Interv Aging. 2(4): 567-576. Retrieved on January 27, 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686330/
- Zarrouf, FA. & Artz, S. (2009). Testosterone and depression: systematic review and meta-analysis. J Psychiatr Pract. 15(4): 289-305. Retrieved on January 27, 2019 from https://www.ncbi.nlm.nih.gov/pubmed/19625884
- Beauchet, O. (2006). Testosterone and cognitive function: current clinical evidence of a relationship. Eur J Endocrinol. 155(6): 773-81. Retrieved on January 27, 2019 from https://www.ncbi.nlm.nih.gov/pubmed/17132744
- Stanworth, R. & Hugh-Jones, J. (2008) Testosterone for the aging male; current evidence and recommended practice. Clin Interv Aging. 3(1): 25-44. Retrieved on January 27, 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2544367/
- Chrysant, SG. & Chrysant, GS. (1995). Cardiovascular benefits and risks of testosterone replacement therapy in older men with low testosterone. Hosp Pract. 46(2): 47-55. Retrieved on January 27, 2019 from https://www.ncbi.nlm.nih.gov/pubmed/29478348
- Tsujimura, A. (2013). The Relationship between Testosterone Deficiency and Men’s Health. World J Mens Health. 31(2): 126.135. Retrieved on January 27, 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3770847/
- Liu, YL. & Zhang, MN. (2017). The effectiveness of zinc supplementation in men with isolated hypogonadotropic hypogonadism. Asian J Androl. 19(3): 280-285. Retrieved on January 27, 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427781/
- Pilz, S. & Frisch, S. (2011). Effect of vitamin D supplementation on testosterone levels in men. Horm Metab Res. 43(3): 223-5. Retrieved on January 27, 2019 from https://www.ncbi.nlm.nih.gov/pubmed/21154195
- Gunnels, TA. &Bloomer, RJ. (2014) Increasing Circulating Testosterone: Impact of Herbal Dietary Supplements. J Plant Biochem Physiol. 2:130. Retrieved on January 27, 2019 from https://www.omicsonline.org/open-access/increasing-circulating-testosterone-impact-of-herbal-dietary-supplements.2329-9029.1000130.php?aid=28009
- Erasmus, N. & Solomon, MC. (2012) Effect of Eurycoma longifolia Jack (Tongkat ali) extract on human spermatozoa in vitro. Andrologia. 44: 301-314. Retrieved on January 27, 2019 from http://onlinelibrary.wiley.com/doi/10.1111/j.1439-0272.2012.01282.x/abstract
- McBride, JA. & Carson, CC. (2015). Diagnosis and management of testosterone deficiency. Asian J Androl. 17(2): 177-186. Retrieved on January 27, 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4650468/
- Tong, SF. & Ng, CJ. (2012). Effect of long-acting testosterone undecanoate treatment on quality of life in men with testosterone deficiency syndrome: a double blind randomized controlled trial. Asian J Androl. 14(4): 604-611. Retrieved on January 27, 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3720089/
- Osterberg, CE. & Bernie, AM. (2014). Risks of testosterone replacement therapy in men. Indian J Urol. 30(1): 2-7. Retrieved on January 27, 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897047/