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What is Hormone Replacement Therapy for Men?

Hormone replacement therapy (HRT) for men is a remedial procedure to correct a disorder called “male hypogonadism”. The condition can be inborn or may develop later in life, wherein your body produces a very low level of testosterone (the male sex hormone).

Testosterone (a natural androgen) is responsible for developing the male sex organs and sexual characteristics. In hormone replacement therapy, you will be given testosterone via medical procedures.

Indications

Hormone replacement therapy is usually recommended to increase the testosterone level in the body. Key indications include:

  • Low sex drive (libido)
  • Erectile dysfunction (ED)
  • Impotence (inability to perform sexually)
  • Infertility (low sperm production)
  • Irritability and depression
  • Decreased muscle mass
  • Loss of facial and body hair
  • Poor energy level and tiredness
  • Weakened bones (osteoporosis)
  • Development of breast tissue
  • Low sense of well-being

Benefits

Hormone replacement therapy can:

  • Increase energy levels in men
  • Boost libido and mood
  • Rectify erectile dysfunction
  • Improve muscle mass
  • Restore muscle strength
  • Prevent bone loss
  • Enhance bone density
  • Improve sense of well-being

How is Hormone Replacement Therapy Administered?

Hormone replacement therapy can be administered in several ways. These include:

Intramuscular testosterone injections

  • Your doctor will inject testosterone directly into the muscles of your buttocks.
  • This is a safe and effective procedure and the patient or caregiver can be instructed on how to administer the injection at home.

Testosterone patches

  • Skin patch
    • A skin patch is applied to your back, upper arm, thigh or abdomen.
    • It releases the hormone daily through the skin and into the bloodstream to prevent the rise or fall of testosterone.
    • The site of the application needs to be rotated to lessen skin reactions.
  • Mouth patch
    • This is a tablet-like patch that sticks to the upper gums above the incisors, the narrow-edged teeth just to the right or left of the two front teeth.
    • It steadily releases testosterone into the blood through the oral tissues.

Topical testosterone gels

There are various types of gels available, and depending on the type it can be:

  • Rubbed into your skin (upper arm or shoulder)
  • Applied with an applicator in the armpits or thigh area
  • Applied with an applicator into the nose three times daily

As the gels dry, your body directly absorbs the testosterone through your skin.

Gum and cheek (buccal cavity) testosterone

  • A small, putty-like gum and cheek testosterone is delivered above your top teeth where the gum meets the upper lip (buccal cavity).
  • The testosterone sticks to your gum line and gets absorbed into your bloodstream.

Implantable pellets

  • Pellets containing testosterone are surgically implanted in the soft tissues under your skin.
  • Your body slowly absorbs the testosterone into the bloodstream over a period.

Risks Associated with the Therapy

Hormone replacement therapy carries the following potential risks:

Minor risks

  • Skin reactions such as oily skin or acne
  • Frequent and increased urination
  • Swelling of the ankles (fluid retention)
  • Increased aggression and irritability

Major risks

  • Prostate disorders
  • Decreased testicle size
  • Reduced sperm count
  • Sleep apnoea
  • Increased cholesterol levels
  • High blood pressure
  • Chest pain, increased chance of heart attack
  • Blood clot or risk of stroke
  • Enlarged breasts

What Precautions should be Taken with HRT?

Usually, prostate cancer is dependent on testosterone levels. You will need to schedule prostate checkups regularly to avoid the onset or development of prostate cancer.

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