Testosterone is responsible for the proper development of male sexual characteristics, muscle bulk, adequate levels of red blood cells, bone growth, sense of well-being and sexual function.  Testosterone Replacement Therapy helps testosterone. Testosterone increases with aging and that is where therapy steps in.

TRT = Testosterone Replacement Therapy

TRT can be given in the form of injections, pills, pellets and patches. The decision who to treat, with which preparation in what doses, and for how long, must rest with the individual physician, as part of a joint and informed venture with the patient. Here I can only give my personal experience, and views derived from that and a review of the extensive literature on the subject.

Though when asked where these testosterone preparations come from, doctors sometimes tell patients that it is extracted from Peruvian Bull’s testicles in the mating season, both to explain the cost of the treatment and maximise the placebo effect, that’s a lot of “Bull” really. In actual fact it is made synthetically in a large scale drug manufacturing process, from cholesterol the same raw material as the body uses to produce it. The cost of these preparations at present is usually roughly two to three times that of equivalent oestrogen preparations used for female HRT, but hopefully as TRT is used more often, drug companies will be able to reduce this sex hormone discrimination against men.

When testosterone was first produced back in 1935 it was realised that being poorly absorbed and rapidly broken down in the liver, it would not be effective when taken by mouth. The answer was to find different routes of administration so as to bye-pass the liver and chemically modify the molecule to slow its rate of absorption and breakdown. One of the most effective means of doing this was to attach side chains to the testosterone molecule and form compounds called esters, the longer the side chain in general, the slower the rate of breakdown.

Injections

Injections of pure testosterone were tried early on, but were found to work for only two hours, and though the effects were nice while they lasted, some means had to be found of getting a longer period of action if the treatment was to become popular. The first attempt at this was by making an ester called testosterone propionate. Having a short side-chain it only lasted two or three days, but this enabled it to be used clinically even if it meant injections two or three times a week. This was the preparation used in 1944 by Heller and Myers to demonstrate for once, if not for all, that the male menopause, or male climacteric as it was called then, is due to testosterone deficiency. They also showed in a controlled trial using placebo injections of sesame oil, how the symptoms of this very real hormonal disorder, including erection problems, could be abolished by TRT.

After the Second World War research on finding newer and more effective preparations got under way, and an ester called testosterone enanthate (Primo-Teston Depot) was produced by the Schering company in Berlin and found to be clinically very effective. Having a longer side chain, it was broken down even more slowly, and injections lasted two or three weeks.

For the last 4 years there have been long-acting injections of testosterone undecanoate in castor oil called Nebido, made by Bayer-Shering. These jast 2-3 months and are very effective, but quite expensive.

Oral Preparations

The stronger of the two preparations is a long chain fatty acid ester called testosterone undecanoate, first used clinically about twenty years ago. It is known under the trade names given to it by the Belgian company Organon that makes it, of Restandol in Europe, and Andriol in the rest of the world, including Canada where it has only recently come onto the market.

It is made in small oval reddish-brown oval capsules containing 40mg of the ester, equivalent to 25 mg of testosterone. It is dissolved in arachis oil so that when taken after a meal it is absorbed by the fat droplets coming from the small intestine, goes into the lymphatic drainage, and bye-passes the liver so that it is not immediately broken down. Peak serum levels are reached after two to four hours, and most is broken down by eight hours, so that this form needs to be taken two or ideally three times a day.

The other safe oral preparation is mesterolone (Pro-Viron), which comes in the form of white 25 mg tablets made by the German firm of Schering. Unlike testosterone itself, and other testosterone derivatives, which are broken down to both an active product called dihyrotestosterone (DHT) and oestrogens, mesterolone only produces raised levels of the former, which makes it a weaker androgen, particularly in relation to improving both libido and potency. However for unknown reasons, it still sometimes seems to work when the undecanoate fails, and so is a useful reserve form, especially when it is wished to maintain or even improve fertility, which the other preparations may suppress. It can for example help young men with the “locker-room syndrome” mentioned earlier, and those who wish to have more facial and body hair to make them feel more “macho”. This is little used now.

Creams and Gels.

These have come to the fore in the last ten years, and are probably the most popular form of testosterone treatment. First in the field was Androgel (Testogel in the UK), which is a clear alcoholic solution of pure testosterone, one application to the arms, shoulders or trunk giving good levels of testosterone for 24 hours.

In Australia, Lawley pharmaceuticals in Perth developed an excellent preparation of testosterone in an aqueous base of Macdemia nut oil, either 1% as Androfem for women, 2% for low dosage in men as Andromen, or 5% for stronger dosage in men.

Dr Malcolm Carruthers is one of the very few UK based physicians who specialise in the diagnosis and treatment of testosterone deficiency. With a broad training in general and laboratory medicine, for the last twenty years he has specialised in Men’s Health, andrology, particularly treating the Andropause aka Male Menopause.

Hormonal imbalance is noted to result in gynecomastia. The less amount of the testosterone and excessive amount of the estrogen in the men’s body results in the occurrence of the gynecomastia. It is the men’s health disorder in which the male breasts enlarge out of proportion. It is a very embarrassing condition for the men as their chest parts becomes very bulgy and gives the appearance of women’s breast. About 8% of the men worldwide are noted to be suffering with the gynecomastia. Specifically those men who are fat are noted to be suffering with this disease more often than others.

Previously, the occurrence of the gynecomastia was noted very rarely. But, now as per the latest conducted statistics there is tremendous increase in the rise in the occurrence of the gynecomastia among men. Many young men are noted to be suffering with this problem. As per the study, it was the hormonal imbalance that is the main reason behind the increase in the occurrence of the gynecomastia in men. Large numbers of men are facing the problem of the hormonal imbalance due to the unhealthy lifestyle they are following.

Teens face this problem of breast enlargement during puberty as the hormonal activity is more during this phase of age. Either one or both the breasts are noted to enlarge during the gynecomastia. But, if you are obese then the extra breast size can’t be due to the extra fats in the body or due to the gynecomastia. Only doctor can decide on the basis of diagnosis that you are suffering with gynecomastia or not.

Excessive weight gain is another reason that causes the hormonal imbalance and further on leads to the formation of the excessive bulge on the chest of the men. The person gains the excessive weight mainly due to the uncontrolled intake of the fats and carbohydrates in the daily diet and lack of the physical activity. Once the person gains the excessive weight then it puts the negative impact on the endocrinal glands that produce the hormone. This ultimately results in the hormonal imbalance.

The amount of the hormones in the human body must be maintained in order to stay away from this embarrassing disease of gynecomastia. For this the best thing is to opt for the healthy lifestyle. Getting adequate amount of the sleep, eating balanced diet, drinking enough fluids, and necessary amount of the physical activity can help you to maintain the healthy lifestyle. Also, you must closely pay attention toward your weight gain habit as this might further on lead to the gynecomastia due to the overgrowth of the adipose tissue in the chest region. You may either suffer with the pure glandular gynecomastia or unilateral gynecomastia or severe gynecomastia due to the hormonal imbalance. Pain in the chest muscles and growth in the size of breasts in men are the symptoms of this disorder observed in the men. If you are facing any of the symptoms then please contact the doctor immediately.

Hypertrophy of the breast tissue and adipose tissue prominent in the chest reason cause the breast enlargement in the men. The occurrence of the gynecomastia is not known by many people, but this negligence may result into serious consequences. Gynecomastia is the warning sign for the breast cancer. Not in all cases of gynecomastia the resultant is breast cancer. But, if this disease remains untreated and the tumor formation begins then you are certainly going to face a breast cancer problem.

Understanding prostrate cancer warning signs is very important as nearly every man experience some type of prostrate problem during his lifetime. Enlargement of the prostate is commonly experienced by men after the age of forty-five. Although this may not be a problem in itself, it is uncomfortable and could potentially develop into more serious maladies.

Prostrate cancer begins when cells in the prostate grow in uncontrollable fashion and invade the surrounding tissues or even spread throughout the body. It is not surprising that prostrate cancer has become one of the major killers of men. Unfortunately, majority of men know little about the disease. It is also suggested that ethnicity is one of the factors that offers some differentiation, with black men the highest risk and Asian men the lowest.

Prostate Cancer Warning Signs

It is possible to cure prostate cancer given the condition is detected in the early stages. One of the best things to do to promote good prostate health is to take a PSA (prostate specific antigen) test every year. The test involves simple procedures to check your prostate and you will be given recommendation if any condition is detected.

The test, however, cannot give you a comprehensive report on the prostate cancer detection. It is simply because prostate cancer symptoms are very difficult to detect. Many men do not even seek medical advice when the symptoms are present, partly because they are very similar to those of another disease: BPH or benign prostatic hypertrophy.

There are some prostrate cancer warning signs that are worth mentioning. They include:

- difficulty starting urination

- painful urination

- incomplete emptying of the bladder

- lower pressure of the urination stream

- frequent urination of small amounts

- pain during ejaculation

- blood in the urine

Treatment for prostate cancer patients has to be specific to the individual case. Doctors have to determine several decisive factors, such as general health condition, age, location of the tumor in the prostate, size of the tumor. The common option for treatment is surgery. However, the main operation, known as radial prostatectomy, is extremely tiring to the body, so the patient has to be in good health condition.

Getting a hormone therapy is also a common option. This treatment does not kill the cancer cells but it reduces the size of the prostate tumor of the majority of patients. Above all, it is important to pay attention to food that you consume. Recent research by the authoritative US National Cancer Institute revealed that men who consumed more than 1/3rd of an ounce of onions, scallions, garlic, chives per day were much less likely to have prostate cancer.