If you are noticing signs and symptoms of hypotestosteronemia and the diagnosis has been confirmed by blood tests, you may be a good candidate for HRT. it is administered in many different ways: through injections, patches, gels or pellets. If you are a transgender or genderqueer person and wish to have a more masculine appearance, you can also decide to follow this cure to modify your physicality and align the hormonal balance to your gender identity.
Steps
Part 1 of 4: Preparing for Hypotestosteronemia Therapy
Step 1. Undergo tests to check the testosterone concentration
Before even considering treatment (which is prescribed by a doctor), you need to make sure your hormone levels are too low by taking a blood test. You are likely to have symptoms potentially attributable to this endocrine imbalance, such as decreased libido or spontaneous erections; however, until the diagnosis is confirmed by laboratory tests, you cannot proceed with therapy.
- The reason for this is that there is still no definitive evidence regarding this therapy, which however carries potential risks.
- Consequently, until your doctor is certain that low testosterone is the cause of your ailments, they do not recommend that you undergo this treatment immediately.
- Remember that replacement therapy should not be considered to manage physiological changes related to aging.
- The reduction in testosterone in men is sometimes called "andropause" or "late hypogonadism"; the consequences of this phenomenon are sexual dysfunctions, bone density problems, greater propensity to fractures, increase in lipid tissue, reduction in muscle mass and cognitive functions.
Step 2. Take another blood test
If the first results show hypestosteronemia, your doctor will have you repeat the test to confirm the diagnosis and make sure it is not an isolated drop or a laboratory error (although these are rare). If both tests are positive, you need to discuss the advantages and disadvantages of therapy with your endocrinologist so that you can make an informed decision and be sure you want to undergo treatment.
- Remember that you are only eligible for HRT if you have symptoms related to hypotestosteronemia and blood tests confirm this.
- The presence of only one of the two factors is not sufficient to proceed with the treatment.
Step 3. Talk to your doctor about the advantages and disadvantages of the treatment
While administering the hormone can help regain libido, erections and muscle mass, it also has risks and side effects, including:
- Formation of acne and other skin reactions;
- Unwanted benign prostatic hypertrophy and / or an increase in any cancer present in the prostate;
- An increased risk of sleep apnea (breathing problems during sleep that cause you to wake up);
- Breast area dilation;
- Reduction of the testicles due to the presence of synthetic testosterone;
- Increased thrombosis in the legs and / or lungs (monitors legs and calves)
- A possible increased risk of heart disease.
Part 2 of 4: Undergo Hormone Therapy
Step 1. Decide which type of administration you prefer
If you and your doctor jointly consider that it is better to proceed with therapy, you must choose how to take the hormone. Testosterone is available for injections, in patches, gels or pellets.
Step 2. Take in the hormone through the skin
One of the simplest methods is transdermal administration (absorption through the skin), which is achieved thanks to patches. These are generally applied daily and have a low dosage, so that the patient can receive the hormone regularly.
- If you prefer, you can spread a gel product.
- It is also possible to apply the patches inside the mouth to absorb the active ingredient through the mucous membrane of the oral cavity.
- The method of administration depends on personal preferences.
Step 3. Undergo testosterone injections or implants
An alternative is represented by the injections which are usually performed in the buttock every 1-3 weeks; your family doctor can give you the hormone by this method.
- You can also have testosterone pellets implanted in soft tissue.
- These procedures have the advantage that they need to be performed less frequently and you don't have to remember to take the hormone dose every day.
- Conversely, however, they are more invasive than transdermal absorption.
- Again, it is a completely personal choice.
Step 4. Understand the risks of oral hormone therapy
Some people wonder why this treatment is not available in the form of tablets for oral use. The reason lies in the fact that if taken by mouth, testosterone is absorbed by the intestines and consequently strains the liver; to avoid this unnecessary stress to the organs, the transdermal method, injections and implantation of pellets are preferred.
Part 3 of 4: Recognizing the Symptoms of Hypotestosteronemia
Step 1. Watch for changes in sexual functions
One of the main symptoms with which a reduced testosterone concentration occurs is a decrease in sexual desire, spontaneous erections or erectile dysfunction in general. It is normal for the levels of this hormone to decrease as humans get older (the rate of decrease is about 1% per year once they are over 30 or 40 years of age). However, if the discomfort has a significant impact, you should talk to your doctor to see if you have hypotestosteronemia.
Sexual function is measured by the frequency of orgasms and the sense of satisfaction
Step 2. Record changes in sleep and energy levels
A reduced testosterone concentration leads to sleep problems and even insomnia; you may complain of increased daytime fatigue and a general lack of energy. If you notice all of these symptoms, make an appointment with your family doctor, as they may be related to testosterone insufficiency.
Step 3. Be aware of mood swings
Hypotestosteronemia can lead to depression, irritability and / or difficulty concentrating. The hormone plays an important role in controlling mood and emotional states. So if you feel "out of tune" from an emotional point of life and you realize that you are in a bad mood, there is a possibility that you have an endocrine imbalance.
A recent study showed that testosterone acts as an antidepressant in men suffering from hypotestosteronemia and depression
Step 4. Watch for physical changes
If you have unexplained loss of hair or physical strength accompanied by an increase in lipid tissue, you may have too low a concentration of testosterone. Cause-and-effect correlation is uncertain, but it is worth discussing with your family doctor.
Part 4 of 4: Undergo Therapy for Gender Identity Matters
Step 1. Consider HRT for gender identity issues
If your gender is female at birth, but you identify with your male gender (e.g. you are transgender or genderqueer), you may want to consider testosterone treatment. Not all individuals in this situation feel the need to have the most masculine physique that can be achieved with hormone therapy; however, many wish to undergo such treatment.
Step 2. Learn about the effects of therapy
Taking testosterone increases the development of facial and body hair in general, lowers the tone of voice, probably increases sexual desire, stops menstruation and dilates the clitoris ("clitoridomegaly"). Possible side effects include: sweating, headache, male pattern baldness, pain at the injection site, increased acne or skin problems and mood swings.
- The recommended dosage is typically 200 mg every two weeks; however, the endocrinologist can vary it as needed to achieve the desired effect.
- You may need to learn how to administer the injections yourself; alternatively, your doctor can teach a family member or friend to get them to you.
Step 3. Get doctor's approval
If you have decided that you want to proceed with hormone therapy, it is important to discuss this with your doctor. He can tell you about the risks and benefits of the treatment, to make sure you understand the impact of testosterone on the body; likely, you are asked to sign an informed consent form before proceeding.
- According to the regulations of the country where you live, a psychiatric examination may be necessary to ascertain the presence of gender identity disorder, to perform a psychological evaluation and finally to have access to testosterone therapy.
- Check with the competent ASL if the Health Service of your Region dispenses hormone replacement therapy for individuals with gender dysphoria; if you have private health insurance, call the company to find out the details of the policy.
- Many times, private insurance does not provide for this type of treatment and in some Regions the Health Service does not cover hormonal therapies; accordingly, you must also take costs into account when making the decision.
