Testosterone replacement therapy is important in treating men suffering from low male hormone levels. It is one of the testes’ most effective treatments for hypogonadism — a condition with low testosterone levels and sperm cell production. According to the Endocrine Society, hypogonadism affects about 2% of adult males. Symptoms include fatigue, loss of sex drive, erectile dysfunction, decreased muscle mass and bone density, and depression.
The most popular treatment for hypogonadism is hormone injections, but this method has many drawbacks. Testosterone injections require frequent doctor visits, can cause bruising and swelling, and use a form of testosterone that is not bio-identical. Specifically, the most popular testosterone injection form is cypionate, created by attaching an ester molecule to the testosterone to stabilize it. By altering the testosterone molecule from that found in nature, the testosterone molecule will be metabolized variably and prone to affecting global hormone balance.
An effective option for testosterone replacement therapy involves pellet therapy, wherein the same testosterone molecule found in nature is used. This testosterone is called bioidentical. Although this method of testosterone delivery is more invasive, it provides improved efficacy and convenience since it is implanted only twice a year. But while the benefits of testosterone replacement therapy are clear, doctors warn against jumping into it without thinking things through. Here are some questions you should ask yourself before getting started:
1. Do I Want To Take Hormones?
If you’re considering testosterone replacement therapy, you probably already know why you might want to do it. But it would help if you considered whether you truly want to go down that road. This is because testosterone replacement therapy requires you to commit to lifelong therapy. You also risk developing gynecomastia, a breast enlargement caused by excess estrogen. This is why testosterone pellets are usually combined with an anastrozole hormone supplement, which inhibits testosterone conversion to estrogen. The Anastrozole supplement is packed as part of your pellet package, thus eliminating the need to supplement it by mouth.
2. Will My Insurance Cover It?
Unfortunately, insurance does not currently cover pellet therapy for testosterone. This is because testosterone pellet therapy is not FDA-approved. You may wonder why this would be the case. The published reason is that testosterone pellet therapy has not proven consistent in its testosterone elevating capacity. However, anybody who has tried testosterone pellets knows that it provides effective testosterone elevation is continuous, and avoid oscillation in levels observed with testosterone injections. Unfortunately, the real reason is that testosterone pellets use bio-identical testosterone identical to the natural hormone, which can not be patented. This is unlike cypionate testosterone, an altered molecule that is patentable and used in injection formulas.
3. Do I Even Need Testosterone Replacement
Not everybody needs testosterone replacement therapy. The problem is that normal testosterone levels range from 200 to 1200 units depending on the laboratory. This is the single most misconception surrounding testosterone since a 20-year-old will possess high levels of testosterone ranging from 800 to 1200, whereas a 50-year-old will maintain 300 to 400. But is it fair to live with lower normal testosterone levels just because you are older? The likely answer is that you should likely have a high normal testosterone level if you want to feel the energy you felt when you were young. To decide whether you need testosterone, you need to assess how you feel, look, and libido and discuss your individual needs with your doctor.
So, schedule a consultation to answer the question: is trt right for me?