Current Status of Testosterone Replacement Therapy in Men 1999

Dr. John Carrozzella LL Testosterone Men

Benefits of androgen replacement therapy include increased energy, hematocrit, muscle mass, strength and stamina; increased ability to perform more physically demanding tasks; and an overall increase in the sense of wellbeing, confidence and motivation. Bone mineral density is increased by testosterone replacement. Improved libido, sexual function and frequency of erection and ejaculation.  With Injectable Therapy, the wide fluctuations in the plasma testosterone level may produce emotional lability, and most importantly the long‐term consequences of the very high peak values that occur immediately after dosing are unknown. Therefore, a more constant mode of hormone delivery seems advantageous (Pellets or Creams). A major disadvantage of the Injectable form is the high level of serum testosterone produced for several days after injection, and low or subnormal levels resulting at the end of the dosing interval. Disturbing fluctuations in sexual function, energy level and mood result. Moreover, in our clinical experience, alkylated androgens (the type used in injectable therapy) may increase levels of low‐density lipoprotein cholesterol (bad cholesterol) and profoundly suppress high‐density lipoprotein cholesterol (good cholesterol) levels because of their route of absorption and metabolism in the liver.