Testosterone Replacement Therapy

There is a normal decrease in testosterone levels that is expected in the aging male. Then there is the controversial topic of “male menopause” which is thought to be caused by lower than normal testosterone level. Normally there is a gradual (1%) per year decrease in the testosterone level beginning at around age 35 and ending around age 80 when the testosterone level is again at what it is at pre-puberty.

This decrease in testosterone level has an effect that can manifest itself in the following ways: noticeable muscle loss, decreased endurance, lack of libido, depression, inability to concentrate, possible cognitive issues. When males try to deal with these symptoms of decreased testosterone levels they become anxious, irritable and even angry or moody.

These symptoms can put a strain on relationships at work and at home. It is understandable that the main way to treat this condition is to replace the testosterone. There are two types of testosterone used in replacement therapy synthetic (man-made) and natural.

Synthetic Testosterone Replacement Therapy

There has been much studied regarding risk factor and side effects for testosterone therapy. The risk for a man that has a family history of prostate cancer is that taking this therapy may increase his risk for this cancer.

The side effects include: infertility, insomnia and also excessive blood production which if left unchecked can lead to stroke. The healthcare professional should evaluate the family history carefully when considering the treatment plan.

There are many methods of delivery including pills, injections, inserts and patches. The delivery systems each have their own pros and cons. The patient should ask questions about side effects, how the method is given (orally, by needle, through the skin), and how often doses need to be administered.

All of these considerations should be weighted carefully when deciding which one to use. The decision should be based on effectiveness, dosage amount and frequency, side effects, total cost including office visits, insurance coverage, and also adverse reactions at site of delivery.


Used to regulate testosterone levels the pill form can have an increased risk of liver damage so healthcare professionals must closely monitor those who chose this method.


This method is popular because of its ease of use. The patch uses a gel that when it is applied to the skin, the gel dries and then releases testosterone throughout the day at regular intervals. The user must check the skin area for any irritations and if there are signs of skin irritation the patch should be discontinued and the healthcare professional notified.


This method must be administered by a healthcare professional and uses needles. This method requires office visits for each dose to be given and the patient should check with insurance for coverage. Weight gain is one side effect of using injectable hormone replacement therapy.


Pellet implants are inserted into the man’s abdomen, buttocks or into the upper arm. Doses are repeated every 6 months.

Natural testosterone (DHEA) can be found in grocery store health aisles, or in health food stores or open markets where herbal treatments are sold. Ginseng is a herb that is used for male menopause. Information about DHEA and Ginseng can be found at your local homeopath.