Testosterone Replacement Therapy Los Angeles

What is Testosterone Replacement Therapy?

Testosterone is a male hormone produced by the testicles and is responsible for the correct development of male sexual characteristics. Testosterone is vital for men to maintain muscle bulk, bone density, energy, low body fat, sufficient levels of red blood cells, overall well-being including sexual and reproductive function. We provide testosterone replacement therapy in our Beverly Hills clinic to optimize low testosterone in men. TRT therapy can have a great impact on the way you feel.

There are millions of men who have low testosterone levels or hypogonadism without knowing it or recognizing any of the symptoms associated with it. Hormone levels such as testosterone usually peak at age 25 and start decreasing more dramatically at age 40. For aging male who have symptoms of low testosterone or are experiencing a decline in their testosterone levels, our doctors are well trained to treat and optimize your testosterone levels. Testosterone replacement to optimal age related levels have helped many of our patients feel dramatically better and younger. Testosterone replacement therapy is the optimization of testosterone levels through bio-identical hormone replacement, testosterone injections, testosterone creams, testosterone pellets, supplements, medications and more.

How do I know if my testosterone levels are low?

The only accurate way to detect the condition is to consult with one of our doctors and have our doctors measure the amount of testosterone in your blood. Because testosterone levels can fluctuate during the day, several measurements may need to be taken to detect a deficiency. Our doctors tend to prefer, if possible, to test levels early in the morning because this is when testosterone levels are at their highest. Usually one blood test and review of symptoms is sufficient to diagnose testosterone deficiency or a decrease in optimal testosterone levels.

Low Testosterone Symptoms & Men’s Health

Low Testosterone Causes in Men

As men age, the amount of testosterone in their bodies gradually declines. This natural decline starts after age 25-30 and continues on throughout their lives. Other potential causes of testosterone deficiency or low t in aging male include:

What Age Should You Consider Testosterone Replacement Therapy?

The age at which a person should consider testosterone replacement therapy (TRT) depends on the individual’s specific situation. Typically, TRT is considered for men who have been diagnosed with hypogonadism, a condition characterized by low testosterone levels. Hypogonadism can occur at any age, but it is more common in older men or past the age of 40.

The American Urological Association (AUA) recommends that TRT should be considered for men with symptoms of hypogonadism and a confirmed testosterone deficiency. The endocrinology Society recommends TRT for men with symptomatic hypogonadism and a serum testosterone level below the normal range for young adult men.

Androgen Deficiency in Men

Androgen deficiency in men, also known as hypogonadism, is a condition in which the body doesn’t produce enough testosterone, the primary male sex hormone. Symptoms of androgen deficiency or low T syndrome can vary, but may include:

• Low sex drive
• Erectile dysfunction
• Fatigue
• Loss of muscle mass
• Increased body fat
• Decreased bone density
• Depression or mood changes
• Decreased body hair and beard growth

Androgen deficiency can occur at any age and may be caused by a variety of factors, including genetic disorders, injury to the testicles, certain medications, chronic illnesses, or a condition called Klinefelter syndrome. Some men may also develop androgen deficiency as a result of aging, a condition known as age-related hypogonadism.

Intramuscular Injectable Testosterone

Testosterone Therapy Dosage

Because of potential risks and side effects of testosterone therapy, your doctor will want to make sure you are safe on testosterone therapy and will want to monitor your testosterone levels in addition to other labs and symptoms. Testosterone therapy dosage is dependent on your total testosterone levels, free testosterone levels, DHEA levels and the kind of testosterone used. Monitoring and screening may include; checking testosterone levels with periodic blood tests, checking prostate with PSA levels or digital rectal exams, testing blood for changes in your blood chemistry and hemoglobin levels. Our healthcare providers are highly trained in TRT and follow the endocrine society clinical practice guidelines on TRT.

Testosterone propionate

Testosterone propionate is a type of testosterone ester and an androgen and anabolic steroid medication. It is used primarily in the treatment of low testosterone levels in men (androgen deficiency) and delayed puberty in boys. Testosterone propionate is usually administered by intramuscular injection and the dosage and frequency of administration is tailored to the individual patient’s needs.

The results of a single-dose study of 50 mg of testosterone propionate (TP) given by intramuscular injection showed that testosterone levels rose above normal levels immediately after the injection, but fell below normal levels by the second day. This indicates that using TP is not an appropriate form of treatment for male hypogonadism due to the rapid fluctuations in testosterone levels it causes and the need for frequent dosing with a 50 mg dose every three days.

Testosterone cypionate

Testosterone cypionate is a form of testosterone, a male sex hormone. It is used to treat low testosterone levels in men, also known as androgen deficiency, and for delayed puberty in boys. It is an oil-based injectable medication, usually administered intramuscularly. The dosage and frequency of administration is tailored to the individual patient’s needs.

Testosterone cypionate is usually administered as an injection every week. The most common side effects are acne, fluid retention, breast enlargement, and increased red blood cell count.

It is important to use testosterone cypionate only under the supervision of a healthcare professional and to follow the dosage and administration instructions exactly as prescribed.

Testosterone cypionate (TC) is a form of testosterone that is available in two concentrations: 100 mg/mL (10 mL vial) and 200 mg/mL (1 and 10 mL vials) and is prepared in cottonseed oil. It is commonly used to treat low testosterone levels in men, known as androgen deficiency, and for delayed puberty in boys. The typical recommended starting dose for male hypogonadism is 75-100 mg given intramuscular on a weekly basis.

Testosterone enanthate

Testosterone enanthate is a form of testosterone, a male sex hormone. It is used to treat low testosterone levels in men, also known as androgen deficiency, and for delayed puberty in boys. It is an oil-based injectable medication, usually administered intramuscularly. The dosage and frequency of administration is tailored to the individual patient’s needs.

Testosterone enanthate is usually administered as an injection every one to two weeks. Testosterone enanthate (TE) is a form of testosterone that is available in 100, 200 mg/mL or 250 mg/mL concentrations and is prepared in sesame oil. The recommended starting dose for TE is the same as that for testosterone cypionate. The effect of varying doses of TE on serum testosterone levels was studied in 23 males with primary hypogonadism. The peak levels occurred at 24-48 hours after the last dose of 100-200 mg and declined to slightly above 600 ng/dL after 1-2 weeks. The peak levels occurred at 36-48 hours after the last dose of 300-400 mg and then plateaued below the therapeutic range (300 ng/dL) by week 3-4. The study concluded that doses of 200 mg have to be injected every two weeks or doses of 300 mg every 3 weeks to guarantee effective substitution therapy. The adverse events associated with TE are similar to those of testosterone cypionate. The short-acting intramuscular injections have the highest incidence of erythrocytosis approaching 40%. It is suggested that the testosterone formulation, dose and pharmacokinetics collectively determine the risk of erythrocytosis by establishing the duration of supraphysiological testosterone levels. Short-acting intramuscular testosterone formulations (TC and TE) are associated with the most rapid and significant increases in serum testosterone levels, with supraphysiological levels achieved within days of an injection and a return to baseline by 10-14 days, followed by a decrease to subphysiological levels within 3 weeks if not re-dosed. Caution should be exercised in prescribing short-acting intramuscular formulations in at-risk populations (type 2 diabetes, smokers, obese, thrombophilic conditions)

Testosterone ester combinations

Testosterone ester combinations are a type of testosterone replacement therapy that involve using a combination of different types of testosterone esters. These combinations are intended to provide more consistent and stable testosterone levels over time.

One example of a testosterone ester combination is Sustanon, which is a mixture of four different testosterone esters: testosterone propionate, testosterone phenylpropionate, testosterone isocaproate, and testosterone decanoate. This combination allows for a gradual release of testosterone into the bloodstream after an injection, which helps to maintain stable testosterone levels over time.

Another example is Omnadren which is a mixture of four different testosterone esters: testosterone propionate, testosterone phenylpropionate, testosterone isocaproate and testosterone caproate. This combination is designed to provide a prolonged release of testosterone in the bloodstream.

The idea behind using a combination of different testosterone esters, such as Sustanon or Omnadren, in the treatment of male hypogonadism is that a short-acting ester (e.g. testosterone propionate) can provide effective substitution during the initial days of treatment, while a longer-acting ester (e.g. testosterone enanthate) can provide effective substitution towards the end of the injection interval. However, studies have shown that the pharmacokinetic parameters of individual esters show that both preparations cause the highest testosterone serum concentrations shortly after injection. The addition of a short-acting ester to a long-acting ester only increases the initial undesired testosterone peak, leading to a wider fluctuation of testosterone serum concentrations compared to the use of the long-acting ester alone. Therefore, there is no advantage in combining short- and long-acting esters for the treatment of male hypogonadism.

Testosterone undecanoate

Testosterone undecanoate (TU) comes in an oral form as well as an injectable form of testosterone, a male sex hormone. It is used to treat low testosterone levels in men, also known as androgen deficiency. It is a pro-drug, meaning that it is converted into testosterone in the body after it is taken. It is available in the form of oral capsules.

The recommended starting dose is usually 120-160 mg/day. The effect of TU on serum T levels was evaluated in hypogonadal men, and the results showed that TU is able to maintain stable and physiological testosterone levels, similar to those obtained with injectable testosterone esters.

It is a long-acting form of testosterone, with a half-life of about 34 days. It is supplied in a concentration of 250 mg/mL dissolved in castor oil and is given by slow intramuscular injection in the gluteus medius muscle. It is approved in the USA at a single dose of 750 mg, followed by 750 mg 4 weeks later, then 750 mg every 10 weeks thereafter. Individual dosage titration is not recommended. In a study of 117 hypogonadal males, TU was able to maintain stable and physiological testosterone levels, similar to those obtained with injectable testosterone esters, without showing supratherapeutic peaks.

TU is generally well tolerated and has been associated with a significant reduction of fat mass and HbA1c in both controlled and uncontrolled trials, as well as improvement of erectile function.

What can be expected from Testosterone Treatment?

Because every man is different, each individual will have different results with different treatments. Regardless of the testosterone treatment, he should notice the effects of testosterone replacement and improvement in his sex drive, energy level, strength, and quality of erections. Other improvements may include; bone density, muscle mass and mood.

Is It A Good Idea To Take Testosterone Replacement Therapy?

Whether or not testosterone replacement therapy (TRT) is a good idea depends on the individual’s specific situation. It is typically recommended for men who have been diagnosed with hypogonadism, which is a condition characterized by low testosterone levels. There are many potential benefits associated with raising low testosterone concentrations. We will discuss the risks and benefits of TRT below.

Testosterone Therapy Benefits & Risks

Testosterone treatment can have a number of effects on the body, both positive and negative. Some of the potential effects of testosterone treatment include: