How to Undergo Testosterone Therapy

Four Parts:Preparing For Testosterone Therapy for Low TestosteroneReceiving Testosterone TherapyRecognizing Symptoms of Low TestosteroneReceiving Testosterone For Gender Identity Reasons

If you are noticing signs and symptoms of low testosterone, and have your diagnosis confirmed via blood tests, you may be eligible for testosterone replacement therapy. Testosterone replacement therapy can be administered in many different ways, including by injections, patches, pellets, or gels. You may also receive testosterone therapy as a means to modify your physical appearance and hormones to be in alignment with your gender identity, if you are transgender or genderqueer and looking to have a more masculine appearance.

Part 1
Preparing For Testosterone Therapy for Low Testosterone

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    Have your testosterone levels checked.[1] The first step, before you will even be eligible to consider testosterone therapy (as prescribed by a medical doctor) is to have your testosterone levels checked via a blood test. You are likely noticing symptoms that are potentially correlated to decreased testosterone, such as a decreased libido and/or less spontaneous erections. However, until low testosterone has been confirmed via a blood test as the cause of these issues, you will not be able to move forward with therapy.
    • The reason for this is that there is mixed evidence around testosterone therapy, and there are potential risks involved.
    • Therefore, until your doctor is sure that abnormally low testosterone is the real issue behind your symptoms, he or she will likely not advise that you proceed straight to treatment.
    • Note that testosterone therapy is not advised as a means to treat natural age-related changes in men.
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    Get a repeat blood test.[2] If your first blood test does come back showing low testosterone, your doctor will ask that you get a repeat blood test. This is to confirm the diagnosis, and to ensure that it was not simply a one-time low reading, or a laboratory error (although these are uncommon). If both of your blood tests show low testosterone, you and your doctor can proceed to discussing the pros and cons of treatment so that you can make an informed decision as to whether or not this is something you would like to undergo.
    • Note that you are only eligible for testosterone replacement therapy if you have both symptoms that are linked to low testosterone and two blood tests demonstrating low levels.
    • One of the two criteria is not sufficient to proceed with medical treatment.
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    Discuss with your doctor the pros and cons of receiving treatment.[3] Although testosterone may help with libido, erections, and building muscle mass, among other things, there are also risks involved to undergoing the therapy. The risks and possible side effects include:
    • Developing acne or other skin reactions
    • Unwanted benign prostate growth, and/or growth of any existing prostate cancers
    • A higher risk of sleep apnea (respiratory troubles leading to disrupted sleep)
    • Enlargement of your breast area
    • Testicle shrinkage due to the presence of external testosterone
    • An increased risk of blood clots in the legs and/or lungs
    • A possibly increased risk of heart disease.

Part 2
Receiving Testosterone Therapy

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    Decide upon a route of administration.[4] If you and your doctor jointly decide that it is in your best interest to proceed with testosterone replacement therapy, you will next need to decide how you would like to receive the testosterone. Testosterone replacement therapy is available in the form of injections, pellets, patches, or gels.
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    Receive testosterone through your skin.[5] One of the simplest ways to receive your testosterone is through your skin. There are patches you can apply through transdermal application (for absorption through your skin) - these are generally applied daily in small doses, so that you are receiving testosterone on a regular basis.
    • You can also apply a testosterone gel to your skin, if you prefer that to a patch.
    • Patches may also be placed inside your mouth for absorption through the oral mucosa.
    • The route of administration that you choose will depend on your personal preference.
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    Have testosterone injected or implanted into your body.[6] Another option is to receive testosterone injections every 1-3 weeks. The shot is normally given into your gluteal muscle (the buttock). This can be done at your family doctor's office.
    • You can also have testosterone pellets inserted into your soft tissues.
    • The advantage of an injection or a pellet is that it can be done less frequently, and it is not something that you will have to remember on a daily basis.
    • The downside, however, is that it's a slightly more invasive method than simply absorbing testosterone through your skin.
    • Again, your chosen route of administration will depend on your personal preference.
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    Understand the risk of receiving testosterone orally.[7] Some people may wonder why testosterone therapy is not offered via pills. The reason for this is that it is thought that testosterone taken orally, and absorbed via your intestines, can put strain on your liver. To avoid this possible stress to your liver, either transdermal (through the skin) methods, or injections or implantations are preferred by medical professionals.

Part 3
Recognizing Symptoms of Low Testosterone

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    Observe changes to your sexual function.[8] One of the main ways in which low testosterone can manifest is as a low sexual desire and/or reduced spontaneous erections, or trouble with erections overall. Testosterone naturally declines in men as they age (testosterone levels decrease by about 1% per year after the age of 30 or 40). However, if you are noticing a significant decline in your sexual function, it is advisable to speak to your doctor about the possibility that you may have low testosterone.
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    Make note of changes to your sleep and energy levels.[9] Low testosterone can also lead to problems sleeping and even insomnia. It may cause heightened daytime fatigue and an overall reduced energy level. If you notice these things happening to you, book an appointment with your family doctor, as they may be correlated with reduced or low testosterone.
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    Be aware of changes to your mood.[10] Low testosterone may contribute to depression, irritability, and/or difficulty concentrating. Testosterone plays a significant role in controlling mood and emotional states. Therefore, if you feel "off" emotionally and like your moods have declined, there is the possibility that this is related to low testosterone.
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    Notice changes to your physical body.[11] If you have unexplained hair loss, or an unusual decline in your body's strength and muscle mass, this may be a sign that your testosterone levels are low. It is not a guarantee that the two are correlated, but it is worth exploring with your family doctor.

Part 4
Receiving Testosterone For Gender Identity Reasons

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    Consider testosterone therapy for gender identity purposes.[12] If you were assigned female at birth, but identify more with the male gender (such as if you are transgender or genderqueer), testosterone therapy may be something that you would like to consider. Not all people who are assigned female at birth but identify as male feel that they need the more masculine physical appearance that testosterone therapy can provide; however, for many people in this boat, testosterone therapy is something that is desired.
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    Know the effects that testosterone therapy can provide.[13] Undergoing testosterone therapy will increase your facial hair and your overall body hair, will lower your voice, will likely increase your libido, will stop your menstruation, and may enlarge your clitoris (called "clitoromegaly"). Possible side effects include sweating, headaches, the development of male pattern baldness, soreness at the injection site, increased acne or skin problems, and/or mood swings.[14]
    • The typical dosage is 200mg every 2 weeks; however, this can be adjusted by your physician as needed to obtain the desired effect.
    • You will likely learn how to self-inject your own testosterone. Alternatively, your doctor may teach a family member or friend how to do this for you, if you prefer not to do it on your own.
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    Get approved for the treatment.[15] If you have decided that testosterone therapy is something you would like to go forward with, it is important to have this discussion with your doctor. He or she will go over the risks and benefits of treatment with you, to make sure you fully understand the impacts of testosterone therapy. Your doctor will also have you sign an informed consent form before proceeding.
    • Depending upon the rules in the area in which you live, you may be required to see a psychiatrist prior to receiving testosterone therapy for a mental and psychological evaluation.
    • It is also important to check whether or not you are eligible for healthcare coverage or insurance for medical therapies relating to "gender dysphoria" (identifying with a gender or sex other than that which is stated on your birth certificate).
    • Many times there is no coverage offered, so it is important to consider the costs of testosterone therapy when you make your decision.

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Categories: Men's Health