Testosterone Treatment

Testosterone treatment is not limited to replacement alone.  When exogenous (not produced in the body)testosterone is administered it does affect the ability of the pituitary gland to stimulate the testicles and in affect “ replaces testicular function.  Depending on the dosage and duration of treatment, testicular production of both sperm and testosterone can be lowered and affect fertility.  Testosterone therapy alone is usually for men approaching 60-65 who demonstrate low testicular function on laboratory values and history.  Younger men, especially those who desire future fertility yet need testosterone therapy can be treated with a drug, Clomid (Clomphene) both alone or in combination with low dosing of testosterone, stimulating testosterone production as well as increasing sperm counts.  Using this method can preserve  and improve testicular function before the need for  replacement.

 

Estrogen in Men

Estrogen:  Men and women both have the same hormones, just in different amounts, different balance and used for both the same and differing functions.  Men are testosterone dominant and worm estrogen dominant.  Men require estrogen and would suffer the same consequences of low estrogen levels as women would, especially when menopause:  bone health, muscle mass, CV disease and stroke, loss of libido to name a few.  However, higher estrogen levels in men is detrimental countering many of the effects of testosterone  as well as promoting feminizing characteristics such as gynecomastia (swollen often times tender breasts) as well as belly fat.  As men age they tend to aromatize or convert testosterone to estrogen and in affect lower total testosterone and elevating estrogens.  Liver disease can also influence elevated estrogen, especially cirrhoisis etc.  During testosterone enhancement and replacement therapy estrogen levels are monitored very closely

Excessive aromatization or conversion of testosterone to estrogen is controlled by using an aromatase inhibitor called Anastrazole.  Using a very small weekly dose can keep the estrogen levels in the proper range with few if any side effects.