Low T Treatments
When managed responsibly, testosterone replacement therapy is a safe treatment option for men experiencing symptoms of hypogonadism. However, like any medication, there are potential side effects. Polycythemia, an increase in red blood cells, can cause blood to become thick, putting the patient at a higher risk of blood clots, heart attacks, and strokes. Liver toxicity can occur with high doses of testosterone.
While testosterone replacement therapy will not cause obstructive sleep apnea (OSA), there is data to suggest that replacing testosterone may worsen existing OSA. Therefore, we recommend men with sleep apnea are actively treated.
Testosterone replacement therapy will not cause prostate cancer, although there is data to suggest that increasing a man’s testosterone level may encourage the growth of already-existing prostate cancer.
Lastly, infertility is a common side effect of testosterone therapy. If you are planning on having children in the future please let your provider know prior to starting testosterone replacement. There are other options for normalizing testosterone levels for men who desire to maintain their fertility.
There is controversy around the risk of testosterone replacement therapy and the risk of major cardiovascular risks including heart attack, stroke, and sudden death. The American Urologic Association and Society of Sexual Medicine of North America both support a position that there is insufficient evidence regarding the potential increased or decreased risk of heart attacks, stroke, or other cardiovascular risks for men using testosterone replacement therapy.
According to the most recent American Urological Association (AUA) guidelines, men on testosterone replacement therapy should have routine monitoring of red blood cell count, testosterone, and PSA levels depending on the age of the patient. We also monitor liver functions tests due to potential hepatotoxicity that can occur with testosterone replacement therapy. After initiating testosterone replacement therapy it is recommended that the above labs are monitored regularly. Our goal is to gain symptom control by normalizing testosterone levels and not under or overtreating any man. In doing so, we believe the risk of potential side effects and complications of testosterone replacement therapy will be minimized.Low T