A healthy lifestyle has been shown to be associated with higher hormone levels, and higher hormone levels seem to induce a more active, healthier lifestyle. When hormone levels decline, we become less active and gain weight. As we gain weight, hormones are stored in fat and become unavailable to meet the body’s demands. Lack of exercise, excessive alcohol use, and many diseases can reduce bioavailable hormone levels. For optimal results, hormone therapy should be individualized and combined with adequate exercise, proper nutrition, and appropriate use of natural supplements.

Administration of a transdermal testosterone (T) gel formulation to hypogonadal men provided dose-proportional increases in serum T levels to the normal adult male range. Testosterone 1% gel (50 or 100 mg/day) was compared to the permeation-enhanced T patch.  After 180 days, skin irritation was reported in 5.5% of subjects treated with T gel and in 66% of subjects in the permeation-enhanced T patch group. This research at UCLA concluded that T gel replacement improved sexual function and mood, increased lean mass and muscle strength (principally in the legs), and decreased fat mass in hypogonadal men with less skin irritation and discontinuation compared with the recommended dose of the permeation-enhanced T patch.

J Clin Endocrinol Metab. 2000 Aug;85(8):2839-53

The following study concluded that replacing testosterone in hypogonadal men increases bone mineral density of the spine and hip, fat-free mass, prostate volume, erythropoiesis, energy, and sexual function. The full effect of testosterone on bone mineral density took 24 months, but the full effects on the other tissues took only 3-6 months.

J Clin Endocrinol Metab 2000 Aug;85(8):2670-7

Testosterone Replacement Therapy for men with low testosterone levels may produce a wide range of benefits including:

• Improvement in libido and sexual function
• Increased muscle mass and body composition
• Increased strength and stature
• Preservation of bone mass
• Improvement in mood and depression
• Enhanced cognition, concentration and memory
• Improvement in sleep and quality of life
• Possible decrease in cardiovascular risk

Testosterone replacement can also improve:

Osteoporosis – Gradual loss of testosterone is one of the major causes of osteoporosis in elderly men. In one study, 59% of men with hip fracture had low teststerone, compared with 18% of controls. Fracture occurs at a later age in men than women because men’s bones are denser at baseline. Several studies have reported beneficial effects of testosterone therapy on bone in older men, showing an increase in BMD (bone mineral density) and slowing of bone degeneration.

Cardiovascular disease – Risk is associated with low serum total testosterone levels, according to most reports. A number of studies have demonstrated that testosterone minimizes several important risk factors for heart attack, including:

• reducing cholesterol and triglycerides
• reducing blood glucose levels
• decreasing visceral fat mass
• normalizing blood clotting

The degree of atherosclerotic disease increases significantly with declining levels of free testosterone. Visceral fat accumulation is connected with increased vascular risk, and studies have shown that androgen administration can decrease this fat accumulation.

Diabetes – Low testosterone levels are associated with an increase in the risk for developing type 2 diabetes mellitus and metabolic syndrome.

Depression – Depression is more common when levels of bioavailable testosterone are low; perhaps because an associated decrease in sexual function results in depression, irritability, and mood swings. In a study which examined the association between levels of sex hormones and depressed mood in 856 men ages 50-89, bioavailable testosterone levels were 17% lower for depressed men. The results suggest that testosterone treatment may elevate depressed mood in older men who have lower levels of bioavailable testosterone. 

What is the Optimal Form of Testosterone for Replacement Therapy?

Testosterone USP is THE natural bio-identical testosterone that has been approved by the United States Pharmacopoeia and is available as a bulk chemical. Upon a prescription order, compounding pharmacists can use Testosterone USP to prepare numerous dosage forms.

The term “testosterone” is often used generically when referring to numerous synthetic derivatives, as well as natural bio-identical testosterone. Confusion is responsible for conflicting data in the medical literature about the benefits and risks of testosterone therapy. Studies must be reviewed carefully to determine the form of testosterone that was used. Natural testosterone must not be confused with its synthetic derivatives or “anabolic steroids,” which when used by athletes and bodybuilders have caused disastrous effects. For example, administration of synthetic non-aromatizable androgens, like stanozolol or methyltestosterone, causes profound decreases in HDL-C (“good cholesterol”) and significant increases in LDL-C (“bad cholesterol”). Yet, hormone replacement with aromatizable androgens, such as testosterone, results in lower total cholesterol and LDL cholesterol levels while having little to no impact on serum HDL cholesterol levels. Proper monitoring of laboratory values and clinical response are essential when prescribing testosterone replacement therapy.

The only absolute contra-indications to androgen replacement therapy are the presence of prostate or breast cancer. “Although it is known that the clinical course of prostate cancer is accelerated by testosterone, its incidence is not increased by [testosterone] administration… There is even no clear evidence that testosterone replacement accelerates the development of BPH.”