How is Testosterone Hormone Replaced in Men and Women?

Importance of Testosterone for Men and Women

Testosterone, long considered the “male” sex hormone, actually plays a vital role in both men and women. Its effects are similar for both sexes-helping with mood, body composition, bone density, overall, energy level, overall well-being and sexual desire, performance.1 This blog seeks to demystify the process of testosterone replacement, addressing its importance, methods, costs, benefits, and potential risks for both genders.

Challenges of Diminishing Testosterone Levels

Testosterone levels begin decreasing in the late twenties, affecting both men and women. The sharp drop during menopause in women contrasts with a more gradual decline in men. The challenge lies in recognizing symptoms often dismissed as a natural part of aging, despite their potential impact on overall health.

While many dismiss this as a natural aspect of aging, it’s essential to recognize that these levels can plummet, leading to elusive yet concerning symptoms and medical issues. Unfortunately, only a limited number of physicians are adequately trained or comfortable in diagnosing and treating low testosterone. Though this can be a source of frustration, seeking the expertise of experienced professionals can readily address this issue.

Methods of Hormonal Replacement

The uniqueness of each patient’s symptoms, concerns, and health goals necessitates a personalized approach to testosterone replacement. The choice of method and dosing should prioritize the patient’s situation and desires over a one-size-fits-all model. Options range from gels and injections to pellets, with their distinct advantages and disadvantages for both men and women.

Consider the following scenarios: If a man’s testosterone level is only slightly low, topical gels or troches might be the most suitable option. In the case of moderate low levels, weekly intramuscular testosterone injections could be the preferred choice. Alternatively, pellets surgically implanted every 3 to 6 months are also an option. However, Each method carries its own set of advantages and drawbacks. For women, available choices encompass oral pills, topical creams or patches, vaginal rings, and the option of implanted pellets.

Cost of Testosterone Replacement Therapy (TRT)

Affordability is a key factor in Testosterone Replacement Therapy (TRT), generally costing under $50 per month. Whether your health insurance plan covers testosterone replacement therapy varies. Another consideration is the experience and comfort level of your primary care physician in performing TRT. You might be referred to a specialized practitioner, such as a gynecologist, urologist, or endocrinologist, with expertise in this field. Unfortunately, these specialists are often time-pressed and may not provide the comprehensive attention patients need.

Opting for an experienced doctor in these modalities offering self-payment may be best, with potential reimbursement depending on your insurance. While the cost is reasonable, the substantial and wide-ranging benefits make it a worthwhile investment.

Benefits of Testosterone Replacement in Men and Women

Despite ongoing debates (for more information, consult my books men and women or previous blogs), the general agreement is that if a patient displays symptoms of low testosterone and lab results validate low levels, replacement therapy offers substantial benefits. These include better mood, overall well-being, increased sexual desire, improved functional abilities, and positive changes in body composition. Furthermore, there’s potential for improvements in the immune system, cognition, and heart function. It’s important to note that individual responses to therapy can vary, as demonstrated by the unique experiences of two patients. Further details are provided below.

Risks of Testosterone Replacement and Men and Women

Generally, the risk of proper testosterone replacement in men and women with low or minor levels is relatively low. However, continuous monitoring of the patient’s response to therapy and hormone levels is crucial, considering both the benefits and potential risks. As testosterone is often seen as the “male sex hormone,” side effects may include virilization — the development of male characteristics like body or facial hair, a deep voice, hyperactivity, precociousness, and similar traits. More severe side effects and risks involve elevated liver function tests and increased hemoglobin levels.

A word of caution is necessary: Any sex hormone replacement can potentially advance hormone-sensitive cancers, like prostate or breast cancer. This underscores the importance of ongoing monitoring by an experienced doctor. Despite these considerations, when proper monitoring is in place, the consensus is that the benefits of testosterone replacement far outweigh the associated risks.

Navigating Testosterone Replacement Safely

Testosterone replacement therapy in men and women can offer substantial benefits and is typically considered low-risk. However, the evaluation, replacement method, and ongoing monitoring and adjustments should be entrusted to an experienced physician well-versed in hormonal replacements. It’s crucial to recognize that TRT is not a standalone solution but rather a component of a comprehensive approach to optimize one’s health.

At UPY, we specialize in providing this personalized care and expertise, tailored to both men and women. For further inquiries or to explore these topics in-depth, reach out to us via email at [email protected], or visit our website. Lastly, don’t hesitate to schedule a meet-and-greet to continue the conversation. – Chris Rao, MD, FAAFP

  1. Anne R. Cappola; Richard J. Auchus; Ghada El-Hajj Fuleihan; David J. Handelsman; Rita R. Kalyani; Michael McClung; Cynthia A. Stuenkel; Michael O. Thorner; Joseph G. Verbalis. J Clin Endocrinol Metab. 2023;108(8):1835-1874 ↩︎