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Doctors' Answers to "Frequently Asked Questions" - Testosterone

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 07/17/2000]
Question: I have a few questions: 1st, I have always believed that I have been testosterone deficient. Now, the reasons are as follows...I have always had trouble growing hair facial as well as body and head. I have little to no libido so speak of. I am almost 31 years old and my penis size is that of a youngster. Are all these things a result of testosterone deficiency? I have always thought so as I mentioned before! Please! What are my options for a solution to these problems? All of these things make me feel more like a woman then a man as far as i'm concerned! I always feel inadequate as a man because of this! What can I do? What kind of costs can I expect? How will these things affect me as I age even older? Please respond as this has been a problem in my immediate mind for quite a few years now and i'm afraid that the longer I go without answers and/or help, my life will deteriorate even more then it already has!! Thank you!!

Answer: Check your testerone levels, this will be about 75$ in most cities.

[posted 04/8/2000]
Question: I am currently on hormone replacement therapy which includes testosterone. The injections are painful and I have a strong aversion to needles. The patches cause skin irritations and rashes. I believe I heard on a news station that there is a testosterone pill - is this true?

Answer: Not to my knowledge, but there may be one in the experimental works.

[posted 04/5/2000]
Question: Approx 2 yrs ago I was diagnosed with hypogonadism based on a series of testosterone tests over a period of about 6 mo.
I was put on Androderm 5mg, one patch a day and have used them fairly routinely thereafter. Shortly after starting the treatment
my testosterone level was again checked and it was in the normal range. I have just started going to a new doc. He claims
only one type of test was given (free testosterone?) and 2 other types of blood tests should have been taken before a diagnosis of hypogonadism
could be substantiated. I have stopped the androderm treatment in preparation for a new tests. Question: If I was not hypogondadic, did the
Androderm therapy impare my natural testosterone production? My new doc said that it is a feedback type of arrangement (my words) if the testes sense
adequate or elevated testosterone levels, the testes decrease production and maybe cease production all together. If this is true, do they shut down for good?

Answer: Not usually, but possible. The tests the doctor are referring to are LH and FSH which are the hormones produced by the pituitary to turn on or turn off the testicles. However, a low testerone usually is pretty reliable and indicates low production either by the testicles or by lack of pituitary stimulation. This needs to be determined, but I suspect you will be back on testerone regardless.

[posted 03/21/2000]

Answer: Oral testerone is not thought to be useful since it is completely metabolized by the liver on absorption. Testerone given by mds for deficiency syndromes is given as a shot or a dermal patch. I think this is a waste of your money and potentially toxic for no gain. Testerone will cause increased muscle size/strength, but not by a pill.

[posted 03/18/2000]
Question: I have been treated for depression since 1993. I saw on TV the other night about a disease called Gonad (something) Deals with lack of enough testosterone and the symptoms fit what I have. Insomnia, erectial disfunction, moodyness, at time hard to get going, there was more but I can't remember them. I lift weights and take Multi Vitmins, Gensing, Mega Creatine fuel-Not all the time, and just recently DHEA. I think that the DHEA kind of fights with the Prozac because after a couple weeks I get to be a real bear. What I am wondering is should I try the DHEA and leave the Prozac alone for awhile??? I really think that I have this Gonad-whatever proplem. Thanks for any help... :)

Answer: Sounds like you are describing sexual steroid deficiency. This is what the gonads are supposed to make(testicles or ovaries). Blood levels of testerone or pituitary function(LH and FSH) are easily checked. If normal, not present.

[posted 11/6/1999]
Question: What causes abnormally low testosterone levels? A 50 year old male friend has a low level, fatigue, depression, decreased sex drive. He's been told DM, cancer & several other causes need to be considered. If the cause is prostate cancer, can receiving hormone injections be dangerous? Thanks.

Answer: Testerone is made by the testicles. It's production is stimulated by the pituitary. Consequently, any decrease by the pituitary in stimulation or decreased production by the testicles will produce low levels of testerone. The most common cause is mumps as a child which affected the testicles. It has absolutely nothing to do with cancer or diabetes mellitus. Testerone replacement is known to increase prostate size and should be avoided if prostate cancer is present. Lack of testerone is one way that cancer of the prostate is treated -either chemical suppression or surgical removal of the testicles. Prostate cancer does not cause testerone suppression but testerone suppression is a treatment of prostate cancer.

[posted 11/1/1999]
Question: Sir/Madam, I am looking for a solution to the dangerously overactive sexual drive of an 18 year old boy. Are there any herbal or medical solutions that could help to calm him down? Your help is very much appreciated.

Answer: None that I'm aware of.

[posted 10/30/1999]
Question: I am in my 30's and even though I work our regularly I have
experienced some muscle loss, fatigue, and loss of sex drive.
If I asked a physician for help with testosterone therapy
would the above symptoms justify its use? And would short
term usage result is loss of gains after I discontinue its
use? Thats if I continue my normal workout regimine.

Answer: Only if your serum level of testerone was low, easily checked. The gains you obtain using supplements would disappear after 1-2 months off the drug.

[posted 10/29/1999]
Question: I have just started taking Testosterone for training purpose. On the drug there is some serious warnings. However searching on the web I can only find positive comments and different problems that Testosterone can help for. What are realy the pros and cons?

Answer: Testerone is a steroid and is generally an anabolic steroid, producing greater muscle strength and endurance. But, there is a potential cost. Moods may become more irritable and some patients experience uncontrollable outbreaks or violence episodes, occasionally depression. Breast formation and hair loss is common and is usually irreversible. Liver toxicity leading to liver failure (some would say a risk of liver cancer) is also present depending on dosage and other drugs. Once the testerone is stopped, the muscle growth and extra strength will go away , so the supplements must be continued to maintain its advantage. Occasional patients experience testicular atrophy and inability to get an erection. This usually abates with distcontinuation of the drug. In general, it can be a very toxic drug with only temporary benefits-not a drug that any physician would advocate for training which should give you pause.

[posted 10/20/1999]
Question: What are the effects of elevated androgen/testosterone levels in women? I've recently been told by my endocrinologist that I do have an elevated androgen level. In the past I have also been told that I have an elevated prolactin level as well. I have not yet discussed any further tests or treatments with my doctor. I just assumed though that if I had an elevated testosterone level I would be experiencing symptoms relating to high testosterone levels like increased hair growth, increased sex drive, faster metabolism or ability to form and increase muscle mass when in fact, I have been experiencing quite the oppsosite. I've been an athlete for many years and within the last 2 years, I've gained about 60 pounds, I exercise and lift weights regularly and get very few results. I have not had a normal menstrual cycle in many years. What kind of treatments and side effects do I have to look forward to? Can I expect weight loss? Will my voice change? etc...etc....Any info. would be greatly appreciated. Thank you in advance.

Answer: This would depend a great deal on the level of your testerone and whether there is estrogen around or not. You are correct about the general side effects, plus hair redistribution(pelvic, chest, occasional balding). You need to discuss this with your endocrinologist, because it would vary a great deal based on the level and source of testerone.

Androgen Deficiency & Testosterone [posted 11/24/98]
Question: I have a complex problem from reduced efficiency,easy fatigability, lack of concentration, weak memory, chronic fatique, to frequent dizzness. I am told that those are the symptoms of Androgen-deficiency as a result of retarded growth due severe illness during my childhood. I once used Testesterone tablets when I was 21 years old(1983) to help me develop secondary male sex characteristics normally, but they did'nt show any positive effects. I am now 36 years old and the situation seem to be worsen as time goes on especially tireness and dizzness. Is there any medication to cure this?

Answer: Are you taking testerone? If you were taking correct dosing you will develop secondary sex characterists.

Testosterone Patches [posted 10/23/98]
Question: Could you please tell me if there are any testosterone transdermal systems available other than the brand names Androderm and Testoderm. I am currently using the Androderm system, but have skin irritation in the form of swelling and itching from it. I got sample of a Testoderm patch, but the adhesive used on it is not adequate. Any information you can give me would be appreciated.

Answer: Those are the only two I am aware of, injections are about the only alternative.

Testosterone [posted 10/2/98]
Question: I am now taking 2cc of Testosterone for bodybuilding purposes. I am taking these 2ccs every 2 weeks and have as of now taken 3 doses and have been working out hard and regularly. How long before results will begin to show ? I would like to stay this protocol for 3 months and then stop. How is that for a dosage? What could happen to muscle mass after I stop dosing? Thank you

Answer: Time to achieve effect will be 6 months or longer depending also on your work ethic. The time to decrease the muscle mass will also be 6-8 months. Pretty risky drug by the way.

Testosterone & Testicle Pain [posted 10/2/98]
Question:I am 24 yrs old and when I was young I had striking pain in my testicles. Then it was tested and some medicines were admisnistered by a qualified professsional. i don't remember what were the medicines. Now I have seen that one of my testicles has shrunk to almost negligible size. please advice what would be the cuase or what would be the reason or is this some kind of disease ?

Answer: Several possibilities. First, it was a variation of mumps or some of the viral infections that affect testicles, second an infection of the collecting system of the testicle that impaired the blood supply to the testicle, thirdly, a mechanical tortion-however, these are usually treated with surgery and not with medications. You should see if you have viable sperm and have your testerone levels checked occasionally. You are at risk with aging to develop low testerone levels which will need replacement.

Testosterone for Increased Sex Drive [posted 7/23/98]
Question: I saw a segment on Dateline about two months ago about a woman using testosterone to help her sex drive. It seemed to me that she used a cream that she claimed worked right away. I tried to get an answer from Dateline exactly what it was she used, but I only got some sort of form letter, no answer. I asked my doctor and she didn't know of anything like that. Is there something like a testosterone cream or something like that? Would you let me know so that I can have my doctor write a prescription for me for it. My problems stem from having a hysterectomy. If I knew then what I know now I wouldn't have let them do it.

Answer: The cream was a testosterone based cream. Curiously, in both men and women testosterone is responsible for sex drive. However, excessive testosterone in women will produce male characteristics (hair, deep voice, etc.) so it must be used in small doses. Any testosterone cream will work, I think that particular show used testosterone propionate (available only by special mixture at the pharmacy). However, any testosterone should improve a women's sex drive. Use very small doses and watch carefully for any male pattern changes. Also, fat cells change estrogen to testosterone in women, so sufficient estrogen replacement will also work. This is important because most physicians will not prescribe testosterone to women merely for changes in their sex drives.

2% Testosterone Propionate Cream [posted 7/23/98]
Question: Has a Testosterone gel (Testos Pro?) been approved by the FDA? Are any pharmaceutical companies in the process of marketing 2% Testosterone Propionate cream? In January 1998 Oprah had a show where a gyn mentioned this 2% Testosterone propionate cream for application to external female genitalia. As Oprah has a huge viewership and indicated over 40 million women have low sexual interest, I would think this would be profitable for a pharmaceutical company. I would prefer to not have to go to a compounding pharmacy because of the cost.

Answer: Not currently available without the pharmacist doing the work. I don't know about plans by drug companies.

Testosterone Compound Cream [posted 7/17/98]
Question: I was recently prescribed a cp testost. prop 2% in wt pet cream and was not given any information on how to use this. Where do I apply? How often? This is supposed to help with my desire for sex, since I had a complete hysterectomy and have no desire.

Answer: Strangely enough, testosterone (the "male" hormone) is the major steroid responsible for sex drive in both men and women. Estrogen is converted to testosterone in fat and the adrenal glands and is the necessary drug for sex drive. Small doses in women can improve sex drive, this is usually applied in the vaginal area, but can be used anywhere. If applied in the vaginal area it sometimes helps the dryness of the area, although estrogen cream is better. Taking oral estrogen should also help the problem. The cream is usually not absorbed enough to give sufficient results.

Question: What information do you have about the new testosterone patches marketed under the name "Testroderm"?

Answer: There are several dermal testosterone patches now available. The original was Testogerm- applied to the scrotal skin. This gave erections, but it required constant shaving of the hair in the area-- a nuisance. Recently, there is androderm which is applied to the chest or wherever. This is better tolerated and tends to avoid the high/low phenomenon of testosterone shots (the alternative). Their major disadvantage is cost, but my patients usually prefer the patches.

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