From the Guidelines
Testosterone replacement therapy (TRT) is primarily used to treat hypogonadism, a condition where the testes do not produce enough testosterone, and its pathophysiology involves replacing the deficient hormone to alleviate symptoms.
Pathophysiology of TRT
The goal of TRT is to restore normal testosterone levels, which can help improve symptoms such as:
- Low energy and fatigue
- Decreased sex drive and erectile dysfunction
- Loss of muscle mass and strength
- Decreased bone density TRT can be administered through various routes, including:
- Transdermal gels or patches
- Intramuscular injections
- Oral tablets Each formulation has its own advantages and disadvantages, and the choice of formulation depends on individual patient preferences and needs 1.
Effects of TRT on the Body
TRT has been shown to have various effects on the body, including:
- Improved sexual function and libido
- Increased muscle mass and strength
- Improved bone density
- Enhanced quality of life However, TRT can also have potential risks and side effects, such as:
- Cardiovascular events
- Prostate cancer
- Sleep apnea
- Acne and skin reactions It is essential to carefully evaluate the benefits and risks of TRT for each individual patient and to monitor them regularly for any potential side effects 1.
Patient Preferences and Willingness to Undergo Treatment
Studies have shown that patient preferences play a significant role in the choice of TRT formulation, with some patients preferring injectable testosterone due to lower cost, while others prefer topical gels due to convenience and ease of use 1. Additionally, patients' willingness to undergo treatment is influenced by their symptoms, with erectile dysfunction, loss of energy, and decreased sex drive being the most common reasons for seeking treatment 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Pathophysiology of Testosterone Replacement Therapy
The pathophysiology of testosterone replacement therapy (TRT) involves the use of exogenous testosterone to restore normal testosterone levels in hypogonadal men, thereby alleviating symptoms such as decreased libido, erectile dysfunction, and loss of muscle mass 2, 3.
Mechanism of Action
The mechanism of action of TRT involves increasing serum testosterone levels to within the physiologic range, which in turn improves symptoms and signs of testosterone deficiency 2, 3.
Effects on Cardiovascular Health
The effects of TRT on cardiovascular health are controversial, with some studies suggesting a potential increased risk of cardiovascular events 4, while others have found no significant association between TRT and myocardial infarction risk 5, 6.
Benefits and Risks
The benefits of TRT include improved sexual function, quality of life, and increased muscle mass and bone density 2, 6. However, the risks of TRT include potential adverse effects on cardiovascular and cerebrovascular health, although the evidence is not uniform and more research is needed to fully understand the risks and benefits of TRT 4, 5, 6.
Monitoring and Contraindications
Monitoring of TRT is essential to minimize the risks, and contraindications include a history of heart failure, prostate cancer, and sleep apnea 2.
Formulations and Routes of Delivery
Various formulations and routes of delivery are available for TRT, including buccal, nasal, subdermal, transdermal, and intramuscular routes, each with its own pharmacokinetics and adverse effects 2, 3.
Patient Selection and Participation
Patient selection and participation are crucial in choosing the most appropriate formulation and route of delivery for TRT, as the decision depends highly on individual patient characteristics and preferences 2, 3.