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TREATMENTS TO INCREASE A MAN’S TESTOSTERONE LEVELS

// October 29th, 2010 // No Comments » // Hormones

Testosterone Pills and Injections

Hormone therapy returns sexual function to the vast majority of men with specific disturbances in their body chemistry. The basic principle of any hormone therapy is to re-create a state of hormonal equilibrium. For men with thyroid or adrenal hormone disorders, this can be accomplished with hormone pills. Unfortunately, such is not the case for impotent men with testosterone deficiency.

Testosterone pills are available, but they are less effective than testosterone given by injection. Testosterone pills are not well absorbed from the stomach, and blood testosterone does not always reach useful therapeutic levels. The pills also have a serious side effect — liver damage.

Giving testosterone injections once a week, every two weeks, or even once a month, although effective, causes wide fluctuations in serum testosterone levels, with highest values occurring shortly after injection. Then, with normal metabolism, levels fall until the next injection. This results in a variable sexual response. Adjusting the dose or frequency of testosterone injections smoothes out testosterone levels and maintains a steady state of sexual function.

Testosterone Skin Patches

Prescribing testosterone has, until recently, been fairly prosaic, for doctors had only to choose between the daily administration of a testosterone pill or periodic testosterone injections to maintain normal testosterone levels in the bloodstream of testosterone-deficient men. Testosterone pills had been under a cloud because they were burdened by a legacy of liver toxicity. No comparable problem plagued testosterone injections, but even though they were safe, their effectiveness depended on their being given as deep intramuscular injections every two to three weeks. Although both testosterone pills and injections worked, they were considered to be far from ideal, and scientists started looking for new, less toxic and more convenient ways to provide a man with the testosterone he needed. That is what spurred the development of the testosterone skin patch.

Doctors have been rubbing medications on the skin surface for years with good results, for they knew that blood circulating under the skin and nourishing it would absorb and transport medicine from the skin into the bloodstream. Cigarette smokers eager to stop can go into any drug store and pick up a set of nicotine-impregnated skin patches programmed to deliver progressively decreasing amounts of that drug to help them kick the nicotine habit.

Today postmenopausal women have, at their disposal, a variety of estrogen-containing pills and at least two different types of estrogen skin patches to overcome their diminished estrogen production, but until recently, the production of a testosterone patch seemed to stymie scientists. However, the technical problems that plagued early efforts of testosterone-patch development have been overcome. Today, there are three testosterone skin patches available. They are marketed under the names Testoderm, Androderm, and Testoderm TTS.

All three patches provide a steady supply of testosterone, helping to stabilize serum testosterone levels in testosterone-deficient men, and they avoid the dramatic swings in serum testosterone levels that occur with testosterone injections. However, to maintain their effectiveness, patches must be changed daily and applied properly.

What Causes the Sudden Increase in Testosterone Production During Adolescence?

// October 29th, 2010 // No Comments » // Hormones

Spontaneous testosterone secretion does not occur. The testicle requires a go-ahead signal from the youngster’s brain, which somehow knows that it is time to make the transition from boy to man. The pituitary gland, a tiny pea-sized structure tucked away at the base of the brain, is pressed into service. The pituitary hormone responsible for overseeing testosterone production is luteinizing hormone (LH). Under the influence of LH, the testicle starts siphoning cholesterol from the bloodstream. Enzymes in the testicle gnaw away at the unwieldy cholesterol molecule to manufacture and release testosterone.

Anything that interferes with normal testosterone production or action causes a decrease in libido and ultimately impotence. Some men have suboptimal testosterone production as a consequence of inadequate pituitary stimulation of the testicle. Without LH to stimulate it, the testicle does not manufacture testosterone. But it is not only the mere availability of LH but also the manner in which LH is delivered to a man’s gonads that determines the testicle’s ability to make testosterone.

The testicle is finicky. It will not respond to a steady stream of LH. The testicle produces testosterone only when periodic bursts or pulses of LH appear in the bloodstream. This is precisely what occurs at the onset of adolescence when there is a sudden shift in activity in the hypothalamus.

The hypothalamus, pituitary, and testicle remain in a state of suspended animation until adolescence. Then, for reasons not fully understood, the hypothalamus acquires the ability to release bursts of a hormone that triggers the pulsatile secretion of pituitary LH. Pulses of LH released from the pituitary travel through the bloodstream to activate testosterone production.

LH is referred to as a gonadotropin because it stimulates the male gonad (testicle). The hypothalamic hormone, called gonadotropin-releasing hormone (GnRH), provides the hypothalamic stimulus for pulsatile release of LH from the pituitary.

The hormonal interaction among the hypothalamus, the pituitary, and the testicles is a bond that persists throughout a man’s life. This entire system, referred to as the hypothalamic-pituitary-testicular axis, is responsible for creating and maintaining a man’s libido, sexual potency, and fertility.

Testosterone in the Womb and the Normal Infant Male

// October 29th, 2010 // No Comments » // Hormones

The impact of testosterone is apparent very early in life. Immediately before conception, a swarm of sperm circle the ovum. Only one will inseminate. All others will be rebuffed. If the inseminating sperm carries a Y chromosome, the fetus will be genetically destined to develop as a boy. Then the developing infant’s gonad is programmed to develop as a testicle. Thereafter, hormones take over. Surprisingly, all of the hormonal activity required to define a child as a male takes place in his mother’s womb within a relatively narrow time frame.The developing boy’s fetal testicle begins to secrete testosterone as early as the twelfth week of pregnancy. From this point on, testosterone and its metabolic offspring, the powerful male hormone dihydrotestosterone (DHT), help sculpt the appearance of the normal baby boy’s genitals. The period of fetal testosterone-dihydrotestosterone production is fleeting, extending only from the twelfth to the twenty-fourth week of pregnancy. After the twenty-fourth week of pregnancy, the testicles enter a state of hormonal hibernation and are dormant. By this time, the short-lived intrauterine exposure to testosterone and dihydrotestosterone have properly defined the genital anatomy of the male fetus. Weeks later, when the child emerges from the womb to be born, all eyes will be riveted on the area between the newborn’s thighs. Then, seeing a penis and a well-developed scrotum swaddling two tiny testicles, the doctor, midwife, or mother will proclaim with some glee, “It’s a boy!”