TRT – The Best Treatment for Balancing Testosterone in Middle Aged Men

Abstract

Balance is critical to many aspects of life. Work-life balance ensures that we have time to enjoy the fruits of our labor. Hormones control bodily processes like – metabolism, homeostasis, growth and development, sexual function, reproduction, sleep-wake cycle, and mood. Most men see a gradual and progressive decline of testosterone, the primary male sex hormone, starting around age 30, at a rate of 1–2% per year, though in some men, the decline is faster than the body can adequately compensate. In these cases, the fallout can be felt throughout the body with symptoms that are both disruptive and inconvenient. It is produced in the testicles and the adrenal glands but regulated by the hypothalamic-pituitary-gonadal (HPG) axis, a feedback system that responds to circulating hormone levels. Hormonal imbalance in men closely parallels the aging process. The most effective way of balancing male hormones is using testosterone replacement therapy (TRT). Generally, a value < 300 ng/dL is considered low, leading to a condition called hypogonadism. While one-third of Indian men above 40 years of age suffer from hypogonadism, the proportion of them as appropriate candidates for testosterone therapy (TTh) is not clear, not only in India but also in most countries. TTh helps reverse the effects of hypogonadism, but it’s unclear if it would benefit otherwise healthy older men. Primary care physicians encounter clinical conditions of hormonal imbalances in males, such as precocious puberty, delayed puberty, and hypogonadism, in general practice, needing specialists’ consultation and guidance for their management. Quoting half a dozen case reports of hormonal imbalance and their management, this article provides the evidence to prescribe or not to prescribe hormones for men. Materials and Methods: Sample cases of precocious puberty, delayed puberty, male hypogonadism (MH) (general, diabetic, and intracranial hypertension), and a case of complication of TTh cases in adults and how they were diagnosed and managed. Literature review for current evidence for TTh in men globally and in Indian practices.