Testosterone

Symptoms of testosterone deficiency affect approximately 1 in 200 men and may include:

• weakness
• fatigue
• reduced libido
• osteoporosis
• depressed mood
• loss of energy
• erectile dysfunction
• aches and pains

This condition is commonly referred to as “Andropause”.

A man may be considered hypogonadal at any age if total testosterone is less than 200 ng/dl, or bioavailable testosterone is less than 60 ng/dl. Basaria and Dobs of Johns Hopkins University recommend that elderly men with symptoms of hypogonadism and a total testosterone level < 300 ng/dl should be started on hormone replacement.

Testosterone Goals

Testosterone USP is natural testosterone that has been approved by the United States Pharmacopoeia and is available as a pure chemical. Upon a prescription order, compounding pharmacists can use Testosterone USP to prepare numerous dosage forms.

The term “testosterone” is often used generically when referring to numerous synthetic derivatives, as well as natural testosterone. Confusion is responsible for conflicting data in the medical literature about the benefits and risks of testosterone therapy. Studies must be reviewed carefully to determine the form of testosterone that was used. Natural testosterone must not be confused with synthetic derivatives or “anabolic steroids,” which when used by athletes and body builders have caused disastrous effects.

For example, administration of synthetic non-aromatizable androgens, like stanozolol or methyltestosterone, causes profound decreases in HDL-C (“good cholesterol”) and significant increases in LDL-C (“bad cholesterol”). Yet, hormone replacement with aromatizable androgens, such as testosterone, results in lower total cholesterol and LDL cholesterol levels while having little to no impact on serum HDL cholesterol levels. Proper monitoring of laboratory values and clinical response are essential when prescribing testosterone replacement therapy.

Testosterone Goals and Therapy

• Improvement in psychological well-being and mood
• Improvement in erectile dysfunction
• Improvement in libido
• Increased muscle mass
• Increased strength and stature
• Preservation of bone mass

A man may be considered hypogonadal at any age if total testosterone is less than 200 ng/dl, or bioavailable testosterone is less than 60 ng/dl. Basaria and Dobs of Johns Hopkins University recommend that elderly men with symptoms of hypogonadism and a total testosterone level < 300 ng/dl should be started on hormone replacement.