Despite the proven benefits of replacement therapy, only about 20% of patients with
symptomatic low testosterone levels receive treatment. Let’s delve into the challenges patients
face – from under-diagnosis to reluctant doctors – and explore the proven advantages of
testosterone replacement therapy.
The Basics of Low Testosterone:
Testosterone deficiency primarily affects men over 40, leading to various symptoms such as
sexual problems, physical issues like fatigue and loss of muscle mass, and mental disorders like
anxiety and depression. In Canada, an estimated 1.7 million men suffer from symptomatic
testosterone deficiency, but only a small percentage of these men are undergoing testosterone
replacement therapy.
Challenges in Diagnosis:
Underdiagnosis is a significant hurdle, with routine screening not recommended for the general
population. However, individuals with metabolic disorders, cardiovascular diseases, or chronic
conditions may be at higher risk. At Port Moody Health we emphasize the importance of
diagnosing based on free or bioavailable testosterone levels, tested twice, one month apart, in
the morning and while fasting.
Prostate Cancer Concerns:
One major reluctance in prescribing replacement therapy is the perceived link between
testosterone and prostate cancer. However, numerous studies contradict this belief, suggesting
that low testosterone levels might even increase the risk of aggressive cancer. Urologists are
urged to follow French recommendations, indicating that testosterone is not contraindicated
for patients with a history of prostate cancer, provided certain conditions are met.
Cardiovascular Considerations:
Concerns about cardiovascular health have also deterred doctors from prescribing
testosterone. While early 2010 studies raised alarms, more recent research suggests
cardiovascular benefits. The European Society of Cardiology even advocates replacement
therapy to prevent cardiovascular risk, highlighting the hormone’s potential positive effects on
arterial health.
Patient Preconceptions:
One of the final obstacles is patient perception. Many wrongly believe that testosterone
treatment can increase cancer risk, induce aggression, cause weight gain, hair loss, and
unwanted body hair growth. Overcoming these misconceptions is crucial for patients to make
informed decisions about their health.
Available Treatment Options:
Testosterone replacement therapies come in various formulations, including transcutaneous
gels and injectables. It’s essential for patients to discuss with their healthcare providers to find
the most suitable option based on individual needs and preferences.
Conclusion:
Despite the challenges, treating low testosterone levels is essential for improving a patient’s
quality of life and general health. Communication efforts need to be intensified to raise
awareness among both patients and doctors about the proven benefits of supplementation.
Understanding the nuances of diagnosis, and addressing misconceptions are crucial steps in
ensuring that individuals with low testosterone levels receive the care they deserve. At Port
Moody Health we take a comprehensive approach to testosterone deficiency that includes
targeted nutrition and lifestyle changes.
