Last week in In Part 1 in our series on testosterone replacement therapy, we illustrated the benefits and dangers of going on TRT, and the importance of finding a good endocrinologist, Here’s the important stuff to know when you go and see your doctor and what to expect during treatment.
What to do before seeking treatment
Most men tend to ask for hormone treatment before they even know what is actually wrong. These men go to the doctor and demand medication, without exhausting all possibilities before doing so. As I stated in the last article, hormone therapy isn’t a game. The wrong medication or dosage could seriously mess you up. Low T will seem like heaven if your prostate swells up or you start growing breasts. I can not emphasize the importance of taking this seriously and consulting with a competent doctor. Don’t go on line and buy products that may or may not even be testosterone, and inject them into your body. That would be madness, but many men do this every single day.
Before you even consider TRT do everything possible to raise your testosterone levels naturally. Here are a few things that can get you started on your journey to healthy hormone levels:
If you don’t lift weights, then you should start. Make sure that you have proper instruction and are consistent with your exercise plan.
High intensity interval training or HIIT is excellent for raising your T levels naturally. You’ll look and feel like a stud too!
Get yourself checked out with your primary doctor to rule out any other potential issues other than low T, as a cause for your low sex drive and lack of mental focus.
Assuming that you have done all of the above, with no positive results, then you can go and ask the doctors about hormone therapy.
Why an Endocrinologist?
Your endocrinologist is a doctor who specializes in the endocrine system. These are glands that make up our hormonal system. Testosterone is not the only gland that your specialist will be addressing. There are other glands such as estrogen, that are vital to our health. It’s important to have a specialist who understands these hormones and how to balance them. Your normal medical doctor may not have the level of training to make these distinctions.
Undergo a thorough exam with your healthcare provider that should include the following:
Write down all your questions before you go to the doctor. Ask questions and speak openly about your symptoms.
During the exam, your doctor may check your genitals, body hair, breasts and other parts of the body for possible signs of low testosterone. Other tests may be done to rule out alternative causes.
Have blood testing for testosterone levels if indicated. Your doctor may order other, related blood tests as well. For accuracy and consistency, testosterone blood testing should be done in the morning. Repeat testing should be done at a later date rather than relying on a single blood sample.
If your testosterone levels are consistently low, and you’re interested in treatment, discuss the risks, benefits and side effects with your doctor.
Choose the right form of treatment for yourself. They’ve got patches, topical solutions, and injections to choose from. Ask your doctor which is best for you.
Once treatment begins, make sure your doctor regularly monitors your testosterone blood levels and treatment response. Other periodic blood tests might include PSA tests, red blood cell counts and cholesterol and liver function tests.
If you decide to go on hormone replacement therapy, make sure that you drop me a line and let me know how it’s going for you. I’d love to hear about it!
EVERY MAN OVER 40 thinking about testosterone replacement therapy (TRT) for energy, mental focus, and libido, needs to ask these questions. Do you actually have low testosterone levels, confirmed by blood tests? Do you have normal or low-normal testosterone levels and want to try treatment anyway? What’s “normal” anyway?
Hypogonadism also known as “low T” afflicts 200,000 men a year. It can start as early as fetal development. It could begin later in life as well. One potential problem is the testicles are not making enough testosterone, for one reason or another. These men experience certain symptoms, such as low sex drive, weak erections, and depression . TRT may help. Fatigue, increased body fat, reduced focus, difficulty concentrating and other symptoms could also be signs of low T.
Some men with normal testosterone levels, think they’ll get an extra boost of testosterone. They think they’ll feel like an 18-year-old football star. It doesn’t work that way. If you have normal T levels, testosterone replacement therapy, will not give you super human strength. It will not turn you into a love god.
Prescription testosterone isn’t really helpful in the case, of normal hormone levels in men. Research suggests, taking supplemental testosterone may expose men to unnecessary health risks. Some of these risks are: fluid retention, enlarged breasts, and sleep apnea. Other alarming risks are enlarged prostate, increased anxiety, high blood pressure, strokes, and heart attacks. I think that you’ll agree that these are serious complications. If you’re going to go on TRT, then please make sure that you are consulting with a physician. AND not just any old doctor – go and consult with an endocrinologist.
Testosterone is known as the male hormone, produced primarily in your testicles. This androgen effects the density of our bones, muscle size and strength. It also effects body fat, body hair, sperm production, sex drive and red blood cell production. Testosterone is key for maintenance and health in men of all ages.
Our testosterone levels change and adjust throughout our lives. Any adult man knows about the changes in physical, mental, and emotional states during our adolescent years. Puberty begins in boys around the ages of 10 to 14. This is when testosterone production starts cranking. It hits its peak sometime in adolescence or in our early twenties. Unfortunately, testosterone slowly decreases approximately 1 percent a year after a man hits his 30’s and 40’s.
The Endocrine Society, says that average total testosterone ranges from about 265 to 915 nanograms per deciliter for younger men ages 19 to 39. Current guidelines discourage physicians from prescribing testosterone unless blood levels are demonstrably low. With men ages 65 and older, low testosterone levels alone does not lead to TRT, according to the society’s recommendations.
The Rising Tide
As, more and more men, are now asking for TRT therapy. It’s hard to imagine that big pharma is will ignore the demand for better tools to manage an aging population. We are living longer than any time in human history. As TRT gets more attention, and new research is published and peer-reviewed, better products will come to the market.
Who knows how the demand will affect the future of anti-aging products and TRT, as big pharma can clearly see that this is a lucrative revenue stream. For the men that have benefited from hormone replacement therapy, it’s been described as a game changer. A man described the effects as if “somebody switched on a light in a dark room”.
Don’t dream. Lift!
Some of the other benefits are greater sex drive, improved cognition, and if you are into working out – bigger muscles too! I know several men who swear by TRT. They say it’s the best thing that has ever happened to them. One man, who thought his competitive days were over, started to do competitive martial arts after taking TRT just for a few months. Better sex drive, stronger and bigger muscles – this sounds great! With such rave reviews, why has the health industry become reluctant to break out the old prescription pad, when it comes to TRT?
Slowing your Hormonal Roll
Evidence suggests, that there was an early boom in hormone replacement therapy for men. Drug manufacturers, enthusiastically marketed TRT to the public and medical professionals alike. Today, doctors are writing fewer testosterone prescriptions.
In 2013, JAMA Internal Medicine – the American Medical Association’s peer-reviewed monthly journal published a study based on insurance prescription data for approximately 10 million men starting at the age of 40 and older. From 2001 to 2011, androgen replacement therapy, was prescribed in the form of topical gels, skin patches, pills and injections. Sales had tripled.
The trend reversed in 2013. TRT prescriptions for American men from 30 and older decreased by almost fifty percent from 2013 to 2016, according to findings published July 10, 2018, in JAMA.
It was discovered that in the five-year’s since the original study, heart attacks and stroke risk from testosterone therapy appeared in respected medical journals. In October 2016, the FDA approved changes to TRT labeling to emphasize possible risks for heart-related problems and mental health issues having to do with testosterone products.
What’s worse is that, in the first study, about 25 percent of the men on TRT were not tested for low T-levels. Many of these men were not hypogonadal, and put at risk for heart disease, and prostate issues for no good reason.
Judge for Yourself
For men how have significantly low testosterone levels, the benefits of hormone replacement therapy usually outweigh potential risks. If you are a man with moderate to borderline levels, you’re going to have to make some decisions with your doctor. There is a lot to think about. On the one hand, It offers men who feel like garbage an opportunity to feel as right as rain, and on the other hand, that magic bullet could put you at higher risk for heart disease and prostate cancer.
There is some debate as to whether heart and prostate problems increase with the use of hormone replacement therapy. There just have not been enough studies conducted yet. However, keep these potential risks in mind when weighing the pros and cons of TRT. Is it worth it, if you don’t really need it?
I will be doing later articles on what you should do before you go and see the doctor to talk about TRT, and what you can do to increase your testosterone levels without using any of the many products such as gels, and pills.
If you have anything to add to the conversation please post your thoughts in the comment section.
Episode 25: Sexual Empowerment Over 40 with Celeste Hirschman. Some of our deepest pain is related to sex and personal relationships. Sexual empowerment over 40 with Celeste Hirschman, is an open conversation about feeling loved and held instead of abandoned and disconnected. It gets easier to be sexually empowered after the age of 40. Advertising and media are not marketing to you as heavily. This frees you up to live the life you always wanted. That includes great sex!
About Celeste Hirschman
Celeste Hirschman received her Master’s Degree in Human Sexuality Studies from San Francisco State University. Ms. Hirshman taught as a lecturer at San Francisco State University (SFSU) in the Human Sexuality Studies Department and was a Project Manager at SFSU’s Center for Research on Gender and Sexuality, where she co-authored numerous articles on adolescent sexual development. She is the Co-founder and the Co-creator of the Somatica Method ® and trains coaches in the method. Celeste also has her own private practice where she sees clients in her San Francisco office.
Somatica’s Mission Statement
Our Mission is to fill the world with love, erotic pleasure, connection, satisfying relationships, and self-aware people who feel free to fully express themselves and can support others in doing the same. April 8th 2018 is when the next Introduction to Somatica Core Training. The program begins on the 26th of April. Enrollment is open until the 25th of April.
Successfully Using Cannabis to Reduce Inhibitions and Enhance Sexual Pleasure
Does cannabis enhance the sexual experience by reducing inhibitions, and increasing intimate pleasure? Canna-sexual expert, Ashley Manta gives the 411 on this topic. Plus, get some sex tips, and learn about her upcoming workshops in Los Angeles celebrating sexual self acceptance – and weed.
Ashley Manta Sexuality Educator, Coach
Ashley Manta likes to talk about sex—a lot. It’s not taboo for her. You know what’s else isn’t taboo for her? Cannabis. In fact, this bubbly buxom blonde has become a sought-after authority on mindfully combining sex and cannabis as part of her CannaSexual™ brand. As a professional sex educator, writer, coach, and facilitator, Ashley helps people navigate these topics to make sure they are interacting, loving, and feeling their best in and out of the bedroom. By creating a safe space for people to feel and be heard, Ashley works on softening the restrictive boundaries holding clients back from being their best selves—and doing so in a way that makes people incredibly comfortable.
~From Ashley Manta’s website
What you’ll learn:
Is Cannabis useful for sex?
Should people be wary of using Cannabis?
For what else is Cannabis useful?
Tips on loving yourself and using cannabis for relaxation and pleasure.
Working with Ashley and booking her for your own events.
Episode #5: Is your fantasy “weird”? Should you try it anyway?
This episode, we discuss sexual fantasies. Are they weird? Sick? Maybe they’re a personal manifestation, of an authentic sexual identity, waiting to be expressed. Sex Therapist Galen Fous discusses this and more.
The big changes such as, divorce, changing cities, or a relationship that is going cold, that drop into our lives like a dive bomber, can sometimes inspire us to make a change for the better. Sexual desires get distorted and repressed in our society. Something like a divorce can be the inspiration to seek out and explore those hidden desires from the shadows.
Transpersonal Psychologist, Galen Fous
Galen Fous is a Transpersonal Psychologist, sex researcher, a kink sex educator. For the past 17 years, Galen has been helping people express their sexuality in an honest healthy and shame free way. Galen advocates for honesty and transparency in expressing our desires, negotiating consent, and boundaries.
What You’ll Learn:
What are sexual fantasies, and from where do they come?
Is my fantasy “weird”?
What if I’m actually pretty kinky? What next?
How to introduce your fantasies and kinks to sex partners – new and longstanding.
Avoiding an erotic mismatch.
Finding a community, to play in, that supports you, and resources for education.
Attraction is a question that comes up often for anyone who’s ever been a relationship coach. How to get a woman’s attention after 40, is at the heart of that question for single men over 40. Breakups such as divorce are often unwelcome surprises and can leave a man unprepared for the dating world. Maybe confidence in yourself is on the rocks? Is trust an issue for you? Career, finances, and family obligations are the sacrifices that we make to achieve our goals. Sometimes these obligations stand in the way of romance. Years pass and you get more anxious about your prospects for finding the woman of your dreams, or an awesome sexual partner. The older you get the harder it seems to find a great woman. All the good ones seem to be taken. You’ve got to fix this.
You’re in luck. On today’s podcast, I’ve brought in one of the top relationship and dating coaches for men. Shana James has a rare talent. She explains what women think, feel, and want you to do – and she explains it in ways that make for actionable plans.
“I like to talk about this as an opportunity …to get more real.”
~Coach and facilitator – Shana James
Shana has coached nearly a thousand men and almost as many women, around the world, in the past decade. She has led events for Match.com and Table for Six. Ms. James is a dating consultant for an MTV reality show. Shana is an ally for men. She brings a combination of Western and Eastern wisdom with her Masters in psychology, training in man/woman dynamics, as well as yoga, meditation, tantra and various spiritual practices. She does not teach games or pick up lines, but works specifically with each man in the places he holds back and feels stuck.
With incredible love and compassion for men, vulnerability and willingness to tell the truth, Shana makes it safe for you to work through your biggest fears and deepest shame, so you are free to have passionate, fulfilling connections, relationships and sex with the women you really want.
What you’ll learn:
How to get a woman’s attention after 40
Dealing with rejection
Are we a good match vs. am I good enough for her? (self-respect)
How to recover from desperation/grasping and start automatically attracting a woman’s attention