Testosterone Replacement

A low testosterone level is quite common in men living with HIV. MC had been HIV infected for almost ten years. While he had his share of nagging illnesses; sinus infections, thrush and the like, he always prided himself on feeling pretty good. Recently, after turning 40 years old, MC noticed he felt more fatigued than usual. He had little energy after dinner, wanting to sleep more and more each day. His problems were not just with energy levels. In the bedroom he found that his sexual desire had all but disappeared. When he was in the mood he sometimes had trouble getting an erection. When he did, it was not as strong or as long lasting as it once was. To top it all off, he felt sad at times, and finding joy in any activity was difficult. MC had all the classic signs of low testosterone and felt testosterone replacement may be exactly what he needed.

Testosterone Fact Sheet

What is Testosterone?

Testosterone is the male sex hormone secreted by the testes. The production of testosterone is responsible for the development of the male sex organs, muscle growth, sex drive and energy levels in the male. During puberty, male adolescents have increased production of testosterone resulting in the development of facial hair and a deepening of the voice.

Medical Illustration - The Testes and Other Parts of The Male Reproductive System

For years, experts have been aware of the affect HIV has on testosterone production. Specifically diminished levels of testosterone are common in HIV+ men. The incidence of low testosterone increases in men who have lived long-term with HIV. To compound the problem, it's normal for the body to slow production of testosterone (hypogonadism) after the age of 40 regardless of HIV status.

What is Hypogonadism?

How Do I Know My Testosterone is Low?

Normal testosterone values can vary from person to person. But as the levels fall, symptoms will emerge. The most common symptoms include:

• Decreased energy levels (fatigue)
• Decreased sex drive
• Difficulty achieving and/or maintaining an erection
• Loss of muscle mass (e.g., in AIDS wasting)
• Symptoms of depression

Is There a Blood Test to Measure My Testosterone Level?

Low testosterone can be diagnosed with a simple blood test that measures the amount of free testosterone circulating in your blood. If the level is too low, testosterone replacement therapy is needed to return the level back to normal which in turn will relieve your symptoms.

Understanding Your Blood Tests

How is Low Testosterone Treated?

Testosterone replacement can be done is a variety of ways.

• Testosterone can be administered by injection every 2-4 weeks. The injectable form provides a rapid increase in testosterone levels but leave the man experiencing a "roller coaster" of energy levels when the level falls again immediately prior to the next dose.

• Testosterone patches or gels applied every 24 hours to a major muscle {e.g., thigh, buttock, upper arm). In this case, testosterone absorbs slowly into the muscle through the skin. The patch and gel on the other hand, provide a constant dose of testosterone, eliminating the highs and lows common to the injectable replacement therapy. The downside of gels and patches is that it takes longer to bring the testosterone level back to normal.

  Testosterone Replacement Options - A Fact Sheet