Deficiency of testosterone

Deficiency of testosterone is a deficiency in the human body (both men and women) of this sex hormone.

[1], [2], [3]

Causes of the testosterone deficiency

Testosterone is the main sex hormone, androgen, which determines the functioning of the body of a man. Testosterone is responsible for the virilization of boys, that is, masculinization, the appearance of male characteristics in males. The complex of symptoms of male constitution and appearance are the results of testosterone activity. This hormone is responsible for a certain male body type, the growth of the skeleton and muscles of the boy, the widening of the shoulder girdle, the development of the penis, the appearance of the body hair of the male type, the emergence of a specific male voice of the voice, an increase in the jaw and so on. Testosterone is produced in men in the cells of the testicle Leidings and in the adrenal cortex, but in smaller amounts and refers to the products of peripheral metabolism.

The activity of  testosterone  together with the hormones dihydrotestosterone and androstenedione, as well as the derivatives of their activity, leads to the necessary tone of the central nervous system of the man, his subcortical areas, the centers of the autonomic nervous system. This activity of the nervous system, conditioned by hormonal regulation, maintains the functioning of the sexual glands in the correct mode, which is manifested in the provision of their copulative function.

In the female body, testosterone is produced in small amounts in the ovaries and adrenal cortex. In girls, testosterone causes the processes of androgenization, that is, the activation of male hormones, which cause changes in the appearance of a woman in the male type, as well as the transformation of the functioning of the female body.

Also, the activity of testosterone in the body of both sexes - both male and female - leads to a strong anabolic effect in various tissues and organs of man. This is manifested in the activation of protein synthesis and the growth of muscle tissue, kidneys, liver, uterus and so on.

The causes of testosterone deficiency in men have different origins:

• Dysfunction of the testes

If the testicles began to function improperly, then this can cause a testosterone deficiency in the male body. For example, abnormalities in functioning appear as the effects of various testicular injuries or surgical interventions. Removal of the testicles also leads to a decrease in testosterone levels in the male body.

Sometimes boys are born at all without testicles or with certain defects in these organs. It happens that the testicles are located incorrectly, that is, not in the scrotum. Such anomalies in the structure and development of men affect the level of testosterone in the body, leading to its production in small doses, insufficient for the normal development of the boy and man.

Inflammatory diseases, transferred at different ages (for example, parotitis and others), cause changes in the production of testosterone, leading to its deficiency.

• Dysfunction of the hypothalamic-pituitary system

The pituitary and hypothalamus produce hormones that lead to the production of testosterone in the testicles. It happens that the amount of hormones produced by the pituitary and hypothalamus is inadequate. Such abnormalities cause a decrease in the functioning of the testicles, which leads to a deficiency of testosterone.

The production of hormones by the hypothalamus is disrupted for a number of reasons, one of which may be the presence of genetic defects, for example, Callman's syndrome.

The hypothalamus with a small mass is also incapable of producing hormones in the right amount to stimulate the activity of the testicles. Such a deficiency in the mass of the hypothalamus is caused by various diseases, large physical exertion, psychological disorders, for example, bulimia.

Violation of the pituitary gland also causes a deficiency of testosterone. There are congenital anomalies that cause the production of low amounts of hormones in the pituitary gland. Various diseases of this organ, for example, a pituitary tumor, also leads to a decrease in its functioning.

Drug addiction, obtaining large doses of radiation, exposure to toxins from the environment lead to communication defects between the hypothalamus, pituitary gland and testicles, as well as disruption of their functioning. As a result, there is a decrease in the production of testosterone in the male body.

• Age changes in the body

At a certain age, men develop a gradual decline in testosterone production. A specific, dramatic moment when this occurs, the male body is not available. The male gonads - testicles - do not reach the threshold when they stop functioning, and the man can no longer reproduce the offspring. The process of reducing testosterone in the male body is slow, but constant.

With age, men have a certain interacting process. Aging of the body, which affect all functions and systems, including the testicles, the hypothalamus and the pituitary, leads to a decrease in the production of testosterone. It should be taken into account that the general level of health in a man decreases, there is a bad state of health due to the development of various age-related diseases, which is another reason for the appearance of testosterone deficiency. But a decrease in the amount of testosterone in the body of a man stimulates the aging process and adversely affects his health.

• Clyufelter's syndrome

It happens that hereditary changes in the body of men, having a genetic origin, for example, the Claifelter syndrome, affect the production of testosterone.

With this syndrome, a certain gene contains not the number of chromosomes Y for the male sex, but their smaller number. For example, instead of the usual configuration of XYY chromosomes, there is a modified configuration of XXY.

Such genetic abnormalities cause a testosterone deficiency in the male body. The consequences of low testosterone levels are sexual development disorders, insufficient virilization of boys, infertility and other diseases, for example, osteoporosis.

• The Callman Syndrome

The disease, which is genetically conditioned, is manifested in a violation of the production of gonadotropin-releasing hormone in the hypothalamus. Accordingly, an insufficient amount of the above hormone reduces the production of luteinizing hormone and follicle-stimulating hormone in the pituitary gland. A deficiency in the body of the last hormones affects the reduced synthesis of testosterone in the testicles, as well as sperm.

• Down Syndrome

People who suffer from this genetic disease, in addition to other symptoms, have a low level of testosterone in the body.

• Bulimia and anorexia

This is a mental disorder that is associated with eating disorders. Usually, a maniacal desire to lose weight or fear of gaining extra pounds is found in women. But some men suffer from similar deviations. Usually, the fight against excess weight is poured into a rigid diet, which is replaced by uncontrolled excessive eating of food.

Then, in a fit of remorse, some men stimulate the urge to vomit or take laxatives to quickly get rid of the food they eat.

It happens that in the pursuit of harmony men refuse normal amounts of food for a long time and eat minimal. Or, for this purpose, exhausting, prolonged exercise and exercise are used.

Such unnatural experiments on themselves cause a testosterone deficiency in the male body.

• Menopause and menopause

As already mentioned above, men do not have a specific age range, followed by a sharp decline in sexual functions. However, in medical practice the terms men's menopause and men's menopause are used. This means that the amount of testosterone produced in men begins to decrease smoothly from about thirty-five years of age. Such gradual, gradual changes cause serious dysfunctions and diseases of the male body.

And yet, there are individual differences in which some men, even in old age, have a normal testosterone level. And in certain categories of the male population, testosterone levels begin to decline very early, much earlier than the norm, which leads to hormonal deficiency in the body.

• Taking medications that affect the production of testosterone, namely, glucocorticoids, ketoconazole and opioids. And also taking medications called antiandrogens, which block the production of testosterone.
• The presence of bad habits, such as smoking, drinking, addiction, which lead to failure or complete destabilization of the hormonal system.
• Increased mental stress and stress.
• The constant presence of stress, which is caused by problems at work and in the family, leads to the exhaustion of the nervous system, which lowers the level of testosterone in the blood. Also, the inability to receive normal male pleasure affects similarly the level of testosterone in the body.
• Factors that are associated with an unhealthy lifestyle.

Long-term abstinence, eating foods containing female hormones, environmentally unfriendly living conditions, an office routine, a small amount of physical exertion or, conversely, their excessive amount, overweight, etc., lead to a strong drop in testosterone levels in the blood.

The causes of testosterone deficiency in women are as follows:

• Menopause and menopause.
• The introduction of a woman during the menopause is accompanied by a change in the hormonal balance in the body. The amount of production of certain hormones (including testosterone) begins to drop sharply, which leads to their deficiency.
• Renal failure, in which the adrenal glands can not produce enough testosterone.
• Down Syndrome.
• Women, like men with a similar disease, are low in testosterone in the body.
• Taking certain medications can cause testosterone deficiency in women, namely glucocorticoids, opioids and ketoconazole.
• Ovariectomy.

Ovariectomy is the surgical removal of one or both ovaries. Since these testosterone generates testosterone, the absence of one or both ovaries leads to a deficiency of testosterone in the female body.

When removing the ovaries, the woman enters the premature period of menopause and menopause, which is due to the lack of production of sex hormones. In this case, it increases the risk of serious diseases such as osteoporosis, heart disease and so on.

• Adrenalectomy.

Adrenalectomy is a surgical operation, during which one or two adrenal glands are removed. Since the adrenal glands are responsible for producing testosterone, in their absence, testosterone deficiency in the body is observed in women.

[4], [5], [6], [7]

Symptoms of the testosterone deficiency

Symptoms of testosterone deficiency in men are more pronounced than in women, because this hormone is the main male sex hormone. Symptoms of a lack of testosterone in the male body can be divided into several groups:

1. Vegeto-vascular disorders:
   • increased heart rate,
   • the appearance of hot tides,
   • the emergence of cardialgia,
   • the appearance of anemia,
   • the appearance of excessive sweating.
2. Disorders of the endocrine system:
   • the emergence of  obesity,
   • the appearance of gynecomastia - the growth of breast glands,
   • decrease the amount of hair on the face, pubic and in the armpits.
3. Disturbances of the musculoskeletal system:
   • the occurrence of osteoporosis and a decrease in the overall level of bone density,
   • the appearance of pain in the bones,
   • lowering the total mass of muscles,
   • a decrease in physical strength.
4. Psychoemotional disorders:
   • tendency to frequent changes in mood,
   • the appearance of addiction is often depressed,
   • the emergence of rapid fatigue,
   • a feeling of constant fatigue,
   • the appearance of memory disorders,
   • the occurrence of various sleep disorders, the appearance of insomnia,
   • low level of creative productivity,
   • impossibility of long concentration.
5. Trophic disorders:
   • appearance of dry skin,
   • the appearance of wrinkles.
6. Genitourinary disorders and sexual disorders:
   • a decrease in the level of libido, a decrease in sensations during orgasm,
   • the appearance of accelerated ejaculation,
   • occurrence of erectile dysfunction,
   • decrease in the number of involuntary erections,
   • the occurrence of frequent urge to empty the bladder,
   • decrease in the size of the testicles.

Symptoms of testosterone deficiency in women are less than in men, because this hormone is not the main sex hormone. Signs of a shortage of testosterone in the female body are as follows:

1. Low libido, that is, the lack of desire to have sex.
2. Insensitivity of the genitals and other erogenous zones during sex and the inability to have pleasure during sexual intercourse.
3. Violations of the menstrual cycle, manifested in the absence of regular menstrual bleeding.
4. Excessive sweating of the body.
5. Increased dry skin and wrinkles.
6. Increase the dryness of hair and increase their fragility.
7. The appearance of constant fatigue and rapid fatigue.
8. Decrease in general ability to work and physical strength.
9. The appearance of memory and attention violations.

Forms

Testosterone deficiency in men

The testosterone deficiency in men is caused by genetic diseases, age changes or common diseases affecting the amount of testosterone in the blood.

The age-related decrease in the amount of testosterone is considered a normal physiological phenomenon. There is such a process after thirty-five years, closer to forty years. At the same time, there is a smooth, gradual, but constant decrease in testosterone levels in the blood, on average, in quantities of one to two percent per year. All males of middle and old age experience the process of slow decrease of testosterone, but there are cases when the amount of this hormone drops sharply to a level below the norm.

Experts believe that if there are no symptoms characteristic of testosterone deficiency in the body, it makes no sense even to conduct tests and, even more so, prescribe treatment. There is an opinion that in the absence of these symptoms, therapy may prove ineffective.

But when symptoms of testosterone deficiency appear, drug therapy should be used. Because the low level of testosterone, far below the norm, significantly affects the deterioration of men's health. In this case, treatment of this problem will necessarily lead to an improvement in the patient's condition.

Deficiency of testosterone in the body occurs with a decrease in its amount to 300 nanograms and lower per deciliter of blood. In the presence of such a problem in men, the quality of life significantly deteriorates, since a large number of ailments and diseases appear. Some members of the stronger sex notice permanent fatigue and reduced ability to work, a decrease in physical strength, constant mood swings, a tendency to depressed states, poor sleep or insomnia, a decrease or absence of sexual desire, erectile dysfunction and ejaculation, and so on. But only two-thirds of men who have similar problems turn to specialists for help.

It happens that the stronger sex has symptoms of testosterone deficiency, but they do not pay attention to these signs and, therefore, do not receive timely treatment.

Deficiency of testosterone in men in middle and old age leads to the appearance of the following diseases: osteoporosis, endocrine disorders, anemia, obesity, kidney disease, the appearance of hypertension, cardialgia, shortness of breath, prostatitis and so on.

Testosterone deficiency in boys and adolescents, caused by childhood diseases or genetic disorders, leads to insufficient virilization, that is, an insufficient formation of a male-type adolescent. There is a decreased hairiness in the male type, the figure of the teenager acquires female outlines, the width of the shoulders decreases, the amount of muscle mass decreases, the fat layer is distributed along the body according to the female type, the mammary glands are enlarged, the tone of the voice acquires female intonations, the behavior shifts towards the female manifestations. In addition, bone fragility and the tendency to osteoporosis increase, endocrine and vegetative-vascular disorders are observed, anemia arises, serious acne forms appear, sexual desire and erection functions decrease, infertility may occur, infertility may occur, physical strength decreases, there is a tendency to depression and so on.

[8]

Testosterone deficiency in women

Testosterone is the main hormone that affects the female libido. A normal amount of testosterone in the female body contributes to the appearance of sexual desire in women. Studies that have been conducted in this area have found a clear relationship between testosterone levels in the blood and the level of sexual desire, as well as the normal sensitivity of the genitals and the frequency of sex.

The lack of testosterone in women significantly reduces the level of libido, which leads to a loss of desire to have sex, as well as a decrease in the overall sensitivity of the genitals and the enjoyment of sex. Possible complete absence of orgasm with a lowered level of testosterone.

Testosterone plays an important role in the maturation of the follicle in the ovaries. In adolescent girls in the cells of a mature egg, the male hormone testosterone is transformed into a female hormone estrogen, which affects the development of breast glands during this period. In puberty, the amount of testosterone in the girls' body rises, which is due to the number of transformations that must occur in the girl's body.

If the amount of testosterone is reduced, then such a violation can lead to infertility of the girl and the woman. Insufficient testosterone levels can lead to a lack of estrogen in girls, which will affect the lack of formation of their secondary sexual characteristics.

Testosterone is also responsible for the normal activity of the bone marrow and sebaceous glands, as well as for the development of the bones of the skeleton. The low amount of testosterone in the female body affects the strength of bones and a sufficient level of their development.

The increased emotional tone of a woman and a good mood are associated with a normal amount of testosterone in the blood. The lowered level of testosterone affects the worsening of mood and well-being, increases mood swings towards depressive states. A woman with testosterone deficiency feels constant lethargy and fast fatigue.

There is also a low resistance to stress factors and minimal mental stability.

The deficiency of testosterone in women also affects the reduction of the total muscle mass and the reduction of physical strength.

Diagnostics of the testosterone deficiency

There are diseases in which it is recommended to check the level of testosterone in the body:

1. The formation of large increases in the area of the Turkish saddle, as well as the available facts of the effect of radiation on the zone of the Turkish saddle, as well as the presence of other diseases of the Turkish saddle zone.
2. Strong weight loss due to HIV infection.
3. Drugs of groups of glucocorticoids, opioids, ketoconazole.
4. The presence of the last stage of renal failure.
5. Conducting the procedure of hemodialysis, namely, extrarenal blood purification, which is used in acute and chronic forms of renal failure.
6. The presence in the body of diseases of medium and severe severity of obstructive nature.
7. The history of infertility.
8. The presence of osteoporosis or bone fractures with minor injuries.
9. A history of type 2 diabetes mellitus.

There are other symptoms that require an analysis of the amount of testosterone in the blood:

• Reduction of libido - sexual desire - in men and women.
• The diagnosis of primary or secondary hypogonadism.
• Various violations of sexual functions in men - reduced potency, serious manifestations of men's menopause.
• Serious disorders of the menstrual cycle in women, for example, with oligomenorrhea or anovulation.
• The existing chronic prostatitis in men.
• Serious skin rashes like acne - acne, red pimples in men and women.
• Manifestation of osteoporosis in both sexes.
• There is a strong pattern of hair loss in men.
• Symptoms of obesity in both sexes.
• Emerging testicular tumors in men.
• The diagnosed inadequate functioning of the pituitary gland, which leads to a growth disruption - gipolituitarizm - in both sexes.
• Genetic diseases in boys, for example, Klinefelter's syndrome, which lead to a violation of sexual development.
• Reduced amount in the body of albumin, which has the function of binding sex hormones.
• Isolation with feces of some undigested starch, which is accompanied by increased intestinal peristalsis - amylorea in women.
• Benign formations in the muscular layer of the uterus - with uterine myomas in women.
• In the syndrome of polycystic ovaries in women.

Diagnosis of testosterone deficiency is carried out in the laboratory. To pass the test to determine the level of testosterone, you must donate blood from the vein, which is placed in a test tube. In this case, there is a registration of the patient's data, in which his surname, name, patronymic, gender and age are indicated. If by this time the patient already undergoes hormonal treatment, then it is indicated which hormonal preparations he takes. The results of the tests performed, usually, can be found in a few hours.

The blood test for determining testosterone levels is performed on serum. It must be passed on an empty stomach, from seven to eleven in the morning, when the testosterone level in the blood is maximal. Before passing the test, you need to limit yourself:

• in smoking - do not use cigarettes an hour before the procedure,
• in stressful situations and unrest,
• in physical activity and training,
• various other factors that affect the fluctuation of testosterone levels.

Also, the level of testosterone is affected by the use of certain drugs - for example, hormones, drugs containing barbiturates. These medicines increase the level of testosterone. To reduce the amount of testosterone with the administration of cardiac preparations - glycosides, for example, digoxin; neuroleptics, for example, phenothiazine; diuretics, as well as alcoholic beverages.

Therefore, it is necessary to exclude the use of alcohol, as well as the aforementioned medicines, the day before the test. The exception is those drugs that are used by courses or shown for vital necessity, the reception of which can not be interrupted. In any case, before passing the test, you need to consult a doctor about the medications you are taking.

It is known that the level of testosterone in the body rises in the morning, and in the evening it decreases. Also, different times of the year affect the amount of testosterone in the blood. For example, in autumn the maximum content of testosterone in the body is observed. Therefore, you need to consult with specialists about the time of the optimal passage of the test to determine the level of testosterone.

Decreased testosterone levels with the available vegetarian diet, as well as curative fasting and at elevated temperature.

When analyzing test data for testosterone levels, the level of total and calculated free testosterone is taken into account. These parameters are determined by calculating the level of total testosterone and globulin, which binds the sex hormone.

It is known that the minimum level of testosterone in the body is not a constant in all men and depends on some factors. For example, ethnicity and geographical location affect the minimum level of testosterone in humans. But official medicine has established the lowest threshold of testosterone in the male body, below which special hormonal treatment is required. So, the minimum level of total testosterone in a man is considered to be 12 nmol / L or 346 ng / dL, and free testosterone is 250 lmol / l or 72 lg / ml. At the level of total testosterone, defined as 8 nmol / l or 231 lg / ml and free testosterone - 180 nmol / l or 52 lg / ml, hormonal treatment should be used.

It is worth considering that repeated tests to identify testosterone levels in thirty percent of cases show a normal amount of testosterone. It is necessary to pay attention that at fifteen percent of healthy young men within a day there is a decrease in the amount of testosterone below the normal level. Therefore, in order to exclude the error of diagnosis, it is necessary to conduct repeated studies.

In men, the level of total testosterone in the amount of 2.6 to 11 ng / ml is considered normal. The level of free testosterone in men under the age of twenty is the amount of 0.2 - 42.5 lg / ml; from twenty to fifty nine years - 6.6 - 30 lg / ml, and over sixty years - 4.9 - 21.6 lg / ml.

In women, the testosterone level is considered to be 0.7 - 3 nmol / l. The amount of testosterone at the time of ovulation increases, and during menopause - decreases. The most suitable time for women, when it is best to take tests for testosterone - the sixth or seventh day of the cycle.

[9], [10], [11], [12]

Treatment of the testosterone deficiency

Treatment of testosterone deficiency in men is carried out by the appointment of hormone replacement therapy. Drugs that contain testosterone are used as monotherapy or combined with other drugs.

Monotherapy is an effective treatment for erectile dysfunction. But the use of only testosterone drugs affects, rather, an increase in sexual desire, than to restore the erection. During such therapy, men develop an increased level of sexual activity, they often think and fantasize about sex, erotic stimuli are more likely to influence, the number and duration of erections at night increases.

Also increases the hair flow of areas of the body, which depend on the level of androgens. There is an increase in muscle mass and a decrease in fat tissue. The mineral density of bones increases.

Monotherapy with testosterone drugs affects mood improvement. There are tides of energy and sensations of psychological comfort and contentment with life. In some cases, monotherapy with testosterone has an effect on improving visual perception, verbal memory and free speech.

It can be said that treatment with testosterone drugs in men helps maintain secondary sexual characteristics, activates sexual functioning, improves well-being and mood, supports the necessary level of bone mineral density, that is, corrects the main symptoms of a lack of testosterone.

In monotherapy, a satisfactory result of treatment is an increase in the amount of testosterone to an average level within the framework of normal values.

In the treatment of testosterone deficiency, the following testosterone medicines are used in men:

1. Medicines for intramuscular injection.
2. Subdermal preparations.
3. Transdermal preparations.
4. Oral medicines in the form of tablets.
5. Buccal tablets.

A brief description of the use of testosterone preparations is as follows:

Intramuscular injections

There are three groups of injectable testosterone preparations:

• short-acting drugs - testosterone propionate,
• medications of average action - testosterone enanate, testosterone cypionate, sustanon,
• long-acting medicines - testosterone undecanoate and testosterone bucyclate.

The testosterone preparations enanthate and testosterone cypionate are used, which are similar in their pharmacological manifestations. Medications are administered on a weekly basis, the usual daily dose is 100 mg. 200-300 mg of the drug is administered every two or three weeks. The maximum amount of testosterone is observed after five days, but returns to its usual level in ten to fourteen days.

Advantages of these drugs is their low cost, as well as the ability to achieve a high amount of testosterone in the blood. The drawbacks of this group of drugs include the appearance of pain at the injection site, as well as the constant visit to the doctor for repeated injections.

Recently, a new testosterone drug undecanoate (nebido) has been developed, which makes it possible to achieve a stable effect from the application. After two initial doses of 1000 mg were administered with a break of six weeks, other injections should be given every twelve weeks. It happens that interruptions between injections can be increased to fourteen weeks, due to the normalization of testosterone levels in the blood.

Subdermal drugs or subcutaneous testosterone implants

One of the earliest ways to treat testosterone deficiency is to implant pellets under the skin, which contain testosterone. When testosterone preparations for intramuscular injections were invented, this form of treatment lacked testosterone. But in some countries, for example, in the UK and Australia, these drugs are still available for use.

Subcutaneous implants are the hormone testosterone, which is compressed into a cylindrical shape. At a time, three to six cylinders are injected, each containing twenty grams of testosterone. The drug is administered using local anesthesia with a trocar through a small incision in the skin in the subdermal layer of fat in the front wall of the abdomen. Within six months, the drug provides the body with the required amount of testosterone. For example, the drug testbell is injected under the skin at a dose of 1200 mg every six months.

With this method of treatment of testosterone deficiency, there are side effects associated with the displacement and ejection of pellets, the formation of bruises and various hematomas at the site of implantation, as well as the possibility of infection.

Transdermal preparations

The transdermal form of drugs that raise the level of testosterone is represented by patches and gels. To have the effect of using these medicines was persistent, you need to use them every day. With this method of increasing testosterone, its daily dose is five to ten grams of the substance. Plasters are attached to the body or directly on the scrotum to have close access to the testes.

Advantages of these drugs is to ensure a constant level of testosterone in the body during the use of drugs.

Among the side effects of using patches, one can distinguish the appearance of irritation at the site of application. Such side effects are not observed when using gels.

It is possible that the daily dose of the drug should be doubled due to the peculiarities of the absorption of the active substance into the skin of the patient.

Drugs for oral use in the form of tablets

There are three groups of oral means, which differ in their chemical structure:

• 17-alpha-alkylated androgens - methyltestosterone, flucymyrone, oxymetholone,
• preparations similar to dihydrosterone - placeolone,
• preparations containing natural molecules of testosterone - testosterone undecanoate.

The drug testosterone undecanoate (andriop) has a good digestibility. But because of rapid metabolism and withdrawal of the drug, it is impossible to optimally maintain a sufficient level of testosterone in the body.

There are resistant to the action of liver enzymes, testosterone derivatives, for example, seventeen-alpha-alkylated - meliltestosterone and others. But these drugs are not recommended because of their toxic effects on the liver.

[13], [14], [15], [16]

Buccal tablets

Buccal tablets are absorbed into the oral cavity, they are placed above the upper lip. For example, the drug striatt is prescribed for use at a dose of thirty mg three times a day. Other drugs are prescribed for use twice a day. These drugs are good for patients who need the introduction of testosterone for a short period of time and who have had adverse reactions to transdermal drugs.

Side effects of drugs are manifested in the form of changes in taste and the appearance of irritation of the mucosa of the gums. Also, side effects of drug use include the possibility of passing testosterone to a partner with saliva.

When prescribing drug therapy for testosterone deficiency, complications can arise, such as the presence of contraindications. In these cases, it is necessary to resort to rapid withdrawal of the drug, therefore, in the late stage of testosterone deficiency, it is recommended to use drugs with a short range of action, namely, oral, buccal and transdermal drugs.

[17], [18], [19], [20], [21], [22],

Prevention

Prophylaxis of testosterone deficiency in healthy men is in the following actions:

• Maintaining a healthy lifestyle, namely, the refusal to smoke the use of alcoholic beverages and narcotic drugs.
• Eating clean food, try to avoid foods that are grown with hormones.
• Avoid fatiguing with diet and giving up a normal amount of food.
• Do not overeat and follow the level of normal weight.
• Avoid strong and debilitating physical exertion.
• Maintain a constant good physical shape, avoid hypodynamia, engage in regular training.
• Avoid stress and stay in groups with an unhealthy psychological atmosphere. In time, seek psychological help in the event of conflicts at work and in the family. Do auto-training and other types of psychological training.
• To lead a full emotional and sexual life, to have hobbies and "ventilations", to fully and regularly rest and restore physical and emotional strength.
• Change the place of residence from environmentally unfavorable to the place with an acceptable level of ecological purity.

For men who have a history of a disease that can lead to a decrease in testosterone levels, regular treatment and prevention of major diseases should be undertaken.

When entering the age of thirty-five to forty years, when the testosterone level in men begins to decrease smoothly, it is necessary to monitor the appearance of symptoms characteristic of testosterone deficiency. And if at least minimal manifestations begin to appear, it is necessary to turn to specialists for appropriate treatment.

[23], [24], [25], [26]

Forecast

Prognosis of testosterone deficiency with timely treatment in boys is favorable. In this case, the body of adolescents is formed by the male type, the secondary male sexual characteristics are sufficiently developed, the male type of behavior and response is formed. The treatment with testosterone drugs, which was started in time, contributes to the prevention of many diseases and abnormalities from the normal functioning of the body that occur with a deficiency of testosterone. First of all, it concerns the appearance of osteoporosis, cardiovascular diseases, genitourinary disorders, the appearance of sexual dysfunctions, disorders of reproductive functions and endocrine diseases.

With existing genetic diseases, for example, Kalman's syndrome, the constant use of hormonal therapy helps restore lost reproductive functions. However, treatment must start early, even before adolescence.

The prognosis of testosterone deficiency in case of age-related changes is considered favorable when the treatment is started on time. The level of testosterone in modern medicine can be raised to normal and retained by periodic use of drugs.

Since testosterone deficiency affects the metabolic processes in the body, eliminating this problem leads to an improvement in conditions such as diabetes mellitus, coronary heart disease, chronic heart failure, prostatitis and so on. In time, the treatment of testosterone deficiency is initiated by the prevention of osteoporosis.

Elimination of testosterone deficiency has a beneficial effect on maintaining sexual functions, improving the quality of life of men and women, ensuring a good level of well-being and mood.