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Testosterone Replacement Therapy (TRT)
Dr. Bissoon does not advocate a “one-size-fit-all” approach to testosterone replacement therapy. There are multiple options which will be discussed during your consultation.
Before beginning treatment there are certain facts men need to know. First, once you start a testosterone treatment program, regardless of the option, some of your testosterone will be converted to estrogen and some will be converted to Dihydrotestosterone (DHT). Estrogenic side effects include increasing belly fat, impotence and gynecomastia. Elevated DHT has been associated with hair loss, decrease libido, acne and liver cyst. We will discuss blocking the conversion to estrogen and DHT with medications and nutrition.
The use of creams and gels are very common, requiring daily application once or twice a day. There are FDA approved topical testosterone and testosterone patches. We can also have testosterone cream and gels compounded to a specific dose for a particular patient. The upside to using a topical testosterone there is no injection. However, there are a few important concerns when it comes to topical testosterone. Read More
Interestingly many men who seek testosterone replacement therapy prefer injectable therapy For those who are interested in doing self injections, Our office will schedule a training session with Dr. Bissoon in order to teach you how to perform self injections safely. This session takes about 10-15 minutes. Treatment by injection is often a better option; a shot of testosterone is usually performed 1-2 times a week based on the dose. Dr. Bissoon does prefer twice a week dosing with smaller doses to avoid extremely high and low levels. The down side is the hassle of self injection and the pain associated with the shot. In addition to the pain associated with the injection there may be some pain from the actual testosterone –which is rare. Read More
Very few doctors prescribe oral troches and it is not a common route of administration.
Recently, the FDA approved implantable testosterone pellets for men which can last about 5-6 months. This is a major breakthrough since the pellets need to be implanted 2-3 times a year beneath the skin in the upper part of the buttocks. Obviously, this option of testosterone replacement is new to the market but appears to be a better choice for longer lasting therapeutic results. It also eliminates the need for daily creams, gels, troches and weekly injections. Read More
HCG is FDA approved to treat a low testosterone or Hypogonadism stemming from hypo functioning of the pituitary gland. This is an excellent option for some men who feel taking testosterone replacement therapy is “taking steroids” and they don’t want to be associated with this stigma. HCG therapy is a valid from of testosterone replacement therapy without actually taking testosterone. The dose of HCG necessary to elevate testosterone back to normal levels is 500-1000 units 2-3 times a week. Read More
Clomid is FDA approved for use in women with infertility. Although there is no male indication, it is commonly used by infertility specialists who treats men with low testosterone and sperm count. When used to increase testosterone levels it is used off label, this means it is not FDA approved for this indication. Read More