Testosterone has traditionally been considered the male sex-hormone. It has an essential role in fertility, intra-testicular testosterone is produced by the Leydig cells of the testes. The aromatase enzyme within the testis converts testosterone to oestradiol, which helps facilitate the Sertoli cells in the testes to produce sperm, through a process called spermatogenesis. It is also responsible for development of the male sex-organs and secondary sexual characteristics such as beard growth, chest hair and deepening of the voice.
Testosterone is an anabolic hormone; it helps facilitate muscular development which has led to its prolific use as a Performance Enhancing Drug (PED). This use was once confined to Bodybuilding and professional sports. However, its use is now prolific amongst the general male population. Whether it be wanting a sporting or competitive edge, to having gym-muscles on the beach. Testosterone is everywhere!
Testosterone Deficiency has been a largely ignored medical condition due to a combination of factors. There is a general lack of awareness and understanding within the medical community regarding its importance in overall health. Whilst testosterone is an anabolic hormone, hence its association with muscle growth, its primary role is maintaining function. You are a biological organism, your cells have a finite lifespan, you are using and abusing these cells when you are awake, when you are in a predominantly catabolic state. This is the primary role of testosterone, keeping you healthy. The association of testosterone with bodybuilding has created a metaphorical brick wall when an otherwise healthy-looking man presents to their doctor with concerns regarding his testosterone levels.
This lack of interest and appreciation of how important testosterone is, has led to online providers promoting testosterone as a lifestyle drug.
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Testosterone Deficiency is a medical diagnosis. It is a complicated field of medicine. It takes an experienced clinician to effectively diagnose and manage TD with Testosterone Replacement Therapy (TRT). It’s not simply about replacing testosterone, TRT has a suppressive effect on the Hypo-Pituitary Gonadal (HPG) axis, meaning it suppresses Lutenising Hormone (LH) signalling to the testes, which can result in male infertility. This is one of the reasons why I always recommend Human Chorionic Gonadotropin (HCG) alongside testosterone. I am proud to announce we now have 20 confirmed pregnancies.
TRT should be considered male hormone replacement therapy, with an appreciation that the overall goal is to not only restore normal testosterone levels, but to appreciate the importance of the need to balance other hormones such as oestrogen, dihydrotestosterone, and your thyroid hormones. All hormones are dependent, whether that be direct or indirect. TRT is a journey, choose wisely when deciding about where to obtain your testosterone prescription. I would urge you to choose a doctor-patient relationship, not a sales-consumer relationship, your long-term health depends upon it.
Dr Robert Stevens MBChB MRCGP Dip.FIPT
