Do men need testosterone replacement therapy? Phoebe discussed some women’s issues in a previous episode about hormone replacement for Women. Gentlemen, today it’s your turn to get the low down on low Testosterone.

https://youtu.be/Biv3I7YPIYA

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Outline

  1. Reasons:
    1. Reported benefits:
      1. Libido, body fat, muscle, mood, energy, bone density, and quality of erections, erectile dysfunction
    2. Testosterone’s purpose
    3. May prevent issues as we get older
    4. Less indication for “healthy” men
  2. Methods:
    1. Pellets – painful, less fat, scars
    2. Injections – less painful
      1. 2 weeks – big dose, taper off over time, intramuscular
      2. 1 week – less highs/lows, easier to remember, traditionally intramuscular
      3. Daily – It’s a routine, less painful, subcutaneous
  3. Testing
    1. Before for baseline
    2. After a month or so to see your levels
    3. Annual testing once the dose is sorted out
  4. Side effects
    1. Acne, hair growth, sleep apnea
    2. Increased risk of Heart attacks, stroke
    3. Reduced sperm production
    4. Estrogen, resulting in breast tissue, and prostate enlargement
      1. Testing for estrogen
      2. Estrogen blocker
  5. Cautions
    1. No long term testing – benefits / Risks
    2. “For those who have low testosterone levels but no symptoms, treatment isn’t recommended. It’s also not recommended for those whose levels are low because of aging.”

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Testosterone therapy: Potential benefits and risks as you age

Is Testosterone Replacement Therapy Right for You?

260 ‒ Men’s Sexual Health: why it matters, what can go wrong, and how to fix it

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Transcript

Gentlemen, today’s your day to get the low down on low testosterone.

This is very important to understand, as there are some serious risks to taking testosterone if you don’t need it.

Welcome to Swinger University. I’m Phoebe. And I’m Ed. Join us as we explore the exciting world of ethical non-monogamy, sexual health, and sex education with an intellectual and sexy twist. Remember to subscribe to our podcast and YouTube channel. Be sure to join our Patreon community for the behind the scenes stories and extra sexy content. If you like our show, do us a favor and tell a friend about it. We hear all the time how our podcast helps others. So in the spirit of swinging, please share. One of our listeners commented, “You two are the best. You two are the most intelligent pair on the subject. You do your homework regarding swinging.” Thank you. Thanks, Bob. We love you. So why should you start taking testosterone as a hormone replacement if you’re a man?

Well, some of the symptoms that you should be looking for would be drop in libido, muscle strength and mass issues, your mood, sleep problems, your workout recoveries, not recovering, bone density, the fat distribution in your body, and sperm production.

Some people will purport that it helps with erectile dysfunction. Not so much from all the research that we did. It does help with low desire and libido, but that’s different than ED. How much of it is just a sales pitch by somebody and that’s trying to make a quick buck versus legitimate? You know? It’s both. So there are people with these symptoms that really should consider taking testosterone, but you need to work with a very reputable doctor in order to determine whether in fact you have low testosterone or not. And that’s the tricky part. Much like the experience that you had with hormone replacement, going to just any doctor that’s advertising on the internet or at your local gym or wherever and saying, “Hey, I’m having trouble recovering from my workouts.” Well, you should take a healthy dose of testosterone. Probably not a good idea. Let’s get into how you started taking it.

Yeah. Well, we had several friends who were in the lifestyle and they started recommending it. So a little bit of peer pressure was involved. They purported these huge benefits of taking testosterone. And I was like, “I want a huge benefit.” But there’s also this sales pitch that we had heard about staving off future problems in these symptomatic areas. And that was really the part that caught our eye. The fountain of youth and the… Well, in preventative health, right? I don’t want to go in when I have a health issue and then try and fix it. I’m a hundred percent in terms of how do I prevent getting sick in the first place? I don’t want to have these issues. So we went in for a two for one deal when you went in to get your hormone replacement consult and they were doing a discount. And I said, “Well, it’s basically free and everybody says it’s a great thing. Maybe I should do it too.”

That was potentially a huge mistake on my part. So it went from a huge benefit to a huge mistake.

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And one of the things that should have set me off at the very beginning was we don’t know that it’s bad. We haven’t seen any bad side effects from it. So what’s the harm in taking it? Because we think it prevents these other things. That’s the problem. There are no long-term studies talking about these benefits and these health preventative benefits. What’s the process? If you have those symptoms, go get tested. And they do the testing before you start treatment so that you have a baseline. They want to know what your free testosterone levels are. And they test you after you’ve been on the testosterone for a month because they want to see where your levels have risen to to see if they got the right dosage. And once they get you where they think you should be in terms of your levels, you go in annually to make sure that your body hasn’t adjusted or compensated or every six months to make sure that they still have the dosage right. This is where it gets complicated. So only 2% of the testosterone in your body is free testosterone. That means it’s floating around in your bloodstream. All the rest of the testosterone is locked up in the cellular processes that are going on in your body. Free T, as I’m going to call it, is what correlates to those symptoms. So if you have low free testosterone, that’s probably why you have some of those symptoms. Here’s the real problem. You’re a 50-year-old man and you go in and you get tested and you say, “Hey, doc, what should my testosterone levels be?” And the doc will say, “I have no idea.”

If they tell you anything different, they’re making it up. Because at this point, there’s only data for anybody who’s a man over the age of 18. That means that 18-year-olds, 20, 30, 50, 80-year-olds are all lumped together into a giant glob of data. They have no direct age to testosterone levels data. So they have no idea what your specific testosterone level should be. They can generalize, but that’s a big generalization. That’s interesting. Even women have an age range data indicator. Right. Your 20s and 30s and then your 40s, your pre-menopause and then your menopause and post-menopause, we have all that data for our testosterone, actually. There have been more studies, apparently, for women than there have been for men. Interesting.

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So let’s get back to this 2% testosterone, this free T. What happens in your body when your testosterone increases? That floating testosterone, if it’s past your 2% level, your body starts producing something called sex hormone binding globulin, or SHBG. It produces more of it to absorb the testosterone above the 2%. So if you’re taking it beyond the 2%, your body’s fighting to get rid of it at the exact same time. Interesting.

Hence the complication of hormone. Hence the complication. And the other question that a lot of doctors try to figure out is, this free testosterone, is it being used well? So let’s say you do have 2% floating around. If the androgen receptors in your body are already saturated, in other words, there’s testosterone already on them, adding more than the 2%, they can’t be absorbed by the body. They can’t be utilized. Why? Because you’re full. It’s like topping off your gas tank. Once the tank is full, the tank is full.

Yeah. Interesting. Yeah. I was watching an interesting interview with Dr. Kara, Mohit Kara, and there were two doctors that were discussing testosterone. They were going back and forth, and both of them concluded that if their patients don’t have symptoms, in other words, that big list of things that we talked about at the beginning, they don’t treat with testosterone. They just don’t find it effective. They don’t think it is successful, and the risks outweigh any of the potential benefits. What if you’re growing muscle mass? Would you be using it? You think you would be. You would, but your body’s already producing the 2%, and if it’s being absorbed by those androgen receptors, then where’s the excess going to go? It’s not like your body can absorb more. And your muscle building, which I’ll talk about, because I think muscle building is probably the big thing that a lot of men who are listening to this are thinking about, especially with testosterone. Because I’m thinking, doesn’t your muscle just suck it up? It does, but it’s already in your metabolic, the molecular structure of your body. It’s already got a bunch of testosterone for doing a lot of that kind of stuff. So the free tea is just what’s left. And like I said, it’s 2% of all the testosterone in your body. So it’s not that high a percentage. Interesting. Okay, let’s talk about some of the methods. We talked about women and how they take hormones. You can ingest them orally. Men, not so much with testosterone. Two reasons.

The quantity of testosterone that men have floating around in their body is pretty high. Like we absorb a fair amount of testosterone because we have a lot of it floating around, a lot more than women have, because it’s our primary hormone. So the prescribed methods that work really well for men are patches and gels. Although I would say that anything that you’re applying to your skin, there’s a lot of side effects with that. If you’ve got lotion or a lot of hair or you don’t rub it in really well or you don’t use enough, right? Like the dosage is pretty like you’re squeezing lotion out onto your hands. Yes. And it’s messy. I lived with someone that was prescribed the gel lotion and it was massive amounts of quantity on the inner arms and thighs. And it was just, it was sticky and messy. Every day it was a pain in the, to like apply and you can’t touch anything. And you can’t touch your partner, which is another really important thing to consider. You don’t have to wait until it’s fully absorbed. Otherwise, your partner will absorb that testosterone and you don’t want your lady friend, if you’re in that kind of a relationship, absorbing testosterone. Now, if you’re a guy, not necessarily as big a deal, but if they don’t have symptoms, then you’re giving them testosterone and they don’t need it. So regardless of what your sexual orientation is, you shouldn’t be sharing your dosage with your partner. It was annoying, I will say, because even when it started to get rubbed on the thighs and I was nervous about the toilet seat. Right. Because transfer. Right. What happens with myself, Tanner? It’s fricking everywhere. You get it on you if I don’t wipe down the seat. Yeah. Little orange paste. Ed with a little orange.

It’s funny. I can’t help but think it rubs the lotion or else it gets,

let’s talk about the next method for administering testosterone. And this is the method that I started with and it’s pellets. They have some nice benefits to them. I’ll, I’ll, I’ll kind of talk about the benefits first and then I’ll talk about the cons. One, the pellets are a time release capsule. They’re injected into your fat deposits, usually in your side, at least that’s where it was on me. Um, if, and the, the nice thing is it’s you do it once and every four months, three, three to four months, three to four months, you get injected and every three to four months, you can go back and get a new pellet because it slowly absorbs into the body over that time. And when you get low, you refill downsides. Men typically have less fat in their body and getting an injection into your tissue. And it’s, it is not a painless process. They’re basically shoving a large gauge needle, a very large gauge needle into your side. And then they have to butterfly suture it back together. You end up with a whole bunch of neat little half moon scars, wherever they do the injections. And it hurt me probably for a good two, three weeks I was in pain. So sleeping is awkward. Um, it, it’s just not a comfortable process. I, I did not like it at all.

And I have tattoos, so I’ve, I, and I have a high threshold for pain typically. And it’s more challenging for men who have a more thinner physique because there is less fat, right? To, to tap into and that skin is thinner. It’s closer to the muscle. And so it’s not, it’s not enough padding to hide it. So if you think back to the symptoms and you think to what your physique looks like, if you’re not having the fat deposit issues or the muscle building issues, because you’re a fit person, you should really think twice about why you would need a pellet because you already have lean body mass. Okay. I’m still not like, I’m still have questions about the muscle building, but we’re going to go. We’ll get into that. Okay. Injections. And this was the method that I finally settled on after doing the pellet the first round, um, didn’t want to go back, had needle fear. So what did I do? I chose a hypodermic needle injected every single day for a very small dosage of testosterone. Traditionally, testosterone is administered every two weeks. It’s a large dose or a larger dose, and it tapers off over those two week period. And then you go back in and you get another shot. One of the downsides with the two week version is that it’s intramuscular. So it’s a fairly large gauge needle and it goes straight into your muscle tissue.

That hurts. But because you’re only doing it every two weeks, maybe it’s not so bad.

The traditional method nowadays is one week injections. And a lot of people do that because it’s easier to remember because you only have to do it once. And so it’s like every Monday, you, you do the injection and the ups and downs. In other words, that taper off period, and then the injection, it’s a little bit more regular. So it’s not as a high, a high, and a low, a low, you, you kind of maintain a steadier level, but it’s still intramuscular. So it’s still painful. I took a route of daily injections, which were establishing a routine. So every morning I would get up, uh, it’s a much smaller dosage. It’s less painful because it doesn’t go intramuscular. You can inject it kind of into the fat deposits that you have on your side. Um, so it’s just subcutaneous and those small bumps every day, keep a pretty steady stream of testosterone in your system. Okay. So what are some of the side effects? Acne, hair growth, sleep apnea. Those are all pretty common symptoms, uh, or side effects. The hair on your legs is massive now. Yeah. I got my hair. My legs got very hairy gorilla and the back of my neck kind of where my hairline is.

I have to shave that now more frequently, like every couple of days, which I didn’t have to do before. That’s going to dissipate. I hope so. And that’s, we’re going to talk about why it might disappoint, dissipate. Uh, here’s some more serious side effects. Cause you know, a pimple here and there. Um, although if you are prone to acne, your acne could be pretty severe. So it’s almost like going through puberty again. If you had mild acne, when you were a teenager, you’d probably have the same level of acne. So what’s the acne on some guys backs? That’s from steroids. Oh. And it’s a very similar side effect. Uh, shrinking of the testicles, acne on the back, but steroids are a different thing than testosterone. There’s more to it than that.

The more serious side effects, increased risk of heart attacks and stroke. So clotting and brain.

That’s a pretty serious risk. Now, this is with pretty high levels of testosterone. I mean, you’re, you’re pushing. I didn’t look at the exact risk percentages, but just knowing that you don’t need it. And this is a potential side effect. You should really question whether the benefit is worth the risk. Got it. Even if it’s a small percentage, if you’re not, if you’re not going to get a benefit from it, why would you take that risk? Got it. Here’s another more serious risk or side effect, reduced sperm production and your testicle shrinking, which I talked about happening with steroids. Testosterone does the same thing because your testes are where you produce some of the testosterone. So if you introduce an artificial source, your natural source of testosterone does it’s like, Hey, I can take the day off. I don’t need to produce anymore. Exactly. If you were trying to have a baby and you need to be fertile,

this may prevent you from having a baby. This may prevent you from being fertile.

So younger men be very, very cautious about taking testosterone if you don’t need it, because you’re risking that relationship with your wife and your happiness and all the things that you set out for goals with family. Here’s another side effect, estrogen. So the, some of the testosterone does get converted into estrogen and high levels of estrogen will cause the growth of breast tissue and really important prostate enlargement, which puts you at risk for prostate cancer, which is not good. It’s very fast growing cancer and it will probably kill you. So if you don’t need it, if you don’t have symptoms, your body can become dependent on it because you don’t need it. It starts shutting down your natural production. And now your body may actually become dependent on this artificial source. Right. Interesting. Hmm. Yeah. Taking too much of it will also rob you of sleep. So you’re, you’re amped up, you’re juiced up, your metabolism is up, which is probably why the fat production goes down when you’re on testosterone and helps with the muscle building because your metabolism is up. Right. But lack of sleep causes all kinds of other side effects like not being able to recover. So if you’re taking too much testosterone, you’re not helping your muscle recovery because you can’t sleep. Ha ha. What are their cautions?

This really speaks to the long-term benefits issue. There’s no long-term testing. They haven’t looked at it. If you look at the data that we talked about at the beginning, where it’s 18 to to death in terms of the data being all glommed together, they haven’t done enough studies on this. They haven’t really looked at whether or not there are long-term benefits to this. So you’re taking a pretty big risk that someone is telling you that there are benefits, even though there are no studies for it. For those who have low testosterone levels, but no symptoms, treatment isn’t recommended. It’s also not recommended for those whose levels are low because of aging. Now that’s a key quote from Dr. Mohit because a lot of people are taking testosterone as they age because they’re trying to get back their youthful vigor. If a man has symptoms of low testosterone and has a testosterone value of less than 300 nanograms per deciliter, 300 nanograms per deciliter, he should consider starting testosterone replacement therapy, and that’s Dr. Cara. So once again, two criteria. You actually have low testosterone and you have symptoms. Most important thing, don’t fall for the hype.

What are some of the preventative steps? A lot of the symptoms that are in here that I think men are mostly concerned about, which is building muscle and staying youthful and preventative things. That’s what sold me on the whole thing. You can actually get those benefits

with diet, exercise, and sleep. Now those things require work, although sleeping

requires more discipline than work. Those three things will give you the benefits that you’re looking for from testosterone and they don’t require a prescription. So I’m going to talk about

my personal story because I’ve mentioned a few times that I’m not on testosterone anymore, testosterone replacement. I started reevaluating my usage when Phoebe started doing her research and figuring out why the benefits weren’t necessarily everything that they were touted to be. So I of course said, “Gee, I wonder if I got sold the same bill of goods. I wonder if I’m taking something that I don’t need to.” I wasn’t having libido issues. And so for me, it was all these long-term preventative things. I did see some muscle growth, but honestly, the muscle growth that I saw was also directly correlated to me exercising more. So yeah, the testosterone could have helped, but just working out more regularly would have also helped. Then I did some digging. So when I was researching this episode and I started listening to some of these other interviews with doctors and some of their test results, I went back and looked at all of my test results from 2015 to 2022 when I first started the testosterone process. In 2015, I had a free testosterone level of 1.98%. So right at that 2% mark. In February of 2022, where I thought I might have low testosterone, my levels at 1.51%. So I started the low T, the treatment for testosterone, thinking that that would help. And it did go back up. It went up to 2.09% in March of 2022. And then in July, I was way up there at 2.67%. But in thinking about it and looking at these numbers, even at 1.5%, that’s not really that low. And I looked at the other numbers that I had and my non-free testosterone levels were fine. So I wasn’t really suffering from low testosterone. Now hearing all of these numbers and statistics from my health doesn’t necessarily mean that you shouldn’t take testosterone. Once again, if you have the symptoms and you work with your doctor to determine whether you need it or not, you should consider it, especially if you have a health need. One of our listeners, Watchers on YouTube had a comment, Ken of Ken, and his results with taking testosterone aligned with what I had researched. And really, he’d seen some benefits. Some of these symptoms were alleviated for him. So Ken had a key quote that I want to pull out here, which is, “Don’t believe all the hype. It won’t restore you to your 25-year-old self.” And that’s important to remember. You can’t think of this as some cure-all or miracle youth serum. It’s not going to turn you into a 20-year-old. And those long-term benefits that a lot of people are trying to sell you on, we don’t know that those are true. So be very careful. We hope you gained a little more knowledge about hormone replacement for men. You can benefit from our research and experiences to help make a more informed decision for yourself. For more facts and a deeper dive, check out our blog on this subject. And if you want to review the lady side of hormone replacement therapy, check out our episodes for women. Thank you for tuning in, and we appreciate you joining our community. Don’t forget your homework. Tell a friend about our show and leave a review and comment. You can also leave us a voicemail at 916-538-0482 or contact us at swingeruniversity.com. Keep learning, keep growing, and keep it sexy.

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