Using Hormone Replacement Wisely
If a man chooses to pursue hormone testing with the intention of using testosterone supplementation (available orally or as an injection, implant, or skin patch), he should keep several facts and precautions in mind (Rhoden EL et al 2004; Schaeffer EM et al 2004):
* The patterns and trends over time of multiple hormone levels (such as free testosterone, total testosterone, and estrogen) determine the specific hormone replacements required.
* It is not safe to use large amounts of testosterone in any form.
* Hormone replacement should not be initiated without comprehensive testing.
* Because of the risk of worsening prostate cancer, careful screening for prostate cancer, including a digital rectal examination and prostate specific antigen (PSA) screening, must be done before starting any hormone replacement program.
* Certain conditions are contraindications to hormone replacement (Ebert T et al 2005). Prostate cancer, in particular, can be made worse by increasing available testosterone.
* A man who is contemplating taking hormone replacement, whether through a prescription or through supplements, should work closely with a qualified physician to plan a rationale approach to treatment and continued monitoring and screening.
