testosterone is important for red blood cells bone growth and mood and when the levels start to lower men are generally treated with replacement therapy according to a local doctor it may be better to treat low testosterone levels by restoring the body’s own production of the hormone.
low testosterone in the united states
testosterone is an important hormone for an awful lot of things and traditionally the way we’ve treated men with low testosterone which there are about 13 million men that are diagnosed with low testosterone every year in the United States, as we’ve traditionally given them testosterone replacement getting their body testosterone, the issue with that is in Men that still want to have children and build a family.
testosterone replacement therapy side effects
when we give a man testosterone replacement it fools their body and think they made their own testosterone, so all their signaling hormones telling their testicles to work and think they’re doing a good job, so they come to shut down and the sperm production typically drops as nearly zero because there are other drugs that we can use to stimulate the cells to make more testosterone in a way that’s safe for fertility and won’t compromise that man’s ability to have children so the primary drug that we’ve used traditionally for that is just a pill it’s called clomiphene citrate and it stimulates the cells to work harder.
clomiphene citrate therapy
one of the potential side effects that we can see when we give men direct testosterone replacement is an increase of red blood cell production in the blood vessels called polycythemia to a level that’s higher than normal and when we see that there can be associated risks with that and although you know we can see that with different levels of commonality depending on the modality of testosterone we’re giving that’s the side effect that we tend to worry about and watch closely there’s never really been a good study looking at drugs like clomiphene citrate the ones that are fertility preserving to increase testosterone to see does it have a similar risk of increasing red blood cells in the blood vessels white directest-as sure and replacement does and that was our goal to find out.
does clomiphene citrate do that as well so we had two-armed study where we looked at men on testosterone replacement and Men on clomiphene citrate look at their rises in testosterone and looked at their red blood cell count increase and we found that there was not a significant rise in red blood cells on clomiphene citrate that’s one more important piece of safety data telling us that that’s a good sign to go for men that want to maintain fertility potential with low testosterone so we can get those levels up in a way that its safe for their fertility and we don’t even have to worry about that red blood cell increase and how long have you all been working on this I mean how long has been a question that you know we need to look at this.
more people are watching this so interesting, interestingly we’ve been using clomiphene citrate in men for decades it’s an off-label use so this drug was actually designed for female fertility then we learned how well it works in men and increasing testosterone and way this fertility preserving so we’ve been using that off-label and which continue to use off-label but we have a lot of studies on it over the decades so the drug itself has been studied for an awfully long time but the idea of looking at that red blood cell count increase just hadn’t been investigated until now so it’s been about a year that we’ve done this study and we have patients that have been treated for around a 10-year period that we were able to follow so we’ve got nice long-term data on them showing that that’s not a big risk and that we can feel relatively comfortable and honestly my practice I’ve actually stopped checking red blood cells on the patient’s Uncle machine because we don’t see a rise Wowso when people are watching this right now how can they go about this process what do they need to know,
I think the most important thing to know is when a man has low testosterone is he treated with the right treatment and the important thing for all men to know out there is really if you have low testosterone make sure that you indicate to your doctor was treating you whether you still want to have children or not because if fertility is so important we don’t want to put that man on testosterone replacement that’s actually the biggest take-home I would say we’re just getting more evidence that drugs we can use to preserve fertility in a way that we’re treating testosterone levels to increase them are more and safer now.