Testosterone Replacement Strategy (TRS) encompasses the individualized clinical plan for restoring deficient testosterone levels to a healthy, age-appropriate physiological range, primarily for symptomatic men. This strategy requires careful consideration of the patient’s HPG axis status, prostate health, and cardiovascular risk factors. We select the optimal delivery method—injections, gels, or pellets—to maintain stable serum concentrations. The goal is the restoration of anabolic signaling, libido, and mood stability.
Origin
TRS is a long-standing practice within endocrinology and andrology, focusing on mitigating the effects of hypogonadism. “Replacement” signifies supplementing what the body fails to produce adequately. Strategy denotes a comprehensive plan incorporating monitoring and titration.
Mechanism
The primary mechanism involves administering exogenous testosterone to saturate androgen receptors throughout the body, thus restoring anabolic processes like muscle protein synthesis and bone matrix maintenance. Effective TRS requires managing the aromatization pathway to maintain a favorable testosterone-to-estrogen ratio, preventing potential downstream complications. Monitoring hematocrit levels is a critical safety component, as elevated testosterone can increase erythropoiesis via renal erythropoietin stimulation.
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