Testosterone supplementation is the clinical practice of administering exogenous testosterone to an individual with a confirmed deficiency to restore circulating levels to a healthy, physiological range and alleviate the symptomatic manifestations of hypogonadism. This therapeutic intervention is utilized to improve various clinical endpoints, including muscle mass, bone density, libido, and overall energy levels. Careful clinical monitoring is a necessary component to ensure efficacy and mitigate potential adverse effects.
Origin
The concept of testosterone replacement therapy originated with the isolation and subsequent synthesis of the hormone, making its external administration a viable treatment for male hormonal deficiency. The term “supplementation” emphasizes the goal of providing an external source to compensate for the body’s inadequate endogenous production. This practice is a fundamental strategy in contemporary andrology and men’s health.
Mechanism
The administered testosterone, available in various delivery forms, enters the systemic circulation and binds to androgen receptors in target tissues throughout the body. It also serves as a substrate for two key enzymes: 5-alpha reductase, which converts it to the more potent DHT, and aromatase, which converts it to estradiol. This complex, multi-pathway action modulates gene transcription, driving the necessary anabolic and androgenic effects for maintaining health and well-being.
Testosterone therapy may support brain health by influencing neural structure and reducing neuroinflammation, though direct prevention of neurodegeneration requires more research.
Long-term menopausal hormone therapy for bone health carries risks like cardiovascular events and certain cancers, requiring personalized risk-benefit assessment.
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