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Michael A. Werner, M.D., FACS:
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Therapy for andropause is often very effective. The goals of treatment include restoration of sexual functioning, increased libido, increased sense of well-being, prevention of osteoporosis by optimizing bone density, restoration of muscle strength and improved mental functioning.
Biochemically, androgen replacement should aim not only to reach normal levels of serum testosterone, but also to normalize levels of those secondary hormones that are affected by testosterone levels. These include DHT and estradiol.
Current treatment options include oral tablets or capsules, injections, plantable long-acting slow release pellets and transdermal (through the skin) patches and gels. However, at this point, the vast majority of testosterone replacement is done through the skin. This method has a number of advantages:
- It is easy to apply.
- It is relatively safe with low incidence of side effects.
- It more closely mimics the natural daily rhythm, with higher levels of testosterone delivered in the morning and decreasing levels delivered as the day progresses.
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