Testosterone
Optimization for Men.

Minimize the Symptoms
of Low T

Male Testosterone Therapy in Cincinnati

As part of the normal aging process, our body’s hormonal function slowly declines. In addition, many medications (pain meds, antacids, marijuana, cholesterol lowering meds) and lifestyle factors (sedentary lifestyle, illicit drugs, anabolic steroids and excessive alcohol) and environmental toxins can contribute to suboptimal testosterone levels and symptoms. Other hormones (elevated cortisol and prolactin) can contribute to an imbalance in our Hypothalamic-Pituitary-Adrenal axis, leading to fatigue and weight gain. A man’s testosterone usually peaks in his late teens to early 20’s, then begins to drop by approximately 1% every year. Male testosterone optimization therapy in Cincinnati can be extremely beneficial to a male’s health, as well as help alleviate many symptoms.

Reaching an optimal hormone level

Far too often, a physician will dismiss a man’s concerns regarding testosterone unless his serum level of total testosterone is less than 300 (actually AACE states < 300 on two occasions in a fasting state) . We believe there is huge difference in “normal” vs “optimal” hormone levels.

Studies suggest Testosterone levels <450 are associated with an increased risk of cardiovascular disease. Our goal is to optimize your testosterone which may alleviate many of the symptoms associated with testosterone decline.

Symptoms of Low Testosterone:

  • Weight gain (especially in the abdomen)
  • Loss of libido or interest in sex
  • Erectile Dysfunction / decreased morning erections
  • Fatigue
  • Irritability / anxiety (“grumpy old men” syndrome)
  • Joint aches and pains, muscle stiffness
  • Loss of muscle mass
  • Decreased drive and ambition
  • Depression, low mood

Possible Outcomes of
Optimized Testosterone Therapy

 

  • Increased mental and physical energy
  • Improved libido and sexual satisfaction
  • Healthier physique
  • A better sense of well being
  • Decreased fat, improved lean muscle mass
  • Increased bone mineral density, protect bone health
  • Decreased cholesterol, improved cardiovascular health
  • Improved cognition, studies to suggest prevents Alzheimer’s disease
  • Decreased inflammation

Hormone Treatment Options

Our practice offers several options for testosterone optimization or replacement. Testosterone can be delivered via topical creams, injections and subcutaneous inserts (pellets). Testosterone therapy in Cincinnati may decrease sperm production, potentially permanently. For this reason, men desiring future fertility or even those with just a relative androgen deficiency and not quite ready for testosterone therapy, HCG and/or Clomid may be a better option. Each delivery method has advantages and disadvantages that are discussed in detail during your consultation.

Treatment Option 1 Treatment Option 2 Treatment Option 3 Treatment Option 4

Testosterone Pellet Therapy (Subcutaneous Implants)

Testosterone pellets are placed with a local anesthetic, through a 5 mm incision in the hip or love handles. The procedure is done here in our office by one of our doctors in about three minutes and is relatively painless. You will leave the office with adhesive tape covering the wound, this will be removed in four days. Benefits are usually enjoyed within three weeks and last for approximately 4 to 6 months in men. We ask that you do not participate in any intense exercise for 2-3 days, as well as avoid soaking in water (bathtub, swimming pool) for 3 days.

 

 

 

 

Advantages include:

  • Testosterone is delivered in a slow and steady fashion
  • Mimicks the body’s inherent physiology
  • Superior results
  • Enhanced compliance (insertions only 2-4 times a year)
  • No risk of transfer of hormones to family members
  • Hormone Levels monitored via blood-work

Testosterone
Injection Therapy

Testosterone injections are self-administered (2-3 times a week) into subcutaneous tissue (typically the belly or “love handle”) in the comfort of your own home.

 

 

Advantages include:

  • No downtime due to pellet insertion procedure
  • Mimicks the body’s inherent physiology
  • Superior results !
  • Little or no pain at the injection site
  • Hormone levels monitored via blood-work
  • No risk of transfer of hormones to family members

Bioidentical Hormone
Cream Therapy

Testosterone cream is self-administered on a daily basis to the skin in the comfort of your own home.

Advantages include:

  • No needles or procedure required

HCG (Human Chorionic Gonadotropin) and/or Clomid

HCG is a hormone that is produced by the placenta during pregnancy. However, it can be used off label to help maintain testisticular size and reduce the decrease in sperm count that occurs with testosterone therapy.

HCG has also been shown to increase the amount of testosterone your body makes without the side effects of testosterone replacement therapy. HCG is primarily used in men who have suboptimal levels of testosterone along with symptoms of low T who want to preserve their fertility (sperm count).

 

 

HCG can also be used for men with suboptimal levels of testosterone and symptoms of low T who aren’t ready for testosterone therapy due to personal choice or because their testosterone only needs a small boost.

HCG is given via injections twice a week.

Clomid is an oral medication FDA approved for use in females to treat infertility. Clomid use in males is considered “off label.” Clomid works by blocking a male’s estrogen receptors in the hypothalamus, thus “tricking” the hypothalamus to release more GnRH (gonadotropin releasing hormone), which in turn increases LH and FSH release from the pituitary.

 

 

 

This results in increased Testosterone and sperm production, thus maintaining and enhancing fertility.

The advantage of this treatment approach is that it does not impair fertility and is a good option for younger males who wish to maintain or enhance fertility. A disadvantage is that not every patient responds to this therapy.

Clomid is an oral medication taken two to three times weekly.

 

 

Hormone Program Process

Procedure Process

What to expect during your hormone program?

Step 1 Step 2 Step 3 Step 4
Step 1

The Consultation

Your initial consultation with one of our physicians for Male hormone optimization therapy in Cincinnati will begin with a thorough look into your past medical and surgical history, family history, and current medications, with specific attention paid to the symptoms you are struggling with.

Step 2

Blood Tests

Next, we will obtain several blood tests to look at your free and total testosterone levels, other hormones which can contribute to endocrine disruption, and serum markers to get a better picture of your overall health (a complete blood count, complete metabolic panel, CRP-hs, lipid panel, HbA1c for blood sugar, and vitamin levels). Typically, this blood work is done in a fasting state. We encourage patients to bring in any prior blood-work from the past year to decrease costs associated with repeating the tests.

Step 3

Treatment

We will see you back in the office in 1 to 2 weeks, review your test results and initiate therapy if appropriate. We discuss the options of route of testosterone optimization including creams, injections and pellets and the pros and cons of each method. For those men who desire future fertility or not yet a candidate for testosterone therapy, we will discuss other means to “boost” your own production of testosterone such as HCG injections and/or Clomid. Diet, exercise, and optimal supplementation are all discussed as an important part of hormone optimization in Cincinnati.

Step 4

Follow Up Appointments

We recommend checking hormone levels periodically to monitor your response. We anticipate a face-to face office visit every 4 to 6 months while on testosterone replacement/optimization. Periodic blood work is a mandatory component of testosterone optimization in our practice.

Results

Most men start to notice improvement in symptoms at 3 weeks after starting therapy with an improvement in libido at that time. Overall sense of well-being, mood, and quality of life usally occur at 3-4 weeks after initiation of therapy. Changes in erections/ejaculations may require up to 6 months to notice an improvement. Improvements in lipids, CRP-hs (marker of inflammation) and visceral fat usually occur after 6-12 months of therapy. Individual results may vary based on response to therapy.

 

If I optimize my testosterone, will all my symptoms resolve?

It’s not always that simple. Our practice strives to optimize all aspects of your hormones: thyroid, insulin, adrenals (cortisol,DHEA) and growth hormone. There are several lifestyle factors that are essential for optimized health.

Things to consider for optimal results are:

  • Sound Sleep (7-8 hours/night)
  • Regular exercise
  • Appropriate Supplementation, Micronutrient Evaluation
  • Stress Management and Treatment of Adrenal Dysfunction (cortisol and DHEA)
  • Regular Bowel Movements (1-3 times/day)
  • Clean Eating
  • Elimination of food sensitivities
  • Periodic detoxification (2x/ year)
  • Optimal Thyroid function
  • Optimal Growth Hormone function
  • Optimal Insulin function

If testosterone optimization does not give you the results you desire, we have structured our practice and tailored our training to provide you with a comprehensive evaluation of health and wellness. We will work with you to reach your desired goals. From our wellness coach who specializes in nutrition and weight loss, to our medical providers who integrate both traditional and functional medicine, our goal is to approach your health care from a holistic perspective. Our goal is to give you the most complete care in the areas you may need.

Additional Information
Testimonials FAQ's Disclaimer
Testimonials

"So happy for this reat place of healing. My 31 year old son just had his hormones tested and was super low. He is going to get the testosterone pellet on Tuesday. He can’t wait; I can’t either."

Ann M.
FAQ's
Is testosterone therapy covered by insurance?

The initial consultation and associated blood work is billed to your insurance company for Male Hormones in Cincinnati. Otherwise, ongoing therapy testosterone optimization therapy in our practice is not covered by insurance. However, when compared to the cost of treatment for the conditions of low T lessens and prevents, it is very cost effective.

What are the Side Effects of Testosterone?

Supraphysiologic testosterone levels can cause side effects. Potential side effects of treatment are discussed in depth during the consultation process. Side effects are dose related and can include: acne, oily skin, and increased body hair growth, smaller testicles, decreased sperm production, water retention, nipple tenderness (due to estrogen conversion), and scalp hair loss. In short, too much of a good thing can be detrimental. Decreased testicular size and sperm count can occur, for this reason occasionally testosterone will be combined with HCG. Increased red blood cell count (hemoglobin and hematocrit), known as erythrocytosis, can also occur and may require modifications in therapy. You will be monitored closely for development of side effects with periodic visits and blood work.
There are also potential side effects with each route of administration. For example, with pellet therapy , there is a risk of pellet extrusion, infection at the insertion, and bruising/soreness from the procedure. Testosterone/HCG injections can lead to some induration/scar tissue at the injection sites that is best treated with a foam roller at home. Creams can be transferred to family members and pets, and absorption through the skin is often inadequate to impact symptoms of low testosterone.
Although the evidence does not suggest there is an increased risk, men who have been diagnosed with prostate cancer should not undergo testosterone replacement until they have consulted their urologist and/or oncologist.

What is the data regarding the safety and efficacy of Testosterone Replacement?

There have been several concerns raised regarding Testosterone safety, especially in the media. These concerns range from cardiovascular disease and blood clotting, to prostate cancer and efficacy of T replacement. On October 1st, 2015, an international expert consensus conference regarding T deficiency and its treatment was held in Prague, Czech Republic. The meeting included experts from Men’s Health Boston and Harvard Medical School, as well as international representatives from the medical field.
The consensus reaffirmed the safety and efficacy of Testosterone replacement. Some of the highlights of the consensus resolutions include:
1. Symptoms and signs of testosterone deficiency occur as a result of low levels of T and may benefit from treatment regardless of whether there is an identified underlying etiology
2. The evidence does NOT support increased risks of cardiovascular events with T therapy
3. The evidence does NOT support increased risk of prostate cancer with T therapy
This article can be read in its entirety at http://dx.doi.org/10.1016/j.mayocp.2016.04.007

Disclaimer
The term "bioidentical" means the hormones in the product are chemically identical to those your body produces Several hormone therapy products approved by the FDA and prescribed by health care providers contain bioidentical hormones. Testosterone products a( such as Androgel, Depo-Testosterone and Testopel) are FDA approved ONLY for use in men who lack or have low testoerone levels in condjuction with an associated medical condiation (genetic problems/chemotherapy/brain problems). Compounded hormones are not FDA approved and have not been evaluated by the FDA. Statements on the webpage relating to testosterone optimization therapy have not been evaluated by the FDA . Compounded hormones are are not intended to diagnose , cure or prevent any disease. Compounded hormones may be produced in doses and forms that differ from those in FDA approved products. Individual results may vary.

Take our free hormone symptom questionnaire.

Do you think your testosterone levels are causing your negative side effects? Use our questionnaire below to determine if you’re a candidate for testosterone hormone therapy.

Questionnaire

It's simple— identify the problem areas of your body and we will recommend the right treatment plan for you.