Testosterone replacement therapy more than just a shot

 We  will work with you to develop a TRT plan that fits you . There are a variety of types of testosterone and delivery  options.  Injections are the most  effective method of TRT.  Frequency and  tissue depth (muscle vs subcutaneous ) can be adjusted  and tailored to your preferences and tolerance. We can give you your injections but it is easy to learn  and do at home yourself.

Topical creams/gels work well in most men and avoid the need to have an injection. 

Testosterone pellets  are another option for testosterone replacement and have their own advantages and disadvantages. We will discuss the various options with you to develop a personalized testosterone replacement plane. 

 In the context of TRT, clomifene works as a selective estrogen receptor modulator (SERM). It functions by blocking estrogen receptors in the hypothalamus, which prevents negative feedback from estrogen. This action leads to an increase in the release of gonadotropin-releasing hormone (GnRH). The increase in GnRH stimulates the pituitary gland to release more luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which in turn stimulate the testes to produce more testosterone.

Clomifene is often considered for men who have secondary hypogonadism. It can be an attractive option because it can increase endogenous testosterone production without suppressing spermatogenesis, which is a common side effect of traditional TRT.

In the context of TRT, enclomifene works as a selective estrogen recepto modulator (SERM). It functions in the same way as clomifene. It is actually and isolated component of clomifene that has a more targeted approach. This can result in potentially less side effects than clomifene and may be a better option for increasing testosterone (in the the absence of TRT) than clomifene. It is effective in reducing testicular atrophy in TRT. If used as an alternative to TRT the increase in testosterone levels is not as significant. 

Sermorelin is a synthetic peptide that mimics a segment of growth hormone-releasing hormone (GHRH), which is sufficient to stimulate the pituitary gland to produce and release more growth hormone (GH). This action can help increase the levels of growth hormone in the body, which can has a variety of benefits including improved body composition.

Human Chorionic Gonadotropin (hCG) can be used in TRT to help maintain or restore testicular function and fertility in men undergoing TRT. TRT can suppress the body's natural production of testosterone and reduce sperm production, leading to testicular shrinkage and infertility.

hCG mimics the action of Luteinizing Hormone (LH), which stimulates the testes to produce testosterone and sperm. By including hCG in a TRT regimen, it is possible to maintain testicular size and function, potentially preserving fertility. This approach is especially beneficial for men who wish to maintain their fertility while on TRT.

In testosterone replacement therapy aromatase inhibitors are sometimes used to manage elevated estrogen levels. Aromatase is an enzyme that converts testosterone into estrogen, and its inhibitors can help prevent this conversion, thereby maintaining a more favorable balance between testosterone and estrogen levels. 

There are multiple aromatase inhibitors however typically anastroloze is used. It is effective in reducing estrogen levels, which can help mitigate side effects such as gynecomastia (enlargement of breast tissue in men).

The use of aromatase inhibitors in TRT should be carefully managed as excessively low estrogen levels can lead to negative side effects such as joint pain, mood changes, and decreased bone density. The decision to use an aromatase inhibitor, and the specific choice of inhibitor, should be based on individual patient needs and monitored with regular blood tests to ensure hormone levels remain within a healthy range.

Estimated 30 million men in the U.S. struggle with ED. Erectile dysfunction can be a sign of serious underlying vascular disease, heart disease, high blood pressure etc. Many times there are easily reversible causes such as changing medications, increasing activity levels, managing depression

Common symptoms related to erectile dysfunction:

• Unable to achieve an erection
• Partial erection
• Unable to keep an erection
• Having a reduced or no sexual desire
• Low self esteem
• Relationship stress
• Anxiety

Men are  probably most familiar with a class of drugs called PDE-5 inhibitors eg. sildenafil (Viagra), tadalafil (Cialis). They have been established as the gold standard in the treatment of erectile dysfunction. 

Frequently as low testosterone is treated many sexual problems such as low libido and erectile dysfunction improve. However, if symptoms persists, we offer treatment to optimize performance as needed. We offer these and they are dispensed from our in-house pharmacy

SSRIs have also been found to be effective in treating premature ejaculation (PE), a common sexual dysfunction characterized by the inability to control ejaculation and achieving orgasm sooner than desired. SSRIs can delay ejaculation by increasing the serotonin levels in the brain, which helps to inhibit the reflex that triggers ejaculation.

SSRIs can health treat erectile dysfunction if there is a psychosomatic component where stress, anxiety or depression are involved. 

Conversely, SSRIs can also cause delayed ejaculation and erectile dysfunction. it is important for a complete review of current medications and health history. 

We do offer select SSRI's for as needed treatment of premature ejaculation from our in-house pharmacy 

Minoxidil is a medication that is commonly used to treat hair loss and promote hair growth in both men and women. It is available in both topical and oral forms and works by increasing blood flow to the hair follicles, stimulating hair growth. 

We can assess you to see if you are an appropriate candidate for treatment. We offer both the oral (dispensed on-site) and topical forms. 

Finasteride is a medication commonly used to treat male pattern baldness by inhibiting the hormone responsible for hair loss. It has been shown to be effective in slowing down hair loss and promoting hair regrowth in some individuals. While effective it can also lower testosterone so dosing adjustments may be needed. We can work with you and see if you are a candidate and optimize in conjunction with your TRT.