Testosterone Treatment for Men With Head Injuries

If your brain has been injured by a stroke, heart attack, or trauma to the head, your hypothalamus and pituitary glands may be damaged, causing a significant drop in testosterone. Testosterone replacement therapy may be prescribed by your doctor to prevent bone loss, increase muscle mass, and improve red blood cell production.

"According to the Digital Urology Journal, successful management of testosterone replacement therapy requires appropriate evaluation and an understanding of the benefits and risks of treatment (see References 1)."

Symptoms

• Low levels of testosterone can cause fatigue and depression, depleting your energy level. If you experience decreased sexual function, poor concentration, or unusual irritability, you may benefit from testosterone replacement therapy.

Diagnosis

• Your doctor will perform a physical examination and take your medical history.

  A total testosterone blood test, and urine or saliva testing will be performed by the lab, to determine current testosterone levels, and to decide what treatment is necessary.

Treatment

• There are potential risks with any therapy, so consult with your doctor to decide the best treatment option for you. Possible treatments include injections and patches.

  Injection: The patient comes into the doctor's office every two to four weeks, and receives a testosterone shot into the muscle. Between injections your testosterone levels may vary greatly, causing mood swings.

  Transdermal patches: A patch delivers a testosterone-containing gel through the skin at controlled intervals. Each day you apply the patch to a different part of the lower abdomen, upper arm, or shoulder. Patients wear the patch for 12 to 24 hours, and can keep the patch on while bathing or engaged in heavy exercise. Side effects may include itching and irritation at the application site, acne, fluid retention, and some men will have temporary abnormal breast development.

  Buccal testosterone patch: Prescribed by your doctor, buccal testosterone comes in the form of a tablet-shaped patch, and should be applied twice daily to the left and right incisors of the upper gums. (the teeth just to the left and right of the two front teeth). The patch should be applied every 12 hours, alternating sides with each dose. As the buccal testosterone patch softens and molds to the shape of your gums, medication will gradually be released. Any part of the patch that hasn't dissolved within 12 hours should be removed from your mouth. Brushing your teeth, chewing gum, eating or drinking are permitted while you're wearing the patch, but check your gums after these activities to make sure the patch is still in place.

  You may experience headaches, gum irritation, or a bitter taste in your mouth the first two weeks of treatment. If you experience difficulty breathing or urinating, yellowing of the eyes, vomiting, or swelling of the hands, feet, ankles, or lower legs, call your doctor immediately.

Risks

• Testosterone replacement therapy can cause sleep apnea, testicle shrinkage, limit sperm production, and stimulate overproduction of blood.

  Your doctor will monitor your blood count and testosterone levels at regular intervals to prevent any complications.

  Using testosterone can increase your risk of developing prostate cancer, so your doctor may order lab work to monitor prostate levels. If you currently have prostate cancer, your tumor may grow more quickly with testosterone replacement therapy.