Testosterone replacement therapy Archives – Page 2 of 2

When Should a Man Get A Prostate Exam?

When Should Men Get Their First Prostate Exam?

As we finish out November, also known as “No-shave November” or “Movember” to increase awareness about men’s health issues, I want to touch on a part of men’s health that is at the forefront of most men’s minds: Prostate Health, Prostate Enlargement, and Prostate Cancer.

So, when should men get their first prostate exam – and do you need to have them at all? Let’s clarify those questions.

Early Screening

At Redefined Health Clinic, we screen and monitor for prostate health before we even see you as a patient. Part of our initial intake questionnaire asks you about your personal and family history of prostate diseases. Is there a family history of prostate cancer? Did a first-degree male relative have prostate cancer? Answering yes to these questions might put you at risk.

Current recommendations call for Prostate cancer screening at age 50. But if you have an early family history of Prostate Cancer, we will screen even earlier at age 40-45.

What Does Screening Look Like?

The old-school way of thought was that starting at age 50, men would get their prostate checked annually, otherwise known as a digital rectal exam (DRE). A DRE is a rectal exam using a gloved and lubricated finger to examine the prostate internally.

However, we have learned that placing just the slightest amount of pressure on the prostate during the DRE can cause a false positive elevation of the Prostate Specific Antigen (PSA) in a blood test. The PSA is a protein produced by both cancerous and noncancerous tissue in the prostate.

What if Your PSA is High?

High levels of PSA may indicate the presence of prostate cancer. But many other conditions, such as an enlarged or inflamed prostate, constipation, vigorous bicycle riding, motorcycle/motocross riding, long horseback rides, and even intercourse can increase PSA levels. When sending a man to the lab to have his PSA level checked, we ask they refrain from those activities for 3-5 days before their blood test.

If your PSA test comes back high, we may need to do further testing which would include more blood tests, a DRE, and a referral to a urologist.

How Does TRT Affect My Prostate?

Despite internet rumors, Testosterone Replacement Therapy does not cause prostate cancer. However, there are some things that we need to screen for before starting testosterone therapy.

First, our initial blood word includes a baseline PSA level. We want to know what your level is even before starting TRT. We check that level again at least annually, if not twice yearly. If your PSA level begins to increase, we decide together how to handle the testosterone dose.

However, if you already have prostate cancer then TRT can cause already-established prostate cancers to grow more quickly. That’s why we screen for it before starting any TRT.

What is BPH vs Prostate Cancer?

BPH stands for Benign Prostatic Hypertrophy. It just means an enlarged prostate. It is not prostate cancer.

Common symptoms of BPH include frequent urination (especially at night), feeling that you can’t empty the bladder all the way, weak urine stream, or difficulty starting a urine stream. This is a common factor in men as we get older. Simple medications can help reduce the size of the prostate, or you may need a referral to a urologist.

There is no sound evidence connecting BPH to TRT. In fact, there is growing evidence that because men lose testosterone as we age that we may be less susceptible to BPH if we are on weekly low-dose TRT.

Do You Really Need ED Medication for Erectile Dysfunction?

“Can I get ED medication for my erectile dysfunction?” It’s one of the more common requests I get from patients. Unfortunately, that answer isn’t always straightforward.

The typical scenario goes like this: A guy comes to our clinic suffering from erectile dysfunction for a number of years. It’s affecting his sex life with his spouse to the point that he has to explain to his wife that it’s not her, but that it’s him.

His confidence is shaken. Her insecurities grow. Then it becomes a vicious cycle of continued erectile dysfunction causing more and more stress in the relationship.

His solution is to find a men’s health clinic like us to get ED meds like Viagra, Cialis, or Levitra.

But, what he doesn’t realize is that there are a lot of factors that go into causing ED.

Arousal Problems

The problem is the inability to become physically aroused or excited before sexual activity. I’ll often ask a man if he has trouble getting or maintaining an erection. Depending on his answer, that helps steer the direction for the remainder of the visit.

If it’s a problem with getting an erection, there could be problems with depression, anxiety, anti-depressant or anti-anxiety medications, or low testosterone.

Other reasons might include chronic health conditions such as obesity, high blood pressure, high cholesterol, or diabetes.

It’s important to assess for all of these conditions.

Desire Problems

If a guy is lacking sexual desire or interest in sex (we call his low libido), then this might be more of a sign of low testosterone.

Treating a man with ED medications when the problem is low testosterone isn’t really treating the problem. It’s putting a temporary patch on the problem without treating the root cause. This is just one more reason to check testosterone levels with lab work.

Orgasm Problems

A delay or absence of an orgasm/climax is certainly a problem for some men. This will literally take the joy out of sex for men.

Men will feel like they’re able to reach the point of climax, but for one reason or another, they never progress past that point.

Most often the reason is mental/emotional. Whether it be an emotional disconnect with their partner, anti-depressant or anti-anxiety medication side effects, stress, or fatigue. These can all weigh on a man’s confidence and leave him feeling as less of a guy.

If this happens once or twice, it’s usually not a problem. But, if it occurs more and more often, there might be some other underlying factors we need to look at.

Erection or Intercourse Pain

This is certainly all physical. Men that have penile pain with intercourse certainly need to be evaluated:

Peyronie’s disease – scar tissue forms inside the penis causing a painful bend when erect. Normally, most men have a slight curve in their erect penis. A slight bend in the penis that does not cause any problems is normal and nothing to worry about. However, if this does cause sex to be painful, you should consult with a urologist.
Phimosis – for men with foreskin that is too tight, this might cause pain during intercourse.
Priapism is a long-lasting, painful erection and can cause permanent damage to your penis if it is not treated. Some cases may need hospital treatment to drain the excess blood from the penis. This is most often caused by taking too much ED medication causing a prolonged erection.

So, as you can see, there are plenty of reasons men may have erectile dysfunction that certainly doesn’t always require ED medication.

If you suffer from Erectile Dysfunction, certainly talk to your doctor or schedule a visit with us at Redefined Health Clinic for a thorough workup.

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Can Hormone Replacement Therapy Be Done via Telemedicine?

When we first opened Redefined Health Clinic it was in the fall of 2021. At the time, the world was approaching almost 2 years since we had first heard of COVID-19. State and federal regulations of who can or can’t show up at a clinic were changing all the time and were honestly frustrating to keep track of.

The question became: Can Hormone Replacement Therapy Be Done via Telemedicine?

A year prior much of the healthcare world had already switched over to providing telemedicine via Zoom or Microsoft Teams. We knew this was an avenue for providing quality care. We started providing men’s health and hormone replacement therapy through Telemedicine in September 2021.

The Covid-19 pandemic has all but ensured that telemedicine will remain an important aspect of patient care – including hormone and testosterone replacement therapy

Enter Emergency Protocols

Because of all of the emergency COVID protocols that popped up, a lot of rules that previously limited what we could or could not do for hormone replacement therapy (HRT) were temporarily or permanently wiped away, including providing HRT prescriptions via telemedicine.

Because of these rule changes, we were able to initiate HRT therapies like we hadn’t before:

FDA-controlled medications, like testosterone, could be sent to pharmacies across the state.
If a provider was licensed in another state, such as Montana like we are with Redefined Health Clinic, you can also send medications to patients across state lines.
Telemedicine visits counted as legitimate as an in-clinic visit.
Medication refills could be sent electronically instead of sending printed hard copies to a patient.

"Testosterone replacement therapy (TRT) is likely the next frontier for telemedicine in men’s health."

Access to Care

As with anything, there are always positives and negatives. This includes providing care via telemedicine, but especially with TRT. Providing care to brand new, or established, patients through telemedicine improves overall access to care.

Eliminating geographic barriers and improving convenience to patients improves patient outcomes.

Overcoming Stigmas

Telemedicine provides a way for men who may feel uncomfortable traveling to a doctor’s office to discuss their health issues in a more private setting. Symptoms of reduced energy, loss of body hair and beard growth, reduced muscle mass, depressed mood symptoms, reduced sex drive, and reduced erectile function are difficult to talk about.

The more access there is, the better the chances of treating these patients.

Patient Costs

Telemedicine reduces costs for both patients and providers. Considering the costs of travel, time off work, and the inconvenience of going to a clinic, telemedicine can provide financial savings of $124 for each virtual encounter

Patient & Provider Satisfaction

A recently published national survey of 38,000 patients with 620 video visits found that satisfaction scores were significantly higher for video visits compared to in-person visits.

Providers are also highly satisfied with telemedicine. The Telehealth Impact Study, of over 1500 providers, revealed high satisfaction rates with telemedicine.

Possible Pitfalls

As with any positive, there are possible negatives. Here are just a few that we’ve identified as possible pitfalls:

Lack of physical exam – we’re already working on this with plans for Mobile medicine, and a brick & mortar location.
Can’t administer medications – some men simply prefer to receive medication/injections in the clinic.
Technology barriers – just because you own a smart device doesn’t mean it’s set up to use for telemedicine.
Data breech/cyber security.

Redefined Health Clinic Workflow

Telemedicine offers so many possibilities for treating low testosterone. The COVID-19 pandemic and its aftermath have ensured that telemedicine will remain an important part not only in general healthcare but also in men’s health and TRT.

Redefined Health Clinic, and many other men’s health clinics, remain committed to serving their patients with streamlined, convenient, and safe workflows to bring their patients the treatments they need with a convenience not experienced in any period of time. To see more of how Redefined Health Clinic works, visit our detailed workflow on: How the Process Works.

Connect with Redefined Health Clinic:

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Is Testosterone Replacement Therapy Right for You?

Have you ever wondered if Testosterone Replacement Therapy is right for you? I’m not sure how you can’t. Testosterone replacement ads are everywhere: TV, social media, radio, etc. You’d think we’re in some sort of low testosterone epidemic based off the marketing campaigns alone.

But the campaigns are working. If you’ve heard any of these ads you’ve probably wondered, especially if you’re a man aged 35-65, “Do I have low T?” It’s entirely possible. If you’re experiencing loss of your sex drive, fatigue – especially in the afternoon, losing muscle, have ED, can’t concentrate, feel irritable, or just never feel all that great— you’ve probably wondered, could Testosterone replacement therapy (TRT) really help? Here’s how to find out:

1. Get Your Testosterone Levels Checked

It’s an obvious first step, right? But as many as a quarter of the men who are on TRT do it blindly. They feel “off,” so they find some black market compounding hormone lab, and they start a regimen without testing whether they actually have low T! This is a potentially dangerous situation and may actually counteract what you think you need to fix.

If you begin supplementing with testosterone on your own, you actually run the risk of turning off your natural production of testosterone. This can make things much worse for the patient.

Your pituitary is designed to monitor Testosterone levels in the blood. If the testosterone levels is too high (from supplementation) then it stops producing Leutenizing hormone that tells the testicles to make more testosterone.

Visit your primary care provider, and ask for a testosterone test, preferably in the morning when the hormone’s levels peak. Repeat the test at least once, with the second test 2-3 days after the first. Two low morning readings indicate testosterone deficiency – male hypogonadism.

“If you begin supplementing with testosterone on your own, you actually run the risk of turning off your natural production of testosterone.”

2. Rule Out other Causes

If your T levels are a little low, don’t just blame it on your age. Yes, on average men begin to lose 1% of their testosterone starting at age 35. But that’s not true for all men.

A 35-year-old man in poor health is more likely to have low T than a fit 45-year-old man.
Some medications can cause Low T. Opioid pain medications, for example, are notorious for causing low testosterone.
Men with previously undiagnosed thyroid problems may also have low testosterone production.
Sleep apnea is another known cause for low testosterone.
Obesity also causes Low T. Dropping 5-7% of your body weight can increase your testosterone levels 10-15%. This may bring your T level into the normal range. (Insurance calls Total Testosterone levels of 300 ng/dL normal – but that’s a topic for a whole other post.).

3. Risks vs. Benefits

With any good thing, there can be drawbacks.

If you and your wife are trying to have kids, you don’t want to start testosterone replacement therapy. TRT will cause the pituitary to shut down it’s natural hormone production that will decrease your natural sperm production.

There are also side effects of TRT therapy that include an increased risk of:

Forming blood clots
Prostate enlargement
Increased estrogen levels
Acne production
Hair loss

Check your symptoms with our Free Low Testosterone Quiz Now.

4. Should I Make the Jump?

After talking things over with your primary care provider, they may write you an Rx for testosterone. At Redefined Health Clinic, we prescribe injections, topical creams/gels, and oral medications.

In men with low Total T levels below 300 ng/dL – and/or the symptoms of…

Fatigue (especially in the afternoon)
Low libido
Poor sleep
Loss of muscle mass
Fat gain
Apathetic mood

…TRT can do a fantastic job of increasing your mood, energy, libido, physical abilities, sleep, and vitality.

Remember, TRT is not a light switch. You don’t feel the beneficial effects immediately after your first dose. It can take 2-3 months (minimum) before you begin to feel the positive effects.

Since you’re interested in learning more if Testosterone Replacement Therapy is right for you, contact Redefined Health Clinic for a Complimentary Consultation.