Some frequently asked questions about hormone replacement treatment
Testosterone is normally produced by scattered cells within the testicle, which are stimulated to do so by Lutenising Hormone (LH) from the pituitary. The pituitary is in turn stimulated by another hormone from a part of the brain called the hypothalamus. In Klinefelter’s Syndrome (KS) the testicles develop poorly and become rather fibrous such that the cells, which make testosterone in the testicle, are destroyed.
Testosterone is normally produced by scattered cells within the testicle, which are stimulated to do so by Lutenising Hormone (LH) from the pituitary. The pituitary is in turn stimulated by another hormone from a part of the brain called the hypothalamus. In Klinefelter’s Syndrome (KS)/XXY the testicles develop poorly and become rather fibrous such that the cells, which make testosterone in the testicle, are destroyed.
Apart from the initial test to confirm the chromosome disorder in KS, the only blood tests routinely necessary are testosterone, Sex Binding Hormone Globulin (SHBG), Lutenising Hormone (LH), Follicle Stimulating Hormone (FSH) and haematocrit levels.
As well as taking blood tests, your doctor will note how well you are doing – how often you shave, the amount of body hair and body muscle etc.
He should also ask you how you are feeling – are you sleeping well, what your mood is like, do you get very tired, are you irritable. It is important that you think about this in advance – perhaps ask friends and family as well as they may see changes that you do not notice. The KSA has available a testosterone treatment diary for this purpose.
There is no ‘correct’ testosterone level – it varies from person to person. Testosterone should improve your feeling of well being and make you more assertive. If, for example, you are overly aggressive it may be that your levels are rather high for you.
There isn’t a specific age – testosterone levels may remain in the normal range into the 20s or later. Some adults never need treatment – and some prefer not to have it.
Testosterone treatment should normally be continued throughout life, although the dose may need to be adjusted later in life. There is no evidence for a male menopause, and therefore no age at which testosterone should routinely be stopped.
If the body is not making testosterone then there is no influence of additional testosterone on the body’s own capacity. It will certainly not “kick start” the body’s natural production.
Testosterone has a variety of effects on behaviour, in general making men more assertive, and in some situations, rather more aggressive than they might otherwise be. As long as the levels are kept within the normal range, this is entirely normal. However excessive aggression is likely to be a sign that your testosterone levels are too high.
It is always sensible to start with small doses and build up the dose gradually.
You, and those around you, may note an increase in independence and assertiveness.
You may actually feel less aggression as the testosterone can clarify your thought processes causing you to feel less frustrated.
Why do I feel aggression after testosterone injections?
It is extremely difficult to discuss individual cases, in particular whether or not a given patient should have testosterone treatment in the absence of any further background information. However, there are situations in which individual doctors may come to slightly different opinions. In such circumstances, it is probably best to go along with the doctor with whom you feel most comfortable and who appears to have the greater experience of this type of condition.
No, some adults will produce enough testosterone to function well although it is possible they may need some as they age. Some adults may choose not to use testosterone and others may choose oestrogen.