Testosterone – An Education

HERE’S WHAT WE DISCUSS

• Why is testosterone so interesting to Dr. Khera?
• Testosterone and prostate cancer – what do we know.
• Is a lowering testosterone level in men “natural”? And if it isn’t, what causes low testosterone in men?
• What do the new weight loss drugs do to testosterone levels and male fertility?
• We discuss the different ways you can give testosterone to women: topical, pellets and compounded injectable doses of testosterone for women: 50mg/ml and start at 0.1 mg injected a week.
• The benefits of testosterone for women besides low libido.
• The role of chronic pain, testosterone, and pain meds.
• The mechanism of how your testosterone goes up when you lose body fat.
• The four pillars of health for natural testosterone production – diet, exercise, sleep, stress reduction
• Erectile dysfunction is a harbinger for heart attack and heart disease.
• “There is not a better barometer of a man’s overall health than his sexual health” – Dr. Khera
• The role of DHEA (a mild androgen made in the adrenals) in men and women.
• The link with Peyronies disease and Testosterone.
• We discuss penile stretching devices.
• We discuss a 2013 Finkelstein article – they gave men testosterone and blocked its conversion to estrogen. So are we under treating men by not addressing their estrogen?
• Dr. Khera was  part of the NEJM study that came out this summer looking at testosterone in men with low testosterone and high risk CV risk. The Traverse Trial. Conclusions: In men with hypogonadism and preexisting or a high risk of cardiovascular disease, testosterone-replacement therapy was non-inferior to placebo with respect to the incidence of major adverse cardiac events. 
• Barriers to a testosterone prescription include that it is a regulated medication, a physician needs a DEA license to prescribe it – similar to a narcotic.
• Dr. Khera lends his opinion to safely prescribing of testosterone but thinks the DEA regulation is here to stay.
• He clarifies the number of men who suffer from hypogonadism and the number of men who are undergoing treatment for this
• condition.
• Testosterone levels are dropping because men are becoming less healthy. Dr. Khera talks about measuring a baseline
• testosterone level in men as a marker of overall health and focus on lifestyle changes to naturally get this normal.
• 50% of men don’t talk to their doctor about their erectile dysfunction, and 44% of those men don’t talk to their partner about it.