Andropause : Testosterone vs. Synthetics
What is the Optimal Form of Testosterone for Replacement Therapy?
Testosterone USP is natural bio-identical testosterone that has been approved
by the United States Pharmacopoeia and is available as a bulk chemical. Upon
a prescription order, compounding pharmacists can use Testosterone USP to prepare
numerous dosage forms.
Natural Testosterone Replacement is Central to the Treatment of All Facets
of Andropause. The term "testosterone" is often used generically
when referring to numerous synthetic derivatives, as well as natural bio-identical
testosterone. Confusion is responsible for conflicting data in the medical
literature about the benefits and risks of testosterone therapy. Studies must
be reviewed carefully to determine the form of testosterone that was used.
Natural testosterone must not be confused with synthetic derivatives or "anabolic
steroids," which when used by athletes and body builders have caused disastrous
effects. For example, administration of synthetic non-aromatizable androgens,
like stanozolol or methyltestosterone, causes profound decreases in HDL-C ("good
cholesterol") and significant increases in LDL-C ("bad cholesterol").
Yet, hormone replacement with aromatizable androgens, such as testosterone,
results in lower total cholesterol and LDL cholesterol levels while having
little to no impact on serum HDL cholesterol levels. Proper monitoring of laboratory
values and clinical response are essential when prescribing testosterone replacement
The only absolute contraindications to androgen replacement therapy are the
presence of prostate or breast cancer. "Although it is known that the
clinical course of prostate cancer is accelerated by testosterone, its incidence
is not increased by [testosterone] administration... There is even no clear
evidence that testosterone replacement accelerates the development of BPH."
Drugs & Aging 1999 Aug;15(2):131-42