Preserving Testicular Function While on Testosterone Replacement Therapy
Video Transcription
Dr. Phillip Faler: Good morning, everyone. I’m Dr. Phillip Faler with Anti-Aging Northwest. Wanted to take a minute this morning to discuss the preservation of testicular function in testosterone replacement therapy. So with the global decline in testosterone, I’m getting younger and younger men who have testosterone in the 2 and 300s. And these men maybe have one child or haven’t had children yet. They’re 25, 27, 31. And the last thing you want to do is put them on a medication that’s going to make their testicular function less than what it already is, both in testosterone production as well as sperm production should they want to reproduce, which at 25, that’s not something you really know. So I work hard to try to maintain testicular function in as many men as possible while still getting their quality of life improved with testosterone and exercise, nutrition.
So let’s talk for a minute about the effects of injectable testosterone on the testicles, and then we’ll talk about an alternative called enclomiphene. When you give a man testosterone injectable, it’s like putting a space heater directly underneath your thermostat in your house. And if you put a space heater right underneath the thermostat and the heat’s finding its way right up to that thermostat, the furnace is never going to kick on. Same’s true with exogenous or injectable or topical testosterone. If we’re putting on testosterone, it’s going to turn off the signaling from the anterior pituitary of LH and FSH, and the testicles are not going to be asked to produce testosterone. And as by default, they’re also not going to produce sperm. Give that a year or six months or 18 months and the testicles are going to atrophy. They’re going to shrink. They’re going to become weaker, less viable for production.
So this means if they go off testosterone, they are less capable of producing it on their own. And should they want to have children, they’re less likely to be able to reproduce. And sometimes that can be fixed with a protocol of some hCG and some enclomiphene. I have done that, but prevention is a pound of cure, right? Enclomiphene, alternative to exogenous topical injectable testosterone. Tablet, you take, capsule you take every day, well, sometimes five days a week, sometimes even three days a week. It’s a capsule you take. Stimulates the production of luteinizing and follicle stimulating hormone coming from the anterior pituitary going to the testicles. And I see this in follow-ups every day in clinic.
Men who came to me with a testosterone 210, 300, five, six weeks on enclomiphene, maybe 12.5 milligram. And we retest at five weeks, six weeks, and their testosterone would be in the 800s, 900s. And they’re producing all that testosterone themselves. And for younger guys, they can maintain this protocol for years. Now, of course, we want young guys under 35, we want them on nothing if possible, exercise, nutrition, not living a stagnant lifestyle. All these things help contribute to raising testosterone, but sometimes it just won’t come up unless we do something pharmacological.
So there is a safe way to raise testosterone without impeding testicular function. Enclomiphene or hCG works well too. And we love to use that with as many men under the age of 40 as possible. Sometimes we’ll try it with guys over 40, but it becomes less responsive the older we get due to age related male hormone decline.
So yeah, if you’re under the age of 40 and you’re worried about using testosterone, there are alternatives out there you can talk to your doctor about. You can reach out to me here at Anti-Aging Northwest. Thank you so much for listening, and I hope everybody’s having a wonderful day and I hope this information was useful to you. Take care.