If my testosterone is low, will I have to take the Testosterone Replacement Therapy forever? Medical studies conclude that it is safe and effective to stay on a TRT program for 20+ years. As long as a patient is monitored every 6-12 months and remains in a normal human testosterone range, there is no need to ‘cycle’ off of testosterone replacement. Should you decide to stop the program, your body will go back to producing those levels it produced prior to therapy (less the natural 1 to 3% testosterone degradation for each of those years and for each year to follow).
A 31-year-old man presenting with an 18-month history of sexual dysfunction resulting from severe adult-onset IHH (LH U/L, FSH U/L, T nmol/L). Initial therapy with 50 mg of clomiphene citrate (CC) three times a day for 7 days, with overnight LH pulse profiling and 9 am T levels evaluated at baseline and on completion. A 2-month washout period, followed by low-dose maintenance therapy (25-50 mg/d) for 4 months.
MAIN OUTCOME MEASURE(S):Baseline and stimulated T levels and LH pulsatility; effect on sexual function.
RESULT(S):Clomiphene therapy resulted in complete normalization of pulsatile gonadotropin secretion, serum T level, and sexual function. CONCLUSION(S):Isolated hypogonadotropic hypogonadism may result from an acquired defect of enhanced hypothalamic sensitivity to E-mediated negative feedback. Whereas direct T replacement therapy can further suppress endogenous gonadotropin secretion, treating IHH men with gonadotropins can stimulate endogenous T secretion and enhance fertility potential. On theoretical grounds, reversal of gonadotropin deficiency with CC might be expected to have a similar biological effect.
"Despite advances in technology, inconsistent laboratory practices, among other issues, leads to unreliable blood test results. "In some cases, testosterone (T) levels, tested on the same day from a blood sample taken from a single patient, differed by as much 30 percent from one lab to the next," says the study's lead author, Dr. Paduch, a urologist and male sexual medicine specialist at NewYork-Presbyterian/Weill Cornell Medical Center and associate professor of urology and reproductive medicine at Weill Cornell Medical College."