Talking to your patients

Testosterone replacement therapy can improve patient quality of life significantly by providing symptom relief ^[1] and therefore effectively communicating with your patients and setting expectations about when they are likely to experience the benefits of testosterone therapy may help with treatment adherence

Additionally, providing your patients with adequate resources to learn about and monitor their condition at home is paramount to patient empowerment.

Setting expectations

Тime-course of the effects of testosterone replacement therapy

Below the time-course of the effects of testosterone replacement therapy have been estimated and are shown as the time period until their first manifestation until the expected maximum effects are attained. ^[3]

It should be emphasised to patients that while some benefits will be seen in a matter of weeks, adherence is important, the benefits of therapy have been shown to continue to rise years after initiation. ^[3]

3 Weeks

3+ Weeks

6+ Months

Libido

3 weeks

Benefits plateau at 6 weeks with no further benefit expected

Ejections and ejaculations

3-4 weeks

Continued improvement from 6 month is seen with ongoing testosterone therapy for 9 years

Quality of life

3-4 weeks

Improvement can continue for 2-3 years to reach maximum amount

Depression

3-6 weeks

Maximum benefit achieved after 18-30 weeks

Blood pressure

3-9 months

Maximum benefit conferred at 12 months

Reduction in waist circumference

6 months to several years

Reduced fat mass/increased lean body mass

6 months to several years

Bone mineral density

From 6 months

Continued improvements seen for 5 years post initiatio

PSA levels and prostate volume

6+ weeks

Small increase in both is expected with TRT and the increase plateaus at 12 months.

Insulin sensitivity

6+ weeks

Detected improvements from 3-12 months Demonstrated as improved glycemic control. Further improvements for 11 years

3 Weeks

Libido

3 weeks

Benefits plateau at 6 weeks with no further benefit expected

Ejections and ejaculations

3 weeks

Continued improvement from 6 month is seen with ongoing testosterone therapy for 9 years

3+ Weeks

Quality of life

3-4 weeks

Improvement can continue for 2-3 years to reach maximum amount

Depression

3-6 weeks

Maximum benefit achieved after 18-30 weeks

6+ Months

Blood pressure

3-9 months

Maximum benefit conferred at 12 months

Reduction in waist circumference

6-12 months

Continued improvement seen until 11 year

6+ Months

Reduced fat mass/increased lean body mass

6 months to several years

Bone mineral density

From 6 months

Continued improvements seen for 5 years post initiatio

6+ Months

PSA levels and prostate volume

6+ weeks

Small increase in both is expected with TRT and the increase plateaus at 12 months.

Insulin sensitivity

6+ weeks

Detected improvements from 3-12 months Demonstrated as improved glycemic control. Further improvements for 11 years

Prevalence

Communicating how common testosterone deficiency is

Communicating effectively to your patient about how common testosterone deficiency is expected to be is important. This will help them to feel less alone and understand that other people they know may be going through the same thing.

It is estimated that the prevalence of hypogonadism in men over the age of 45 years old is almost 40%. ^[4]

Two men having a discussion at a table with a laptop

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Testavan 2% 20mgg testosterone gel bottle packaging

Tools

Keeping up to date

Providing your patients with the tools to assess their symptoms and wellbeing could be a way of supporting them to track their progress between appointments.

The AMS questionnaire provides a means to assess symptom relief over time. ^[2] By providing a means to tangibly assess their progress, patients could be encouraged to adhere to treatment as they begin to see their symptoms improve.

Calculating and monitoring BMI may help with patient overall health, particularly if they are aware of the other health-related affects of being overweight, in addition to increased risk of hypogonadism. ^[1]

AMS questionnaire

BMI calculator

Talking to your patients

Setting expectations

3 Weeks

3+ Weeks

6+ Months

6+ Months

6+ Months

3 Weeks

3+ Weeks

6+ Months

6+ Months

6+ Months

Prevalence

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Tools

Related Content

References