Testosterone Replacement Therapy

Testosterone is a crucial hormone for both men and women and plays a central role in the body’s functions. Low levels are associated with a range of health issues that can affect both health and quality of life. Men’s testosterone levels begin to decline in their thirties and continue to decrease by about one percent every year for the rest of their lives. This decline in testosterone levels can lead to symptoms such as fatigue, reduced muscle mass, and decreased libido, which not only affect physical health but also overall well-being. Additionally, men may be at increased risk of developing diabetes, metabolic syndrome, cardiovascular diseases, osteoporosis, sexual dysfunction, depression, and possibly dementia. Testosterone hormone therapy, known as Testosterone Replacement Therapy (TRT), restores your testosterone levels, alleviates symptoms, and potentially prevents disease.

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The Interplay between Testosterone and Estrogen

While estrogen is the primary female sex hormone and testosterone is the primary male sex hormone, both men and women require both hormones to maintain proper function and optimal balance between estrogen and testosterone.

Testosterone is necessary for regulating sperm production and the development of male sex characteristics, including facial and body hair, increased muscle and bone mass, and a deeper voice. Estrogen also plays an important role in men’s sexual development and overall health. It contributes to maintaining healthy function in nearly all systems of the body, including the neurological, cardiovascular, musculoskeletal, and immune systems. Estrogen in men is formed through the breakdown of testosterone using the enzyme aromatase, which is found in adipose tissue, adrenal glands, the brain, and the testicles.

Both testosterone and estrogen play a role in regulating sexual functions and reproduction. Their effects also depend on interactions with other hormones that regulate bodily functions such as metabolism, digestion, growth, mood, cognitive development, and temperature regulation. When a single hormone is imbalanced, it can affect other hormones and influence many aspects of one’s overall well-being. Thus, your hormones constitute a complex interplay where multiple hormones affect each other. If you are considering starting Testosterone Replacement Therapy (TRT), it is therefore relevant to measure all your hormone levels.

 

Testosterone Deficiency

Testosterone deficiency can occur due to a condition called hypogonadism, where the body fails to produce a sufficient amount of testosterone. This can lead to hormonal imbalance in men, affecting both the production and levels of estrogen and other hormones. Additionally, certain lifestyle factors can lower testosterone levels, including excessive exercise, improper nutrition, stress, obesity, medications (such as antibiotics or antipsychotics), or serious illness.

Maintaining a healthy lifestyle with regular exercise and a proper diet rich in essential nutrients is important to sustaining normal testosterone levels. Testosterone deficiency can have significant consequences for men’s health and quality of life.

Common symptoms of testosterone deficiency include:

  • Reduced muscle mass and strength
  • Hair loss
  • Development of breast tissue (gynecomastia)
  • Decreased libido (sex drive), erectile dysfunction, infertility
  • Decreased energy, motivation, and initiative
  • Sleep disturbances

In addition to physical symptoms, it can impact mental well-being and contribute to depression and anxiety, as well as decreased concentration and memory.

A blood test can determine if one has lower testosterone levels than what is considered normal for their age. If the test confirms testosterone deficiency, TRT (testosterone replacement therapy) can help restore normal testosterone levels and alleviate symptoms of testosterone deficiency provided one maintains a healthy lifestyle.

 

 

TRT Treatment

Many men suffering from low testosterone face challenges in their daily lives, especially when it comes to physical activity. Even those who dedicate time to regular exercise may feel fatigue and experience a significant reduction in muscle strength. One of the intentions of correcting testosterone levels is to provide the body with the capacity to handle intense physical exertion and improve post-exercise recovery. In addition to physical benefits, initiating hormone therapy can also have positive effects on mental aspects. It can lead to improved energy, increased muscle mass, enhanced libido, and an overall improvement in quality of life.

There are various forms of TRT, and the choice of treatment method depends on individual factors, patient preferences, and the doctor’s assessment. Here are some common forms of TRT:

 

  • Injections: Testosterone can be administered through intramuscular or subcutaneous injections. Intramuscular injections provide a long-lasting release of the hormone and are often administered in large muscles such as the buttocks or thigh. Subcutaneous injections allow for quicker absorption into the bloodstream and are often done in the abdominal skin or thigh.

 

  • Gel: Testosterone in gel form can be applied to the skin, from where it is absorbed into the bloodstream. This provides a more constant release of the hormone. The gel is typically applied to the shoulders, arms, or abdomen.

 

The timeframe for when one will start to experience the effects of TRT can vary significantly from individual to individual. Several factors influence how quickly TRT impacts symptoms of testosterone deficiency, including the administration type, individual factors, dosage, and the onset of symptoms. Generally, some individuals may begin to experience improvements within the first few weeks, while it may take several months for others.

 

Blood Tests

Before starting treatment, it’s relevant to measure your hormone levels as well as albumin, hematocrit, PSA (>40 years), and liver function tests to confirm testosterone deficiency and exclude other diseases. Testosterone therapy can lead to negative side effects, especially if there’s an underlying, undetected disease such as prostate cancer. Prostate-specific antigen (PSA) is a protein produced in the prostate gland. Low PSA levels are considered normal, while elevated levels may indicate various conditions, including prostate cancer. Elevated PSA levels alone are not necessarily an indication of prostate cancer, as they can be caused by other factors such as prostate infection, inflammation, or an enlarged prostate.

Treatment at Aetas

At Aetas, we offer counseling with a specialist doctor in connection with the initiation of hormone therapy. Our specialist evaluates based on your symptoms and blood tests whether hormone therapy may be relevant for you.

Once you have started the treatment and your optimal dosage has been established, you will be scheduled for biannual testing and consultations with the doctor going forward. The consultation (2,200 DKK) and blood tests (1,900 DKK) are required in order to continue treatment with Aetas.

 

Startup Package includes

  • Initial consultation with our specialist doctor at our clinic in Hellerup, including physiological examinations such as blood pressure and BMI
  • Blood tests: Androgen group, including testosterone + free testosterone, DHEAS, progesterone, estradiol, SHBG, LH, liver function tests including ALAT, ASAT, bilirubin, albumin, hematocrits, hCG, and PSA if you are over 40 years old
  • Follow-up blood tests after 2-4 weeks
  • Follow-up consultation after 1-1.5 months
  • Prescription renewal
  • Price: 9,200 DKK.

 

During the first 12 months of treatment, multiple follow-up consultations and blood tests may be necessary to monitor your dosage and the effectiveness of the treatment, ensuring that you receive the optimal dosage. One follow-up consultation and follow-up blood tests are included in the price. Additional consultations and blood tests must be paid for separately.

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Add-ons

  • Blood tests: Price depends on the specific test
  • Consultation with specialist doctor (30 min.): 2,200 DKK
  • suPAR before and after 3 months: 1,400 DKK
  • DEXA Body Scan: 2,200 DKK

 

 

 

 

How It Works

1. Booking

When you book an appointment for TRT, you are booking a date for blood sampling. As soon as you have booked, you will receive a questionnaire by email, which you are kindly requested to answer.

Note: Blood sampling and initial consultation do not take place on the same day.

2. Blood Tests

You will have the following blood tests: Androgen group, including testosterone + free testosterone, DHEAS, progesterone, estradiol, SHBG, LH, liver function tests including ALAT, ASAT, bilirubin, albumin, hematocrit, hCG, and PSA (if you are over 40 years old).

Our hormone panel can determine if you have lower testosterone levels than what is considered normal for your age. Additionally, your albumin level will be measured since testosterone also binds to albumin, and your level of prostate-specific antigen (PSA) (if you are over 40 years old), as elevated levels may indicate cancer, enlarged prostate, or inflammation.

The waiting time from blood sampling to the initial consultation can be between 1-3 weeks depending on the turnaround time of your tests and our availability.

3. Initial Consultation

Once we have received your blood test results, the doctor will assess whether you may be suitable for testosterone therapy based on your results. If this is the case, you will be called in for an initial consultation.

If, based on the blood tests, the doctor determines that you are not suitable for TRT, you will not be called in for an initial consultation, and you will receive a partial refund of the amount paid (6,300 DKK).

You should expect the consultation to take about 30 minutes.

4. Medication

1. After your initial consultation, and the specialist doctor has deemed you suitable for treatment, the doctor will prescribe the medication.

2. You will receive an email from us with the name of the medication and dosage.

3. You can monitor all your prescriptions in the Medicinkortet app. As soon as you can see the prescription for the agreed-upon medication, you can pick it up at your nearest pharmacy. You can collect the medication within a few days.

4. Once you have picked up the medication, you can start the treatment.

5. Follow-up Blood Sample Collection and Consultation

You will have follow-up blood tests after approximately 2-4 weeks to assess if the treatment is effective. Additionally, you will be scheduled for a follow-up consultation with the doctor to determine together if your dosage needs adjustment.

Frequently Asked Questions

Is hormone therapy dangerous?

Recent research has shown that hormone therapy, when administered correctly by a specialist with dose optimisation and ongoing monitoring, minimises the risk of negative side effects. The key is to avoid administering large amounts of testosterone at once, as this can disrupt the balance between various hormones. Testosterone Replacement Therapy (TRT) should be given in small, frequent doses to maintain optimal daily testosterone levels. When done correctly, there is minimal risk of negative side effects.

Are there any side effects of TRT?

In normal doses, testosterone use typically does not result in side effects. Side effects such as acne, hair loss, and aggressive behaviour are usually observed only with overdosing. Overdosing can also negatively impact sperm production, fertility, and the body’s ability to produce testosterone naturally. It’s important to address lifestyle factors, including exercise and diet, before considering testosterone therapy, especially in cases of overweight and inactivity.

What is the optimal dose?

The optimal dose varies based on individual factors. Follow-up blood tests help monitor the treatment’s effectiveness and ensure the correct dose.

Where can I pick up my medication?

You can collect your prescription medication from your nearest pharmacy. Please note that you cannot pick up the medication at Aetas.

Payment

We aim to make it as convenient as possible for our customers, and therefore, we offer the option to split your payments. You can choose between monthly or quarterly instalments.

We strive to accommodate your individual needs, ensuring that finances do not limit your pursuit of better health. Please reach out to us at contact@aetas.dk for more information or if you wish to take advantage of this option.

How often should my prescription be renewed?

How often your prescription needs renewal depends on the medication and the agreement with the doctor. We ensure that your prescription is renewed so that you always have a new one available before running out. An annual consultation with the doctor is required to renew your prescription.

Can I get a refund if I am not suitable for TRT?

You pay for the entire startup package initially. If, based on your blood test results, the doctor determines that you may be suitable for TRT, you will be called in for an initial consultation with the specialist.

If, based on your blood test results, the doctor determines that you are not suitable for TRT, you will not be called in for the initial consultation, and you will receive a partial refund of the amount paid (6,300 DKK). This means that you pay for the initial blood tests regardless of the outcome.

Can I only be tested for testosterone and not the whole panel?

At Aetas, we do not offer TRT if only testosterone levels are measured. All hormones interact with each other, and various individual factors can affect hormone levels. Therefore, it’s essential to consider testosterone in conjunction with other hormones.

How should I store TRT medication?

Store the medication in a closed container at room temperature, away from heat, moisture, and direct light. Do not freeze the medication.

Who are the doctors?

At Aetas, we have two doctors involved in our hormone therapy programs.

One of Aetas’ specialists is Marie Foegh. She is a specialist in gynecology and internal medicine, and has specialized in hormone therapy for many years. Marie Foegh has over 20 years of experience in the field, has published more than 150 clinical studies, and authored over 40 textbook chapters. Throughout her career, Marie Foegh has held numerous national and international lectureships and has been a visiting professor. She served as Associate Professor in the Division of Transplantation at Georgetown University Hospital in Washington D.C., USA, where she was involved in organ transplantation and researched the effects of estrogen on the immune system.

Aetas’ other doctor is Henrik Nistrup. Henrik has a medical background spanning various medical and surgical specialties and has been affiliated with Novo Nordisk for many years. He has over 40 years of experience in general practice both in Denmark and internationally. In addition to his work at Aetas, Henrik practices as a doctor in the Faroe Islands, where he has been involved for many years.

Both doctors oversee Hormone Replacement Therapy (HRT) and Testosterone Replacement Therapy (TRT) and hold monthly medical conferences to review and reassess our clients’ treatment plans.

Can I raise testosterone levels with supplements?

While some supplements may have a small effect, most claims about supplements raising testosterone are not well-documented. DHEA supplements have a documented effect but are not legally sold in Denmark. Boron may have a minimal effect, and other supplements like Ashwaghanda and Tongkat Ali, recommended by some, currently lack clinically documented effects on increasing testosterone.

How can I naturally raise testosterone levels?

Natural ways to increase testosterone include regular exercise, a healthy sex life, fresh air, social interaction, hugs, laughter, and adequate sleep. Additionally, avoiding toxins and ultra-processed foods is recommended. Overweight individuals may face challenges with testosterone levels, and addressing lifestyle factors, such as improved diet and regular exercise, is a priority.

Am I suitable for TRT?

Individuals suffering from severe obesity, depression, enlarged prostate, aggressive behaviour, substance abuse, or illness are not suitable candidates for TRT.

What if I'm already in TRT but want treatment at Aetas?

The process is the same even if you’re already in TRT. This means that it’s a requirement that you have had blood tests done within 1 year, you have a prescription from a Danish doctor, and you pay for a consultation with our specialist doctor.

What are the expected costs?

When it comes to starting the treatment, our initial package costs 8,200 DKK and includes 2x blood tests and 2x doctor consultations + preparation, as well as prescription issuance and renewal. The response to the treatment varies from person to person, which may necessitate additional blood tests or consultations. Therefore, over the first year, you can expect the costs, excluding medication, to be approximately 10,000 DKK.

After the first year, the costs will decrease, as only biannual blood tests and consultations will be needed.

Biannual blood tests cost 1,900 DKK and consultations 2,200 DKK.

Please note that the above is subject to change, as prices may vary depending on your individual course of treatment.