Frequently Asked Questions
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TRT stands for Testosterone Replacement Therapy. The replacement of a man’s natural testosterone production when it is lower than it should be. Mainly this occurs through the use of testosterone medication (exogenous testosterone) that is usually provided through injections, patches, or gel.
Testosterone is the male sex hormone responsible for male characteristics and health. It is important for sexual function, muscle building, cognitive function, fertility and mood enhancement amongst other complex roles within the male body. It occurs naturally to a lesser extent in females.
It is extremely important for good health and general well-being in all men but is often ostracised in the media and by many doctors for its connections to violence, aggression and ‘toxic masculinity’ amongst other things.
Testosterone levels can become low for many reasons, some of which are still not fully understood. We know that the modern man’s testosterone levels are on average 20% less than they were 20 years ago. This may be due to a combination of several factors:
- Environmental factors such as plastics and fertilisers leaching chemicals into the water supply/food
- Hormones from the contraceptive pill disrupting the male hormonal system
- Anabolic steroid use – often a full recovery of the HPTA does not occur after shutdown of natural production
- Soy consumption – phytoestrogens from some foods such as soy can reduce T levels
- Stress – chronically increased cortisol production may reduce T levels
- Congenital disposition
- Age related decline/andropause
- Pesticide exposure
- Obesity – increased body fat can lead to higher conversion of testosterone into oestrogen.
Many of these factors are at play in the men of today. These can lead to suppressed hormone function and symptoms of low testosterone. If you notice these factors in your life then it may be time to get a test, or talk to one of our advisors today who can help you to further identify any symptoms of low testosterone.
- Wash your hands.To reduce the risk of infection, it’s important to keep your hands clean when giving an injection. Wash your hands thoroughly with antibacterial soap and water.
- Use a sterile, suitable needle and syringe.As with all injections, it’s important to use a sterile, never-before-used needle when administering testosterone. Another item to consider is the fact that testosterone is fairly viscous and oily compared to other injectable medications. Because of this, you’ll want to use a slightly thicker-bore needle than normal (21-gauge) to draw up your dose. This will be supplied as part of the service.
- Draw up a dose.Your doctor will have given you a recommended dose – determine the volume of your dose in relation to the concentration of your testosterone. To draw up your dose, first draw air into your syringe equal to the volume of your dosage. Then, wipe the top of the medication bottle with an alcohol wipe, insert your needle through the lid and into the medication, and push the air from your syringe into the bottle. Turn the bottle upside down and draw out the exact dosage of testosterone. Injecting air into the bottle raises its internal air pressure, making it easier to draw the medication into the syringe. This is especially important with testosterone, which can be difficult to draw because it’s so thick.
- Swop needles. Remove the 21-gauge needle and replace with the 27-guage supplied. This is a much thinner needle and will make the injection painless.
- Aspirate the syringe.Injecting air bubbles into a person’s body can cause a serious medical condition called an Because of this, it’s very important to ensure there are no air bubbles in the syringe when you inject the testosterone. Do this via a process called aspiration. See below for instructions:
- Hold the syringe with its needle uncapped and pointing up in front of you.
- Look for air bubbles in the syringe. Flick the side of the syringe to get these bubbles to rise to the top.
- When your dosage is bubble-free, slowly depress the plunger to force the air at the top of the syringe out. Stop when you see a tiny drop of medication come out of the tip of the syringe. Be careful not to squirt or spray a significant portion of your dosage onto the floor.
- Prepare the injection site.Testosterone injections are typically intramuscular – that is, given directly into a muscle. Two relatively easy and accessible sites for intramuscular injection are the deltoid (upper arm) or the glut (upper back portion of the thigh, ie, the butt cheek). These aren’t the only places that testosterone can be injected, but they are by far the most common. Whichever of these sites you choose, take a sterile alcohol pad and wipe the immediate area around where you intend to inject. This will kill bacteria on the skin, preventing infection. If injecting into the glute or buttocks, choose an injection site in the top outside section of the glute. In other words, pick a site either in the top left corner of the left glute or the top right corner of the right glute. These site have the best access to muscle tissue and allow you to avoid hitting nerves and blood vessels in other parts of the glute.
- Hold your loaded syringe like a dart at a 90-degree angle above the sterile injection site. Quickly plunge it into the flesh. Before depressing the plunger, draw back on it slightly. If you draw blood into the syringe, remove the needle and choose a different spot, as this means you’ve hit a vein. Inject the medication at a steady, controlled pace.
- Care for the injection site post-injection.Once you have fully depressed the plunger, slowly pull the needle out. Press around the injection site with a sterile cotton swab as you do so – this prevents the emerging needle from pulling on the skin and causing extra pain. Assess the needle entry point for bleeding, and apply a sterile Band-Aid and/or cotton swab if needed. Dispose of the used needle and syringe in a proper sharps container.
- Always store your medication at the recommended temperature, and always check the expiration date on the bottle.
- Videos online. There are also multiple videos online that demonstrate intramuscular injections.
- Initial bloodwork with Lancet Laboratories.
- R500 doctors consult;
- Depending on the dosage, the monthly fees will range between R1,500 and R2,000.
- Follow-up bloodwork with Lancet Laboratories every 3 to 6 months.