YES…

The oral route: the medication must be taken daily. It undergoes first-pass metabolism in the liver, which increases hypercoagulability and the risk of thrombophlebitis. It can cause nausea or digestive issues. It raises inflammatory markers, SHBG, and triglycerides. It may also increase blood pressure.

The transdermal or vaginal route: the medication must be administered daily or twice daily. It can cause skin irritation, and 45% of women have poor absorption. There is also a possibility of transfer to others.

The injectable route: now rarely used due to too fluctuating release levels.

The subcutaneous route with pellets or implants: this route allows for a stable level in the months that follow. There may be some discomfort related to insertion or a possibility of expulsion. There are minimal restrictions in the days following implantation.

• It is a physiological replacement therapy.
• It uses bio-identical hormones.
• It is biologically active.
• It is absorbed directly.
• It is effective since blood levels remain stable.
• There are no daily “rollercoaster” effects.
• Side effects are minimal.
• It is convenient because its effect lasts about five months, requiring only two or three insertions per year.

Additionally…

• It can lower cholesterol and triglyceride levels.
• It can improve insulin sensitivity.
• There is no weight gain.
• It is the best method for improving bone density.
• There is no increase in inflammatory markers or SHBG.
• There is no increased risk of prostate cancer.
• No risk of clots, thrombophlebitis, heart attack, or stroke.

• A testosterone pellet consists of pure testosterone.
• The pellets are compressed under thousands of pounds of pressure and sterilized by E-Beam (not autoclave).
• They are manufactured by a specialized pharmacy.
• Quality control is performed by an independent pharmacy.
• Their effectiveness begins about 10 days after insertion and can last between three and four months.
• Absorption is not based on a predetermined duration, but rather on cardiac output; indeed, the duration of a pellet can vary depending on a man’s level of physical activity. Active men, especially runners, will have a duration of about four months, whereas the duration of a testosterone pellet will be closer to five months for less active men.

• You will have an initial consultation with Dr. Marois. You will discuss your medical history as well as your current symptoms. At the end of the appointment, if you are a candidate for this therapy, you will receive a request for blood tests.

• A follow-up appointment will be scheduled one month later, and if the results show that you are indeed a candidate for hormone replacement therapy, a nurse will explain the bio-identical hormone treatment. You will be asked to complete questionnaires about your symptoms. This appointment will take approximately 30 minutes.

• An appointment will be scheduled for the insertion of the implants.

• You will be welcomed by a nurse. The testosterone dosage will be determined using computer software, based on your blood tests and your symptoms.

• You will lie on your side or stomach, and local anesthesia will be administered by Dr. Marois at the insertion site and along the subcutaneous pathway above the gluteal fold. He will then make a small incision and insert a trocar. The testosterone implants are then placed into the subcutaneous fat. Dr. Marois will finish by applying closure dressings.

• A nurse will apply pressure to the site for seven minutes while providing you with instructions.

• A blood test will be scheduled six weeks after the first insertion.

• A follow-up phone call by a nurse will be made after two months of treatment. Your symptoms and blood test results will be evaluated. If the test results indicate that your prescription needs adjustment, Dr. Marois will make the necessary changes. It is always a good idea to schedule your next follow-up for the following year in advance.

• At any time during treatment, you can call the clinic to schedule a phone consultation with a nurse if you have questions or feel you may need adjustments.

• It is a procedure that requires local anesthesia.
• There may be slight discomfort during implant insertion.
• There is a low risk of bleeding and infection.
• There is a low risk of implant extrusion.
• There is a period of rest from physical exercise, especially involving the legs, for 48 hours.
• This treatment is not covered by RAMQ.
• This treatment is not covered by many private insurance plans.