Sometimes medication and/or replacement hormones are given, and the endocrinologist will monitor your levels with regular blood tests.
Hormone replacement therapy replaces the hormones that your body no longer naturally produces due to the damage of your pituitary gland. There normally shouldn’t be any side effects of this type of treatment. Not everyone will need hormone therapy, however, if this is a line of treatment that you need then you will most likely be on replacements for life. Elderly people may not be replaced with sex hormones, but there is no real upper age limit. Those treated with oestrogen replacement may find this is discontinued once the average age of menopause is reached.
You should still continue taking your hormone replacement medications even if you are unwell, unless your doctor advises otherwise. If you accidentally miss a dose then it shouldn’t affect your treatment – but you shouldn’t double your dosage next time you take the tablet.
If you are on hydrocortisone, you may need to increase your dosage if you become unwell, this is called the sick day rules.
Replacing Testosterone
Replacing testosterone should improve your sexual function, libido and emotional stability. Your energy and physical stamina will increase and your physical appearance may change. Longer-term benefits include changes in skin texture and a decreased risk of osteoporosis and depression. If your pituitary glandis missing or irreversibly damaged, you will need to replace testosterone for the rest of your life. As you get older, the amount of testosterone that you are given may decrease -testosterone levels normally fall with advancing age.
Taking the testosterone
There are two ways to take testosterone replacements: intramuscular injections and gels. You doctor will decide which option is best for you.
Intramuscular injections –There are 2 injection types, one given every 2-3 weeks and one given every 10-14 weeks. Generally, these are given by a nurse at a Treatment Room or GP practice, however some centres may be happy for you to self-administer the 2-3-week injection once trained to do so. There can be pain at the injection site and there is a possible complication of impingementon the sciatic nerve that can result in a ‘dead’ leg for a few days. Let your nurse know if any of this happens to you. The testosterone level can also swing in peaks and troughs, particularly with the 2-3-week injection and may need careful monitoring to arrive at the best injection interval for you.
Gels –These can easily be applied yourself, and are applied on a daily basis.You should wash your hands after applying the gel to avoid transfer of gel to other people. Some people may notice a skin irritation at the application site please let your Endocrine team know if this becomes an issue. You should alternate your application sites each day.
Whichever type of testosterone replacement therapy you take, you will need to have your levels of testosterone measured after few weeks to ensure you are getting the right amount of hormone. This will involve giving a blood sample. It may be necessary to repeat this blood test at intervals. You will need examination of your prostate gland usually by your GP at least once a year as long as you remain on testosterone as well as a prostate blood test called PSA.
Side Effects of testosterone hormone replacement
The most common side effects with hormone replacement therapy are local reactions. If you are receiving replacement hormones by intramuscular injections, there may be skin redness, swelling and bruising. Gels as mentioned above can cause skin irritation where applied and so the application site should be rotated each day. Other side effects due to hormone replacement therapy seem to be very rare. Remember, the aim is to restore your body’s normal levels of hormones.Testosterone replacement very rarely leads to aggressive behaviour in men, and this is more common if the individual has never before had normal hormone levels.
Replacing Gonadotrophin
Gonadotrophin replacement is only needed if you wish to have a child -once this has been achieved you should discuss your treatment options with your doctor. Replacing the gonadotrophin with hCG/hMG will increase your sperm production and thus improve your fertility. Gonadotrophin injections are given until sufficient sperm is present in the ejaculate which may take up to two years. Sperm can also be frozen for future use. In order to monitor how you are responding to gonadotrophin replacement, your doctor will need to check semen samples to see if your sperm count has risen.
Frequently asked questions
Do I need to keep my medication in the fridge?
Growth hormone commonly needs to be kept refrigerated except for a disposable version.However, if you wish to maintain the expiry date on the pack of GH then all should be stored in the fridge. Desmopressin Intranasal needs to be kept in the fridge, but the tablets, melts and spray don’t. Other pituitary hormones don’t need to be kept in the fridge, but check with your doctor or pharmacist for full details of how you should store your medication.
Can I still drink alcohol?
There is no interaction between alcohol and most replacement hormones and you are allowed to drink in moderation in line with the recommended government amounts. Why do I feel so emotional even though my hormones are replaced?It is common to feel a swing of emotions with a pituitary condition. Treatment, tests and having to take regular medication can affect how you cope emotionally. Our support services can offer you additional advice and guidance on this.
