Male Bioidentical Hormone Replacement Therapy is used to help men find relief from the decline or imbalance of natural hormone levels. Declining or imbalanced hormone levels can be due to a variety of causes – including natural aging, genetic issues, toxins, and others.

Low T And Hormone Replacement Therapy For Men

For men concerned that they may be going through andropause, it’s important to build a relationship with a urologist, have regular evaluations and mitigate the risks that come with aging. Simple baseline testing can help identify underlying conditions and prevent them from surfacing.

Hormones are chemical messengers (signaling molecules) that are produced typically (but not always) by specialized glands of the endocrine system. They are powerful chemical influencers of your underlying physiology – in fact, I consider hormones to be “leveraged” due to the fact that a small amount of hormone can cause a relatively enormous response.

Hormones are signaled (often by other hormones) to be synthesized by your body, then they typically activate a process by binding to a receptor that itself is synthesized and regulated, and then are metabolized or broken down by specific processes, often in your liver. To make things more complicated, some hormones (including Testosterone) are mostly bound to protein molecules in your blood (for Testosterone, it is SHBG – Sex Hormone Binding Globulin) which in effect makes the bound hormone unavailable to your body – leaving ONLY the unbound hormone and “weakly bound” (non-SHBG bound) testosterone available to act upon its receptor. Thus levels of this binding protein affect the availability of active hormone in your body.

Hormones are powerful, and are to be respected, monitored, and managed with care.



  • Lower sex drive and libido (and sexual activity)
  • Decreased erections – AM and spontaneous
  • Osteoporosis (loss of bone mass)
  • Smaller testicles
  • Reduced hair both on face and body
  • Male Breast enlargement
  • Hot Flashes and Night Sweats
  • Fatigue
  • Memory loss and poor concentration
  • Mood swings
  • Heart palpitations
  • Insomnia
  • Anxiety
  • Depression,
  • Constipation/ Diarrhea/ Bloating
  • Increase in body fat
  • Loss of muscle mass

Remember – physiology is complex, interrelated and codependent in a variety of ways. Thus it is important to understand that other key issues can come into play beyond just testosterone decline that will affect health and wellbeing. These can include…

  1. Thyroid issues – both low and high (ie Hypothyroidism as well as Hyperthyroidism)
  2. HPA Axis issues (formerly referred to as Adrenal Fatigue)
  3. Methylation Issues (ie MTHFR)
  4. Detoxification issues
  5. Gut health and balance (including dysbiosis)
  6. and more…

You can feel confident that FoundationMED of Raleigh works to provides male hormone replacement therapy that is integrated in a comprehensive, whole body approach – addressing symptom relief, physiologic dosing, risk mitigation, and whole body support.

Bioidentical Hormones Vs. Synthetic Hormones For Men

Synthetic hormones (often used by physicians) are NOT the same as bioidentical hormones. The chemical structure of a bioidentical hormone is, well, identical to the given hormone as synthesized naturally by your body. This is not true for synthetic (non-bioidentical) hormones – which are NOT chemically identical to your natural hormones and thus not actually hormones at all – they are in fact chemical analogues.

Many times the beautifully complex processes that involve hormones (ie synthesis, activity, breakdown, regulation) are not the same with non-bioidentical hormones (vs bioidentical hormones) and because of that fact can cause significant negative consequences on your physiology and underlying well being.

It is for this reason that FoundationMED will only use Bioidentical hormones in treating our patients. In addition, we are always exquisitely mindful of using physiologic dosing (not high dosing that sometimes is used in some protocols), ongoing risk reduction, and advanced monitoring to insure the absolute minimization of risk.

What Is The Typical Timeline For Male Hormone Imbalance And Decline

As you probably know, testosterone is considered the primary hormone of concern (and the most powerful androgen) as men age and develop male hormonal imbalances.

Testosterone/Androgens are responsible for male traits including deeper voice, strong bones and muscle as well as male hair patterning. Testosterone drives male genital development at puberty and sperm production as well as sex drive and sexual performance, erections, energy, and aggressiveness.

With increasing age (although there can be other causes) testosterone levels fall – often Total Testosterone falls about 1% per year starting at age 40 or so, and Bioavailable Testosterone (Free + Weakly Bound) falls even more – about 2% per year.

With aging, male physiology changes. Bones “thin” (reduced bone calcium), declines are seen in muscle mass, body fat increases, energy levels go down and sexual activity can go down as well.