Cambridge Ontario TRT Clinic

Testosterone Replacement Therapy Clinic serving Cambridge, Ontario patients.

Our Cambridge Ontario TRT Clinic offers testosterone replacement therapy for eligible patients.

We see patients who have symptoms of low testosterone in Cambridge, Ontario and do the appropriate testing. Consultations are covered by OHIP.

If appropriate, we prescribe testosterone and monitor closely with follow up visits.

Causes of Low Testosterone

There are numerous causes of low testosterone. We aim to find out if the cause is primary hypogonadism or secondary hypogonadism where another disease process is causing the low testosterone.

Examples of primary hypogonadism include:

Klinefelter syndrome
LH/FSH receptor mutations
Chronic organ disease such as liver disease
Certain medications
HIV
Mumps
Certain autoimmune diseases
Hemochromatosis
Cryptorchidism

Examples of secondary hypogonadism include:

Chronic opioid use
Hyperprolactinemia
Diabetes
Corticosteroid use
Infiltrative disease
Certain tumors
Kallman syndrome

Testing and Treatment

Diagnosing low testosterone requires blood tests that include the total and free testosterone levels. Once the diagnosis is made, then the next step is to make sure there isn't an underlying disease process. While patients with low testosterone do require replacement therapy, it is important to make sure there isn't anything else being missed.

Additional testing includes:

LH and FSH to help determine primary versus secondary hypogonadism
Ferritin and serum iron studies to rule out hemochromatosis
Prolactin levels
Targeted testing based on your symptoms and other possible causes

The laboratory evaluation is generally quite extensive and always includes "routine" comprehensive blood work. Certain patients may also require an MRI or ultrasound depending on what the laboratory evaluation and history and exam show.

Once the decision is made to start treatment, there are various therapies available. Injectable testosterone is a common modality of treatment. We generally aim for more frequent dosing to ensure stability of the levels. For men who absolutely cannot inject, there are topical creams available as alternatives. In certain cases where immediate fertility is a concern, discussions can be had about non-testosterone agents.

After treatment starts, there will be the need to do periodic monitoring. Monitoring lab tests include:

hemoglobin/hematocrit
total and free testosterone
LH and FSH
PSA (depending on age)
lipid panel & apoB
other targeted testing

These tests are done at approximate 6-8 weeks intervals after treatment initiation and subsequently become spaced out as time goes on. The goal is to ensure your serum testosterone levels are in an appropriate range while watching out for complications.