From My Mailbag ... Plus More Stuff

Hi Tom - Like the automatic subject line. Whenever I get to NYC.... Really writing about the testosterone therapy. My level was low so my Dr started me on the patch (seems to have no effect) and now the gel. Guess I'm wondering why you're taking it and what differences you have noticed. Don't know if I'm just placeboing or if there is a change. Thanks - D-----

Sent: Tuesday, December 14, 2004 3:52 AM
Hello D-----, How've you been? Well, I hope. Here's everything I know or was told by my Dr. re: testosterone replacement. Normally, men produce less testosterone naturally starting in their 40's. It's usually incremental and takes decades before the physical effects are dramatic. ( Meaning difficulty getting/maintaining an erection/difficulty achieving an orgasm/ lack of sex drive/ lack of energy.) In HIV+ men, a progressive and more rapid drop in testosterone production can be a simple side effect of the HIV and can occur anytime in your 20's/30's etc. I haven't found any information as to why this is, just that it is. Further, a drop in testosterone production can occur in otherwise healthy men although a drop for no reason is admittedly rarer.

Low testosterone levels are usually diagnosed from a few (or series) of blood tests that confirm a gradual downward trend in testosterone production. In my case, my levels fluctuated around the low/normal levels for the last eight months with the last two tests being consistently lower. So we decided on beginning treatment. I was given the option of receiving an injection followed by me giving myself injections of testosterone replacement. Aside from the obvious yikes! factor, I declined the option because my research showed that many health professionals think that flooding your system with that much testosterone at once is unhealthy. It taxes, among other things, the liver and other organs that are used to processing the body's testosterone output more gradually. It's why I chose the gel, which is absorbed through the skin over a six hour (approximately) period.

I've been on the therapy for about three weeks now and I have noticed some changes. The return of my morning erection has already been discussed and celebrated in my blog. And while it's not the piece of pipe I used to wake up to in my 20's, it's definitely a change. Further, I'm having a series of what I've dubbed IE's (inappropriate erections). Last week, I was headed to my favorite pizzeria for a couple of slices. A fantasy popped into my head as I was walking down the street and I found myself getting a raging, obvious hard-on in my cords. And, as usual, running commando, so I had to think of dead puppies and kittens and quick. Now, I really, really like the pizza there but honestly....

Today, I was doing cardio on a new piece of gym equipment and between my loose-fitting sweats and the boxer briefs I was wearing and the angle I was pumping my legs at..... dead puppies and kittens.

I have to say I'm noticing some personality changes as well but they're harder to prove. I'm irritable. But I'm always irritable so you'll just have to trust me when I say I'm more irritable than normal. I've had to stop myself on several occasions from exploding in public at a rude cashier or a stupid tourist. Fortunately, I was aware this would be a possibility and seem to be learning how to compensate.

The only way to tell for sure if the testosterone replacement is working is with a blood test. I'm assuming if you claim the patch was having no effect that you had a blood test confirming this. I'll be using the gel for another three weeks before I take a blood test to get some new numbers. Testosterone therapy is by no means experimental. It's a legitimate condition with a legitimate treatment. So I don't see how you would be given a placebo. Placebo's are usually given for drugs in an experimental phase. And while I'm no lawyer, I believe if you are involved in some sort of a program where you can possibly be given a placebo as a control group, you would have to sign some sort of document/agreement stating that. Unless your hometown is Tuskegee. My prescription comes from a national chain drugstore and goes by the brand name Androgel. I would think you could just Google up whatever you're taking and confirm it's the real deal.

I hope this is along the lines of what you were looking for. I admit, I was a bit apprehensive about (in effect) shutting off my balls. But in the end, I've never been a big ball man anyway. And if the trade off is the really (I hate to brag) enormous erection I popped yesterday when my masseur finished his "session" on me, and today when I took matters in hand myself, well then, god bless chemical enhancement.


Also-

Researchers at Rutgers develop three drugs they say destroy HIV.

I've been meaning to highlight his blog. Aside from being highly entertaining, he posted a link and then a very interesting essay on World AIDS day. This elicited a very thoughtful series of comments from a diverse group. All in all a wonderful job. I didn't comment because there was much to digest. There still is.

On a related tip, Larry Kramer sits down with Village Voice columnist Alisa Solomon and expounds on some thoughts and comments widely carried around the blogverse from his Nov. 7 Cooper Union speech. Make no mistake, I consider Larry Kramer to be a living gay hero. But I significantly disagreed with much of that speech. Here, with an interviewer forcing him to clarify and expand his line of thinking, I find his call to arms familiar and inspiring. I can only speak for myself, but I sense something's brewing in the land of cock smokers and muff divers. Be afraid, be very afraid. Read it here.