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As some of you may be aware, the local government in my area has decided, in its infinite wisdom, that testosterone will no longer be a covered medication under the provincial health care system. Evidently, they do not feel that it is 'medically necessary.' As a result, I will have to stop taking it within a month, when my current supply runs out.

However, there is a small chance that I may be able to appeal this decision. It is because of this that I come to you, for help. I need links or other references to medical studies or literature which show that HRT is something that is essential. Perhaps studies dealing with andropause, hypogonadism, etc?

I already have one or two minor references showing links between low testosterone levels and osteoporosis

here (http://courses.washington.edu/bonephys/opmale.html) and here (http://www.urologychannel.com/testoster ... ndex.shtml) but I would like something more official to use as further evidence.

At least the second one also mentions depression & mood disorders as possible results of low testosterone levels. So maybe if my front-on attack doesn't work, I can try again to sneak it through a mental-health department.

For now though, any help would be most appreciative. Thank you all, for reading this, and especially thanks to any of you who help me out with this.

IEunuch.

(Who knows that he'll wind up in hospital within a few months without the shots, but needs evidence to show the govt.)

A quick use of GOOGLE with search words "osteoporosis"and "male" came up with

http://www.applesforhealth.com/maleosteo1.html

I'll do a more comprehensivesearch when I have time later today

IEunuch,

Are you in Canada? If so, which province?

I'm in BC, and the government here is gutting many social and medical services. For instance, we now have to start paying for eye exams, since they don't consider those necessary.

SD

The National Osteoporosis Foundation can be found at...

http://www.nof.org/

They have a page devoted to osteoporosis in men, including the use of testosterone for prevention and treatment, at...

http://www.nof.org/men/index.htm

I'm sure many British Columbians would like to see the Premier

as a non-elective member of this group.

BossTamsin (imported) wrote: Mon Feb 25, 2002 4:11 pm I already have one or two minor references showing links between low testosterone levels and osteoporosis

[

I ran your request throught alt.support.menopause (where I am an Honerary Menobabe) and got some interesting replies.

For starters, it would seem that testosterone to prevent osteoporosis may not fly. Even women at elevated risk for osteoporosis get little help.

However, your doctor CAN prscribe testosterone under certain limited conditions. You will have to find the exact text of the announcement and look for loopholes, then work it out with your doctor.

SplitDick (imported) wrote: Tue Feb 26, 2002 12:58 am IEunuch,

Are you in Canada? If so, which province?

I'm in BC, and the government here is gutting many social and medical services. For instance, we now have to start paying for eye exams, since they don't consider those necessary.

SD

Yes, I am in Canada. Yes, I am in BC. Yes, I would like to castrate Gordon Campbell.

And thank you, Andrew, for your help and links. I'm gonna see if this makes a difference in the application.

BossTamsin (imported) wrote: Tue Feb 26, 2002 4:19 pm And thank you, Andrew, for your help and links. I'm gonna see if this makes a difference in the application.

By the way, did you get that e-mail I sent you that quoted what a Menobabe posted in alt.support.menopause? If I understand it right, you can still get testostertone if your Physician prescribes it, but you may have to pay for it out of your own pocket.

Well, it does seem that not paying for testosterone is a mistake. I could see not paying for it for men who are marginally low, but for those who are actually fully castrated it seems medically necessary.

If test replacement is something you need lifelong, you might need to consider changing provinces.

Gordon Campbell has certainly made himself hated. He has taken something away from everyone. Unfortunately, there still isn't a viable opposition to vote for.

Andrew (imported) wrote: Tue Feb 26, 2002 10:04 pm By the way, did you get that e-mail I sent you that quoted what a Menobabe posted in alt.support.menopause? If I understand it right, you can still get testostertone if your Physician prescribes it, but you may have to pay for it out of your own pocket.

Hmm.... no, haven't seen the e-mail.

And yes, if I could afford it, I could pay for it out of my own pocket. Trouble is, I'm unemployed. I don't have any extra money with which to purchase it. In fact, truth be told, I'm officially considered 'Disabled', and unable to work.

IEunuch.

(Thanks to everyone for helping)

IEUNUCH,

I sympathize with you, my friend. As an ex-Canadian I can fully understand your distress. The Canadian Medical system is in the process of breaking down because of (in my opinion) abuse and over-zealous users. the result is that they keep cutting back benefits.

The good news is, if you can believe this eunuch, you do not need testosterone unless you wish an active sex life. As for osteoporosis, I do not believe the warnings and threats of doctors who have more or less assumed that since females without hormones lose bone densities, men without hormones will do the same. The cold truth is that there simply are no conclusive studies (that I have found).

I am a eunuch and am not taking testosterone. So far my bone density is holding, but I promise to keep all on this board informed. I am also not totally dysfunctional sexually, but I'm close. Again, I believe the use of testosterone replacement is entirely dependent on your age and motives.

BossTamsin (imported) wrote: Wed Feb 27, 2002 4:20 am Hmm.... no, haven't seen the e-mail.

Shall I try to resend it? Ifso, to what e-mail address? I tried to use the one that the Message Board system assigned to you.

IEUNUCH,

Charlieje (imported) wrote: Wed Feb 27, 2002 5:54 am The good news is, if you can believe this eunuch, you do not need testosterone unless you wish an active sex life. As for osteoporosis, I do not believe the warnings and threats of doctors who have more or less assumed that since females without hormones lose bone densities, men without hormones will do the same. The cold truth is that there simply are no conclusive studies (that I have found).

Well, from the bit that I've read, based upon studies of hypogonadal/andropausal men, osteoporosis at least can happen. No guarantees, but it is a possibility.

For me, though, osteo runs heavily through my family (as do a lot of other nasty things), so that is one of the things I am worried about. As important, though (or possibly more) are the mental health issues. Ask anyone who knows me, my mental health isn't all that stable at the best of times. Without testosterone, it sinks farther and faster. Without going too much into specifics and other things that would likely bore/annoy the majority on here, I can say that bad things will happen should I be off it too long.

However, it is incredibly difficult to properly explain mental health issues to anyone who hasn't dealt with them personally. Physical things like osteo are much simpler to grasp for most people. So I think I will present the osteo/physical health aspect first, and leave the mental health issues for second.

IEunuch.

(Mental health: Just say no!)

I have seen studies that suggest bone density can decrease up to 39% when taking anti-androgens. I will post a link when I find one.

This problem can always be solved with calcium supplements.

By the way, Canadians, if you don't like your governer (I assume that is who Gordon Campbell is) you may have Janet Reno. He has already been castrated...or is it she?...both? Whatever.

IEunuch,

This site lists a number of side effects of low adrogen hormones:

http://www.hypertext.org/ENGLISH/HB.html

The list is extensive, and makes me wonder why HRT is considered an unnecessary treatment for those who are castrated.

Osteoporosis is a serious risk when you are castrated (either surgically or chemically). At www.oncology.com one article states:

"In another retrospective review, history of orchiectomy, other risk factors for osteoporosis, and incidence of fractures were evaluated in 235 men with prostate cancer (6). Among 59 men with a history of orchiectomy, 14% had at least one osteoporotic fracture compared to only 1% of men with prostate cancer with no history of orchiectomy or treatment with a GnRH agonist (p=0.001). The cumulative rates of fracture seven years after castration or diagnosis were 28% and 1%, respectively (p=0.001). Among the men surviving longer than five years after orchiectomy, 38% had one or more osteoporotic fractures. Osteoporotic fractures were more common than traumatic or pathological fractures.

...Collectively, these prospective studies suggest that orchiectomy or chronic treatment with a GnRH agonist results in a 5% to 10% annual decrease in BMD in elderly men, a magnitude of bone loss that markedly exceeds the rate of bone loss associated with menopause (5). Extrapolation from fracture data in women suggests that each one to two years of gonadal steroid deprivation for prostate cancer increases fracture risk by two-fold.

. "

So I would say it is a serious health risk.

---------

Madscientist,

To properly counteract the risk of osteoporosis, you need a combination of medication (to inhibit bone reabsorbsion), high daily calcium intake, vitamin D, and strength training. It can be managed, but does require a daily regimen.

Thank you once again everyone for your help with this matter. I tried to present all the information I could, about all the issues involved. I managed to convince my doctor that it was a medically necessary medication. All to no avail.

The BC provincial government has come down with a final ruling. No coverage for testosterone. No exemptions. No matter what. Period.

So, I'm screwed. I've run out, and am now on week 3 of no testosterone. Needless to say, my mood and mental health have taken quite a beating. Not to mention all the other hellish things that are going on in my life right now.

Now if only I could afford booze or drugs to take away the pain...

IEunuch.

(I hate my fucking life...)

IEunuch,

Do you know whether they are still covering estrogen? If they are then I suggest starting a discrimination suit against the government.

I can't see how estrogen would be any more necessary than testosterone.

SplitDick (imported) wrote: Mon Mar 11, 2002 2:49 am IEunuch,

Do you know whether they are still covering estrogen? If they are then I suggest starting a discrimination suit against the government.

I can't see how estrogen would be any more necessary than testosterone.

I wonder if IEunuch could get estrogen prescribed for him instead? I heard that that would help with osteoperosis too...

For those like us who live in BC, here is a statement from the ministry of health regarding coverage plans:

http://www.hlth.gov.bc.ca/cpa/newsrel/services/218.html

I really wonder what the AIDS societies have to say -- my understanding is that testosterone is an important hormone for AIDS patients in order to help them retain muscle mass.

Again, if they still cover estrogen then they are being very discriminatory. What is the difference between a woman who had an ovarectomey and a man who had an orchiectomy? Both are lacking a serious hormonal component in their body, and there are not "less expensive alternatives".

IEunuch,

Here is some important info for you. According to the BC Pharmacare program, they are supposed to supply "low cost alternatives" or "reference drugs" for any medically necessary conditions. Therefore you should ask your doctor what those would be in your case. I suggest your doctor list that you will need medications to control oesteoporosis, mood, and sexual function, etc.

Then, apparently Pharmacare will reimburse you for the amount of the low cost alternatives, even if you chose to buy the more expensive alternative. In other words, you will get some of the cost for the testosterone paid for.

The info is at: http://www.hlth.gov.bc.ca/pharme/lowcost.html

and at:

http://www.hlth.gov.bc.ca/pharme/rdp.html

Hope that helps!

SD