Testosterone therapy and aging men. Weighing out the potential benefits and risks  

For anyone considering starting TRT to help fight off the symptoms of aging, it’s important to know the benefits and risks associated with low T treatment.  

As men age, testosterone replacement therapy sounds like a promising solution to the signs and symptoms of growing older. There are lots of resources out there and most of the things you will read online seem to contradict each other. With so many misconceptions regarding what treatment can actually do, it’s important to speak to licensed and experienced healthcare provider.  It’s important to begin and focus on the facts about Testosterone.

Just what is testosterone?

Testosterone is a Hormone found in both men and women. The difference is that the amount of testosterone produced by men far exceeds the amount that women need for optimized health. Primarily produced in the testes, testosterone helps, maintain several important functions for men such as:

• The production of sperm
• Sex drive/libido
• Bone mineral density
• The distribution of fat throughout the body
• Lean muscle mass
• Strength
• Both facial and body hair
• Mood and self-confidence

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As we age what tends to happen to our testosterone levels?

Unfortunately, the older we get the lower our testosterone levels get. Testosterone levels peak around the age of 18 in men and begin to decline starting In our mid to late 20’s. Men usually lose 1% of our testosterone annually.  Many physicians just shrugged this off as due to the normal aging process however, some men may have an underlying medical condition such as hypogonadism.  Whether it’s an issue with the pituitary gland or the testicles, underlying medical conditions lower the body’s natural ability to produce testosterone can have a significant detrimental impact on a males overall health and well-being, and should be addressed by a licensed and experience medical practitioner.  Testosterone replacement therapy will not alter the body’s natural ability to produce testosterone. However, it can help alleviate the signs and symptoms of low T using exogenous testosterone, such as injections, gels/creams/patches, or even pellets.

How does one know if they have low testosterone?

Most medical experts would make this determination based on two factors. One would be through actual blood tests which measure the serum and free testosterone levels, and the other would be the signs and symptoms related to low testosterone.  Some of the signs and symptoms can include but are not limited to the following.

Decreased interest in sex, otherwise known as low libido. This lack of sex drive coupled with a decreased ability to achieve and maintain erections is a very common sign of low T.

Physical changes in the body. Are you gaining weight around your midsection, breasts, and hip/thighs? It’s possible that you may have a decrease in the amount of testosterone you’re producing which increases the depositing of body fat in these areas, which intern converts more testosterone through aromatization into estrogen.  This creates a cycle that only exacerbates the problem.

Decreases in lean muscle, mass and strength also are signs of low testosterone, and it even causes bone mineral density loss, which contributes to aging men feeling more “brittle and weak”.  

Changes in mood and emotional well-being. Testosterone has a significant psychological effect on men. Low T has been shown to contribute to decreased motivation and self-confidence, as well as increased feelings of depression and sadness. Some men report feeling mental cloudiness and lack of focus when their testosterone levels are low.

Granted, there could be other underlying functions causing these signs and symptoms, which is why it’s always important to confirm your diagnosis through comprehensive bloodwork, and a thorough consultation with your physician.  For example, low testosterone can cause, insomnia and problems with sleep patterns, and these problems can also cause low testosterone, so the question is which came first? An experienced Dr. may be able to get to the root cause and answer many of these questions for you.

According to a study, published in the annual review of medicine, volume 72, 2021, titled “The benefits and risks of testosterone treatment in menwith age related, decline and testosterone”, it states the following:

“Testosterone treatment of older men, with low testosterone levels, improves overall sexual activity, sexual desire, and erectile function; improves areal and volumetric bone density, as well as estimated bone strength in the spine and hip; corrects, unexplained anemia of aging, increases skeletal muscle mass, strength and power, self-reported mobility, and some measures of physical function; and modestly improves depressive symptoms.”

What are some of the potential downsides of testosterone therapy for normal aging men?

One of the major arguments against TRT is that there is not enough long-term evidence supporting TRT in men, however, testosterone replacement therapy has been used for decades and more and more clinical trials and data is coming out supporting its use.  All medication, including testosterone brings with it some potential risk. Some of these risks may include the following:

Worsening of sleep apnea. For patients that may suffer from sleep apnea, TRT may worsen the condition. It’s possible that testosterone therapy can increase the duration of time you have low blood oxygen levels and could increase have disrupted your breathing is during the night.  

Testicular, atrophy and decrease sperm production.  When taking exaggerates testosterone as a medication, it may shut down your body‘s natural production. Fortunately, there’s medication such as hCG, which can mimic the hormones released by the pituitary, which trigger the production of sperm and testosterone, and the testes, so this can be addressed by an experienced physician.  

Increased red blood cell production or polycythemia.  This is beneficial for patients who may be anemic, however bringing your blood hematocrit levels in to hire ranges, may be an area of concern for some patience.  By getting regular blood tests, checking the hemoglobin and hematocrit levels, which are proteins on red blood cells and the percentage of red blood cells per total blood volume will give the physician an indication of whether or not your body is producing an excessive number of red blood cells.  There are other factors besides TRT which may also contribute to polycythemia, so speaking to your physician about how to alleviate the symptoms is recommended.

Who should I talk to about whether testosterone therapy is right for me?

If you were like lots of men who are in their 40s or 50s, you’re probably paying closer attention to some of these commercials that seem to be constantly bombarding us on the radio, TV or Internet. If you want to know if testosterone treatment is right for you, speak with your doctor about the risks and benefits. Unfortunately, many doctors are not familiar with this specific area of medication so in some cases it’s best to speak with a physician who is experienced in hormone replacement therapy (HRT).

If you would like to schedule a free initial online consultation to speak directly with our physician who has years of experience clinically, treating patients with low testosterone, please give us a call so that we can schedule you an appointment.  The initial visit is free and can provide with you extremely valuable insight as to whether low T therapy is beneficial for you.

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