Testosterone Therapy
Understanding Testosterone
Testosterone is a hormone that plays a key role in the body. In men, the testicles make most of the testosterone. This hormone supports bone strength, muscle mass, and body hair growth. It also helps make red blood cells, keeps sex drive (libido) healthy, and aids in sperm production.
Low testosterone levels can affect many functions. Both men and women have testosterone, but men have much higher levels. Women’s bodies make smaller amounts of this hormone, mainly in the ovaries and adrenal glands.
How Testosterone Shifts as People Get Older
Testosterone peaks in the late teenage years and early adulthood. After about age 30 or 40, levels usually drop about 1% each year. This decline is a natural part of the aging process. A condition called hypogonadism can also lower testosterone. With hypogonadism, the body cannot make enough testosterone due to problems in the testicles or the gland that controls them.
People with hypogonadism may benefit from testosterone replacement therapy (TRT). Doctors can prescribe injections, skin patches, gels, or under-skin pellets to increase hormone levels and alleviate symptoms such as low sex drive and fatigue.
Are Aging Symptoms Always Caused by Lower Testosterone?
Not every sign of aging comes from low testosterone. Changes like less energy, lower sex drive, more body fat, or weaker muscles can relate to falling testosterone. Other signs can include trouble with erections, less facial or body hair, and weaker bones.
Other health conditions can cause similar symptoms, such as sleep apnea, thyroid illness, certain medications, diabetes, and depression. Some of these issues can also lower testosterone. Doctors usually use a blood test to confirm low testosterone before starting any treatment.
Can Testosterone Therapy Help Restore Youthfulness?
Testosterone treatment can help people with low testosterone caused by hypogonadism. In these cases, therapy may improve muscle strength, energy, and sexual function. For healthy men who are just aging, the benefits of testosterone replacement remain unclear.
Research indicates that it may slightly enhance sexual desire for some, but there is little evidence that it restores youth, lifts mood, boosts energy, or improves overall vitality in most healthy older adults.
Quick Facts
- TRT does not slow natural aging.
- Effects like improved libido or sexual function may be mild.
Possible Risks and Side Effects of Testosterone Treatments for Older Adults
Testosterone therapy can cause side effects and risks, especially for those with normal aging. Some possible problems include:
| Risk | Description |
|---|---|
| Sleep apnea | TRT may make this sleep disorder worse. |
| Acne or skin reactions | More common with gels, patches, or topical creams. |
| Enlarged breasts | Also called gynecomastia. |
| Shrinking testicles | Sperm production may go down. |
| Prostate growth | Can worsen benign prostatic hyperplasia (BPH). |
| Risk of prostate cancer | May speed growth of existing prostate cancer cells. |
| Too many red blood cells | Can lead to deep vein thrombosis or pulmonary embolism. |
| Heart-related problems | Increased risk of heart attack, stroke, or heart failure. |
Extra red blood cell production increases the chance of blood clots, which can break off and travel to the lungs or other vessels. Researchers are still investigating if TRT increases the risk of heart issues, including heart failure or death from heart disease. Testosterone can also cause fluid retention, affect bone density over time, and may limit fertility.
When to Discuss Testosterone Therapy With Your Healthcare Provider
If you are thinking about testosterone therapy, talk with a doctor first. The doctor will usually order blood tests—sometimes more than once—to make sure levels are truly low.
Doctors do not recommend TRT just for normal aging. If low testosterone is due to treatable issues like obesity or inactivity, a doctor may recommend lifestyle changes as the first step. Losing weight or building more muscle through resistance training can help boost testosterone naturally.
Doctors can determine if testosterone replacement therapy (TRT) is necessary or if natural methods are more suitable. It’s important to discuss any risks, benefits, and possible side effects with a medical professional. Key topics to talk about with your doctor:
- Symptoms such as low libido, fatigue, erectile dysfunction, or decreased muscle mass.
- Types of testosterone treatment (gels, injections, patches, implants, etc.).
- Need for regular monitoring of prostate, blood counts, and heart health.
- Family history of prostate cancer or breast cancer.
If you see signs of low testosterone, consult a medical provider to explore options like TRT, other treatments, or lifestyle changes.
