What are the Benefits and Risks of Testosterone Replacement Therapy?

Aging men in search of the “fountain of youth” often turn to treatments such as testosterone replacement therapy to roll back the hands of time, whether it’s to restore a diminishing sex drive, reverse erectile dysfunction or to simply renew their sense of youthful vigor and vitality.

Testosterone is found primarily in the testes and is responsible for the appropriate development of male sexual characteristics as well as maintaining bone density, fat distribution, muscle bulk, proper red blood cell levels, sperm production and sex drive.

But what happens when this hormone dwindles?

Though a decrease in testosterone levels is part of the normal aging process (usually starting around age 30), unusually low levels of testosterone – hypogonadism – could contribute to noticeable physical and emotional changes such as reduced sexual desire, increased body fat and a general lack of energy.

These symptoms – which are not experienced by all men with lower than normal testosterone levels – are all part of the normal aging process, but may still result from other underlying factors including medication side effects, excessive alcohol use, etc. That’s why a blood test is the only way to provide an adequate diagnosis of low testosterone.

Only when testosterone levels are below average is testosterone replacement therapy an appropriate and safe option.

Various therapies include intramuscular injections or testosterone gels and patches worn on the body or scrotum, which may help to restore muscle mass, boost libido, sharpen memory and concentration and improve energy levels among other things.

Each treatment has its advantages and disadvantages and a doctor can determine what approach is best for you. Nonetheless, it remains unclear whether testosterone therapy would have any benefit for aging men who are otherwise healthy – in fact, the risks may outweigh the advantages.

Side effects of therapy include, but are not limited to: overproduction of red blood cells (polycythemia), which can increase the risk for heart disease; enlargement of breasts (gynecomastia); decrease in sperm count or even infertility; testicle shrinkage; and stimulation of prostate tissue or exacerbation of existing prostate cancer.

While testosterone replacement therapy might seem like the perfect anti-aging solution, the health-related benefits of testosterone therapy for age-related declines in testosterone are uncertain. Supplemental testosterone to treat an unusual decline in testosterone levels may be appropriate – considering the risks and benefits – but treating normal aging with testosterone therapy on the other hand remains controversial and may not produce the results you’re hoping to find.