As men age, their testosterone levels naturally decrease. Some men may experience symptoms such as low energy, reduced sexual drives, impaired ability to concentrate, depression, or mood alterations. If these changes are linked to low testosterone levels, in some cases they can be cured with testosterone replacement therapy. Before initiating testosterone replacement therapy, low testosterone levels should be confirmed using a blood test. However, testosterone replacement therapy may have side effects, some of which are still unknown.
Benefits of Testosterone Replacement Therapy
Before we explore the benefits of testosterone replacement therapy it is important to note that each man is different and may respond differently to treatment. The most common benefits include increased muscle mass and bone density, as well as increased sensitivity to insulin. Some men also report improvements in their sex drive and erections, as well as improvements in mood and level of energy.
Side Effects of Testosterone Replacement Therapy
In general, testosterone replacement is thought to be relatively safe; however, there is not enough data from clinical trials to conclusively state its long-term benefits and risks. The most frequent mild side effects are irritation, itching, and/or rashes at the testosterone application site. There is data to suggest that some health conditions may be worsened by testosterone replacement therapy and these conditions are detailed below.
- Enlarged prostate (Benign prostatic hypertrophy, BPH): Normally, testosterone stimulates the growth of the prostate gland. In most men, the prostate increases with age, and it can become so large that it constricts the urethra thus making urination difficult. Testosterone replacement therapy enhances BPH.
- Prostate cancer: Men who have been diagnosed with prostate cancer should not have testosterone replacement therapy because testosterone can enhance the growth of prostate tumors. In fact, men should be screened for prostate cancer prior to beginning testosterone replacement therapy.
- Sleep apnea: Some men may experience difficulty breathing during sleep when they are given testosterone replacement therapy.
- Erythrocytosis: Testosterone replacement therapy enhances the production of red blood cells, which can make blood more viscous and increase the risk of blot clots. Therefore, it is important to monitor the red blood cell counts of men who are receiving testosterone replacement therapy.
- Congestive heart failure: The ability of the heart to pump sufficient blood throughout the body may be negatively impacted by testosterone replacement therapy. Therefore, a diagnosis of severe congestive heart failure should preclude a man from getting testosterone replacement therapy.
Forms of Testosterone Supplements
Testosterone replacement therapy can be administered using a variety of delivery methods:
- Transdermal administration: Testosterone can be absorbed through the skin. An example of this is the skin patch Androderm, which is applied once daily to the upper body or on the arm. Similarly, the testosterone gels AndroGel and Testim can be applied to the skin once daily.
- Oral administration: Instead of simply taking a testosterone pill, the testosterone tablet Striant is stuck to the gums of the upper incisor. Unlike oral testosterone pills that may negatively impact the liver, the testosterone in Striant is absorbed directly in the blood stream through the gums.
- Injections and implants: The gels AndroGel, Axiron, and Foresta are available in pumps that can be used to administer a steady level of testosterone. In addition, testosterone pellets can be implanted into soft tissues or testosterone can be directly injected into the muscles. In which case, testosterone is slowly absorbed into the blood stream. Here is a video demonstrating the correct way to inject testosterone: