There are many enticing prospects with testosterone therapy. Not only does the therapy enhance your sexual health with a boosted libido and bags of energy, but other areas of your wellbeing can also improve thanks to testosterone’s ability to increase your muscle mass and sharpen your memory and concentration. Put it that way, and testosterone therapy seems like the ultimate formula for your anti-ageing wellness, but testosterone’s benefits in preventing age-related decline aren’t as clear as they may seem. So what do we know, and not know, about using testosterone therapy for normal ageing.
Men produce testosterone primarily in the testicles. This hormone helps to maintain your bone density, fat distribution, muscle strength and mass, red blood cell production, sex drive and sperm production. Your testosterone production peaks during your teenage years and early adulthood and, as you get older, these levels gradually decline – typically by about 1% every year after you reach your 30s. It is important to determine in older men if a low testosterone level is simply due to the decline of normal aging or if it is due to a disease, such as hypogonadism. This occurs when your body is unable to produce normal amounts of testosterone, be it due to a problem with the testicles or with the pituitary gland that controls the testicles. If you have this disease, testosterone replacement therapy can improve the signs and symptoms of low testosterone.
Some people assume that a naturally declining testosterone level causes the signs and symptoms of ageing, but this isn’t necessarily the case. As a man, you can experience many signs and symptoms of ageing, only some of which occur as a result of lower testosterone levels. The signs of ageing related to waning testosterone include:
- Changes in sexual function: You might find that your sexual desire is reduced, you have fewer spontaneous erections — such as during sleep — and you’re less fertile.
- Changes in sleep patterns: Sometimes low testosterone can cause you to experience insomnia or other sleep disturbances.
- Physical changes: There are various possible physical changes when your testosterone levels decrease. You might have more body fat than you used to, less muscle bulk and strength or decreased bone density. It’s also possible to have swollen and tender breasts (which is known as gynecomastia), hot flashes, hair loss and less energy.
- Emotional changes: With lower testosterone levels, you can feel less motivated or self-confident, have trouble concentrating or remembering things and/or be sad or depressed.
So where does testosterone therapy come in? While testosterone therapy has been shown to help reverse the effects of hypogonadism, it remains unclear as to whether testosterone therapy would have any benefit for older men who are otherwise healthy. Some men believe that taking medications containing testosterone help them to feel younger and more vigorous, but few studies have been undertaken in this area, meaning that we do not know whether this feeling of youth is anything more than a placebo effect. Plus, the research that has been done has come back with mixed results. For example, in one study healthy men who took testosterone medications increased muscle mass but didn’t gain strength.
Moreover, there are risks to take into account when considering testosterone therapy:
- Sleep apnoea: This is a potentially serious sleep disorder in which breathing repeatedly stops and starts, and testosterone therapy is thought to contribute to this.
- Polycythemia: This is a condition in which testosterone therapy encourages your body to make too many red blood cells, which can increase your risk of heart disease
- Acne or other skin reactions
- Benign prostatic hyperplasia: Testosterone therapy can stimulate non-cancerous growth of your prostate, and even stimulate growth of existing prostate cancer.
- Enlarged breasts
- Limited sperm production or testicle shrinkage
If you wonder whether testosterone therapy might be right for you, talk with your doctor about the risks and benefits.
