As men age, levels of the hormone testosterone can decline over time. Unfortunately, lower testosterone levels can lead to emotional, physical, and sexual changes. Men who want to counteract these changes and eliminate the possibility of erectile dysfunction that often goes hand in hand with hormonal imbalances due to low testosterone levels may consider testosterone replacement therapy. However, it is important to first understand what testosterone replacement therapy can achieve, what low testosterone levels can affect, what types of replacement therapy are available, and the various pros and cons of testosterone replacement therapy.
What is testosterone replacement therapy and what does it do?
Although testosterone decline is a natural by-product of the aging process in men, many people want to resist these changes for as long as possible. To do this, it is necessary to replenish the naturally declining levels of testosterone in the body. Whether it’s patches or gels, the goal is the same: to reach levels of testosterone that a young man in his 20s or 30s can naturally have.
Testosterone is a steroid hormone present in both men and women and serves as the primary male sex hormone. Although women secrete testosterone from their ovaries, men tend to have eight times more of the hormone in their bodies.
Low testosterone levels can lead to a number of changes in men. Testosterone levels typically peak in men in their 30s, after which they can decline by as much as 1% each year. Low testosterone levels can cause physical changes such as increased body fat, hair loss, decreased energy, and decreased sex drive. Decreased testosterone levels can also lead to emotional changes, such as increased sadness, decreased confidence, or problems with motivation to complete everyday tasks.
Benefits of Testosterone Replacement Therapy
The main reason men consider testosterone replacement therapy is simply to counteract the natural decline of the hormone with age. While it’s not a panacea for all physical, sexual, and emotional problems, it can certainly help many users look and feel better. By identifying the benefits, potential patients can better understand the typical changes.
• Higher energy levels. One of the most notable benefits of testosterone replacement therapy is a marked increase in energy levels. Many men naturally begin to feel more lethargic as they age, and they may even believe that lower energy levels are a natural occurrence in middle age and beyond. However, testosterone replacement therapy can seem like turning back the clock when it comes to energy. Many users report that they sleep better at night, feel more awake at work, and actually want to stay active rather than a nap or watch TV on the couch at the end of the day.
• Improving sexual health. Another major benefit of testosterone replacement therapy is the improvement in overall sexual health. Many men find that boosting their testosterone levels also increases their libido, as well as the quality and duration of their erections. Men over 40 who thought erectile dysfunction was a natural by-product of middle age may be surprised at how effective testosterone can be. Some men even report that their orgasms are stronger than ever, further increasing their sexual desire for a partner.
• Reducing body fat: Replacing testosterone in the body can also change the appearance of a man. Higher testosterone levels are associated with reduced insulin sensitivity, which can lead to lower body fat levels, reduced sugar and carbohydrate requirements, and even reduced stomach fat. With increased energy, higher testosterone levels can also lead to improved workouts and increased muscle mass. These changes result in a leaner, fitter, and overall healthier appearance, which is a big benefit for most men.
• Increase in average life expectancy. A major benefit of testosterone replacement therapy is that it can increase overall life expectancy. Studies show that men with higher testosterone levels in middle age tend to live longer than those with lower testosterone levels at the same age. Although the reason for this association is not entirely understood, there is no doubt that it makes testosterone replacement therapy attractive to men of all ages.
• Decreased irritability and lower rates of depression: While many men focus on the physical and sexual benefits of testosterone replacement therapy, it’s important to note that there are many emotional benefits as well. Increasing testosterone levels in men can often help reduce moodiness or irritability. Men who suffer from depression may notice that after testosterone replacement therapy, their depressive states are less common and perhaps even less intense. Some men even report that increased testosterone levels help them feel more confident and in control of their lives, careers, and relationships.
Disadvantages of Testosterone Replacement Therapy
Unfortunately, not everything about testosterone replacement therapy is positive. There are some disadvantages as well as some risk factors that potential candidates should be aware of before starting treatment.
• Skin irritation: The most common downside of testosterone replacement therapy is skin irritation. As a rule, this occurs in places of direct contact of the testosterone patch or gel with the skin. Half of the men receiving testosterone replacement therapy may complain of a rash, swelling, redness, or other irritation where the testosterone enters or touches the body. However, any irritation usually disappears completely when therapy is stopped.
• Decreased fertility: Many men interested in testosterone replacement therapy already have children, so reduced fertility may not be a concern. However, men who plan to have children in the future should be aware that artificially increasing testosterone levels in the body can lead to a decrease in sperm count, which can make fertility difficult.
• May make sleep apnea worse: While testosterone replacement therapy may help with the sleep problems, low energy levels, and obesity that are associated with sleep apnea, it can still cause problems in men who already have sleep apnea. Men with sleep apnea should have a polysomnogram or sleep study to determine the severity of their condition. If testosterone replacement therapy is chosen as the course of action, they will need to closely monitor their sleep apnea and may even need to rely on a continuous positive airway pressure machine at night.
• May exacerbate prostate cancer: There is a strong association between the increase in prostate cancer and testosterone replacement therapy. In particular, this can lead to the rapid growth of men who already have prostate cancer, which is certainly a negative factor. However, men who do not have a history of prostate cancer and who do not have elevated prostate-specific antigen levels are not usually affected by testosterone replacement therapy in this regard.
• Risk of infection: Men who live with a female partner or children may also be at risk of infection, especially if they use a form of testosterone replacement therapy that is liquid or gel in nature. For example, leftover testosterone creams can get on the skin of people living in your home. Although testosterone is a natural hormone already present in the body of both men and women, too much of it can be harmful. Accidental exposure to testosterone can lead to premature pubic hair growth, premature development of genital organs, accelerated bone aging, and aggressive behavior. Adults using testosterone replacement therapy should always be careful not to expose women or children at home or to anyone they come into contact with during the day.
Types of Testosterone Replacement Therapy
There are several different types of testosterone replacement therapy. Every man interested in raising testosterone levels should consider the various options and learn as much as possible before choosing the right treatment.
• Transdermal patches. One of the most common ways to increase testosterone levels in the body is through a transdermal patch. This small square patch is applied to the arm or any convenient place on the upper body and releases testosterone within 24 hours. This is an affordable option, but users should remember to change the patch once a day or fight hormonal imbalances.
• Gels with testosterone. Another popular and unobtrusive means of carrying out testosterone replacement therapy is a gel. These clear gels come in small tubes and are applied to the skin once a day. While generic versions contain small amounts of testosterone, prescription versions may have testosterone levels tailored to a patient’s specific age, weight, or hormone levels.
• Plasters for a mouth. Like transdermal patches, mouth patches are single-use and should be changed regularly. The most common types of oral testosterone replacement therapy patches are designed to be worn for 12 hours and the user will need to remove and replace the patch twice a day. The patch adheres to the upper gum and should not interfere with speaking or eating, although some users report that they are uncomfortable at first.
• Injections: For men who want to worry about testosterone replacement therapy every few weeks, an injection may be ideal. Testosterone in liquid form will be given by injection into the bloodstream. This allows the body to absorb the required amount of testosterone. These testosterone injections can only be administered by a healthcare professional in a clinical setting.
• Implants. The least common method of testosterone replacement therapy is implantation in the soft tissues of the body. This implant is small and ball-shaped and will release testosterone for approximately six months. Granular implants do not need to be removed as they dissolve in the body over time. However, patients will need to receive a new implant approximately every six months in order to continue testosterone replacement therapy.
Who Should Consider Testosterone Replacement Therapy?
While elevated testosterone levels can affect sexual health, emotional health, and appearance, it’s not for everyone. In fact, many men can see drastic changes simply by changing their diet and exercise regimen. Before starting testosterone replacement therapy, men should make sure that the lack of energy, weight gain or depression is not caused by an unknown disease that must be treated directly.
Generally, testosterone replacement therapy is not recommended for men under the age of 30. With rare exceptions, men under the age of 30 already have normal testosterone levels, and an increase in this level can cause harm, and not provide the increase expected by patients. . Men with severe sleep apnea, a history of prostate cancer, or concerns about blood clots should also avoid testosterone replacement therapy or consult a doctor before starting treatment.
Men who should consider testosterone replacement therapy include those over the age of 50 who experience a natural decline in energy and stamina with age. Although not a panacea, testosterone replacement therapy can improve physical fitness, sexual confidence, and emotional stability over time.
Although testosterone levels naturally decline in men over 30, hormone replacement therapy may be a way to counteract this change. While testosterone replacement therapy can be incredibly beneficial for eligible candidates, it also has some disadvantages and men should carefully consider all of them before deciding on this therapy.
