If you are a man approaching middle age, it’s likely that your body no longer produces as much testosterone as it once did. For most men, testosterone production peaks during early adulthood and begins to decrease gradually after the age of 30. If you are among the small percentage of men with hypogonadism, though, your testes do not produce a normal amount of testosterone for your age. Low testosterone can cause a number of symptoms aside from those associated with the normal aging process. Testosterone replacement therapy resolves those symptoms by boosting your body’s testosterone to a normal level for your age.
What Is Testosterone Replacement Therapy?
Testosterone replacement therapy is the process of taking a medication to add testosterone to the bloodstream. Testosterone medications come in a variety of forms including pills, patches, gels and injections.
How Do I Know if I Have Low Testosterone?
You may instinctively believe that you have low testosterone if you suffer from the symptoms. Some of the most common symptoms of low testosterone include:
- Unusually low sex drive or inability to attain an erection
- Loss of muscle or bone density
- Increase in body fat, even with exercise
- Loss of facial or body hair
Mental problems such as inability to concentrate, low self-esteem, depression, irritability and malaise
Men experience the effects of low testosterone production in different ways, and there is no single symptom that definitively identifies the condition. Upon learning of your symptoms, your doctor will most likely order a blood test. A blood test is the only way to determine with certainty whether your testosterone levels are abnormally low for a man of your age.
Is Low Testosterone Simply a Normal Sign of Aging?
Yes. Once the body’s production of testosterone decreases, it will continue to decrease at the rate of about 1 percent per year. For men with hypogonadism, the testes produce testosterone at below the normal levels. If you have abnormally low testosterone, you’ll experience symptoms beyond those associated with the normal aging process.
How Does Testosterone Replacement Therapy Work?
The most common forms of testosterone replacement therapy include gels, transdermal patches, oral patches, implants and injections. Testosterone pills are also available, but many doctors do not prescribe them because there is a link between oral testosterone and liver damage. When you take a testosterone pill, your digestive system has to process it before it can enter your bloodstream. Other forms of testosterone replacement therapy deliver the medication directly to the bloodstream, skipping the digestive system. Once within the bloodstream, your body processes the testosterone as if your gonads had produced it.
What Are the Benefits of Testosterone Replacement Therapy?
Men report varied benefits from testosterone replacement therapy, but most men who take medical testosterone report positive results. The most common benefits include increased sex drive, increased ability to have sex, improved mood and improved cognitive function. You may also find that taking testosterone improves your energy level. Some men report improved bone density, increased muscle mass and less blood sugar fluctuations.
Whether testosterone therapy is an effective treatment for erectile dysfunction depends on the cause of the dysfunction. If you have difficulty attaining an erection because of poor libido, medical testosterone may help. If the root cause is poor blood circulation, you may need to take an additional drug such as Viagra or Cialis to resolve the underlying issue.
Who Is a Good Candidate for Testosterone Replacement Therapy?
You may be a good candidate for testosterone replacement therapy if you are an otherwise healthy male with testosterone levels that are abnormally low for your age. Most doctors agree that it is wise to confirm low testosterone with a blood test before beginning therapy. Because the long-term effects of testosterone replacement are unknown, doctors generally believe that low testosterone alone isn’t a sufficient reason to begin testosterone therapy. You should also have one or more of the symptoms listed above because experts disagree as to the level of low testosterone that requires supplementation.
Who Should Not Undergo Testosterone Replacement Therapy?
If you believe that you have low testosterone, you should ask your doctor for advice. A test can confirm whether your testosterone levels are abnormally low for your age. If your testosterone levels are slightly low simply because you’re getting older, you are probably not a candidate for testosterone replacement. Your doctor may also recommend against testosterone replacement if you have no apparent symptoms of low testosterone.
Taking medical testosterone is not the same as taking anabolic steroids. You should not take testosterone with the goal of rapidly building muscle mass because the only goal of testosterone replacement therapy is to elevate the testosterone in the body to normal levels.
You should not take medical testosterone if you have prostate problems or a family history of prostate cancer. Testosterone replacement is also not recommended for those with congestive heart failure, sleep apnea or blood clotting disorders.
What Are the Potential Side Effects of Testosterone Replacement Therapy?
The long-term risks of testosterone replacement are not yet known due to a lack of extended clinical trials. Some studies have shown that testosterone supplementation may contribute to poor cardiovascular health, but other studies have not established a link between medical testosterone and heart disease. If testosterone is a risk to heart health, the risk appears to be greater among older men.
The most common side effects of testosterone supplementation include acne, oily skin and hair loss. A few men have reported increased irritability and aggression when taking testosterone. If you experience either of those side effects, lowering your dosage may help. If you experience hair loss when taking testosterone, additional supplements may slow or reverse the loss.
How Do You Use Medical Testosterone?
The method for using medical testosterone varies depending on the delivery method.
If you are using a gel, you should apply it to your arms, shoulders, stomach or thighs. Apply the medication to the portion of the body specified on the gel’s packaging. Your skin should be clean and dry. You should put on your clothing only after allowing the gel to dry, and you should not shower for several hours after applying the gel.
If you are using a transdermal patch, apply the patch to a clean, dry area of the stomach, upper arm or thigh as directed on the patch’s packaging. Do not place the patch on broken skin, and wait at least one week before applying another patch to the same site.
If you are using an oral testosterone supplement, take it one or more times per day as indicated on the package.
If you are using injected liquid testosterone or testosterone pellets, you’ll receive the injections from your doctor.
Are There Natural Ways to Increase Testosterone Levels?
Testosterone replacement therapy is a necessary medical treatment for men with hypogonadism because the condition prevents the testes from producing testosterone in the correct amounts. If you have low testosterone as a side effect of the normal aging process, though, you can try to increase your testosterone levels naturally before beginning supplementation. It may be possible to increase your testosterone naturally by:
Getting more sleep. If you don’t get enough sleep — or if the quality of your sleep is poor — it can cause hormonal imbalances. If you struggle with poor energy levels, consider having yourself tested for sleep apnea.
Maintaining a healthy weight. Studies have found a correlation between obesity and low testosterone levels. Having an unusually low body weight can also contribute to hormonal problems. Try to maintain a healthy weight for your height and body type.
Exercising more often. You don’t need frequent strenuous exercise to increase your testosterone levels naturally. Moderate strength training and cardiovascular exercise sends your body the message that you’re active and need to stimulate muscle growth.
Reducing your stress levels. It’s great to be a hard worker. If your long working hours prevent you from finding adequate time to relax, though, your hormone levels may suffer. Try to make your working hours as productive as they can be. If you get more done at work, you won’t feel guilty about making the most of your downtime.
Changing your medication regimen. In particular, long-term use of opiates has been shown to reduce testosterone levels. If you can find an alternative way to manage your pain, it may allow you to reduce your prescription medication usage.
Alternative Reasons for Testosterone Replacement Therapy
In the United States, the Food and Drug Administration has only approved testosterone replacement therapy as a treatment for low testosterone levels due to hypogonadism. However, some report that testosterone supplementation makes them feel younger and continue to take testosterone for that benefit. Medical testosterone is also used to alter the biochemistry of transgender men.