According to the new guidelines, most older men don't need testosterone replacement. (Reuters Health) - Older men whose testosterone levels have dropped over the years should only receive testosterone replacement to treat sexual dysfunction, according to new guidelines from the American College of Physicians released on Monday. In general, due to the current lack of long-term safety studies on testosterone therapy, testosterone replacement therapy in older men should be used with caution. Many men over 65 with low testosterone levels say that their sense of well-being, not to mention sexual function, is no longer the same as before.
Testosterone levels naturally decline as you age. While testosterone therapy may be an option, it also has drawbacks. Some older men receiving testosterone therapy may be at greater heart risk. Instead, you might be interested in natural testosterone boosters.
Many over-the-counter (OTC) products make claims, but research to support them is limited. Your doctor will likely measure your testosterone levels at least twice before recommending testosterone treatment. The clinical trials analyzed in this review were selected based on a duration of testosterone replacement therapy not less than 6 months, with several follow-up intervals, and in which statistically significant increases in testosterone levels were reported at the start of treatment and throughout the clinical trial. In a one-year study, 65 men who took 3,300 IU of vitamin D a day increased their testosterone levels by 20% compared to those who didn't.
The growing interest in testosterone replacement therapy has further stimulated the pharmaceutical industry to develop a variety of testosterone formulations; therefore, testosterone sales are expected to continue to grow in the near future. However, the effects and consequences of long-term testosterone replacement therapy, especially in older men, remain largely understudied. In fact, another trial published on Tuesday, which was not part of the TTrials, showed a lower risk of cardiovascular events, such as a heart attack or stroke, in men who had received testosterone, on average, for 3.4 years. The studies are collectively called testosterone trials (TTrials) and compared a testosterone gel, AndroGel, with a placebo.
To date, clinical trials have demonstrated some benefits of testosterone replacement therapy in older men, such as improved bone density and bone strength, improved body composition, such as increased lean body mass and decreased fat mass, as well as a modest but significant improvement in physical function. Among men who used the testosterone gel, there were statistically significant improvements in bone density and bone strength in the lumbar spine and hip. The age-related decline in serum testosterone levels is also correlated with the decrease in the number of Leydig cells in the testicles and the decrease in testosterone secretion by Leydig cells in response to stimulation with human chorionic gonadotropin. The long-term effectiveness of testosterone treatment (more than 2 years) is questionable according to the few controlled studies of long-term treatment.
The objective of this review is to analyze the potential benefits and complications of testosterone replacement therapy in men over 60 years of age. While there is limited knowledge about the effects of testosterone on mood in humans, several limited studies have suggested that low testosterone levels in young men may be associated with depressive disorders. Testosterone replacement therapy, in the form of injections, pills, patches, or gels, can improve the signs and symptoms of low testosterone levels in these men.