It is recommended for older men with symptoms of hypogonadism and a total level of testosterone. It is not advisable to treat normal aging with testosterone therapy. If you don't have any medical conditions that contribute to lower testosterone levels, your doctor may recommend natural ways to increase testosterone, such as losing weight and increasing muscle mass through resistance exercise. The substantial increase in men's life expectancy has increasingly focused attention on quality-of-life issues related to reproductive aging. Serum levels of total and free testosterone in men, after peaking in the second and third decades of life, gradually decrease with age.
The trajectory of age-related decline is affected by comorbidities, adiposity, medications and genetic factors. Testosterone treatment in older men with low testosterone levels improves general sexual activity, sexual desire, and erectile function; improves areal and volumetric bone density, as well as estimated bone strength in the spine and hips; corrects unexplained anemia caused by aging; increases skeletal muscle mass, strength, and power, self-reported mobility, and some measures of physical function; and modestly improves depressive symptoms. The long-term effects of testosterone on major cardiovascular events and the risk of prostate cancer remain unclear. The Endocrine Society recommends not giving testosterone therapy to all older men with low testosterone levels, but suggests considering treatment on an individual basis in men who have consistently low testosterone levels and symptoms or conditions that suggest testosterone deficiency. 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.
Overall, testosterone treatment appears to have diverse effects, with modest improvements in a relatively healthy population with low serum testosterone levels, and some potentially adverse effects in the population of older men with pre-existing cardiovascular diseases. Guidelines from the American College of Physicians indicate that testosterone therapy may slightly improve sexual function in some men, but there is little evidence that it improves other functions, such as vitality and energy. To follow up with a patient on testosterone replacement therapy, the provider must check their prostatic specific antigen (PSA), a natural protein that, at high levels, is associated with the risk of prostate cancer. Inclusion in the physical function test required that participants walk slowly, have difficulty walking and climbing stairs.
For example, patients may need blood tests to measure prolactin, a hormone produced by the pituitary gland that, at high levels, may be a sign of a pituitary tumor. The possibility of a higher risk of heart attack or stroke with the use of testosterone led the FDA to place a warning label on testosterone replacement products. A larger study would be needed over many years to determine if testosterone could lower the risk of bone fracture. For older men, it is important to determine if a low testosterone level is due to normal aging or if it is due to a disease (hypogonadism).
Having a normal level of bioavailable testosterone tells us that your body is producing enough testosterone and that you probably won't benefit from testosterone replacement therapy. In addition, steroids are often combined (stacked) with other substances, such as stimulants, pain relievers and growth hormones, to increase general muscle-building effect. The clinical trials analyzed in this review were selected based on a duration of testosterone replacement therapy of no less than 6 months, with several follow-up points, and where statistically significant increases in testosterone levels were reported at the start of treatment and throughout the clinical trial period. This means that the body stops producing intratesticular (natural) testosterone and, consequently, sperm production due to the suppression of LH and FSH.
Only men with symptoms of low testosterone and blood levels that confirm that this is the cause of the symptoms should consider replacing testosterone. Some testosterone supplements have been shown to cause health problems such as erectile dysfunction and kidney failure. While the effects of testosterone on younger men are well described, the effects of testosterone replacement therapy on men over 60 are still understudied.
