Want to pump up your sex drive and muscles, boost your mood and motivation, and have the concentration and energy levels of a college undergrad? It's true that for guys who have low testosterone (Low T) hormone therapy can help address symptoms such as fatigue and erectile dysfunction, but it's not the fountain of youth and it shouldn’t be treated as an elixir for men looking to reclaim the vigor of their school years. Declining testosterone levels are a normal part of aging and don't always warrant treatment.
Be Sure It's Really Low T
Are you tired, irritable, and/or disinterested in all the things that once brought you joy, including sex? If you suspect you have Low T, your doctor can order a blood test, but only after ruling out other causes, such as depression, says Robert Brannigan, a urologist at Northwestern Memorial Hospital and associate professor of urology at Northwestern University Feinberg School of Medicine. Many symptoms of Low T, such as fatigue and erectile dysfunction, mimic depression or present as a side effect of heart disease, obesity, or other health condition. It's important to figure out if an underlying medical condition, such as an autoimmune disorder, is causing your Low T.
Is Testosterone Hormone Therapy Right for You?
According to Brannigan, testosterone levels vary widely from one man to the next. Healthy men can have testosterone levels between 270 and 1,070 ng/dL. "There are very few absolute indications for treating low testosterone," he says.
In other words, treating is optional. In his practice, Brannigan follows the The Endocrine Society's recommendations: If a man doesn't have evidence of breast cancer or untreated prostate cancer; his testosterone levels are below 300; and he's bothered by symptoms of low testosterone, he's a candidate. While there's no doubt that treatment can improve the quality of life for men with low testosterone levels, there's no consensus on whether it's beneficial to men who aren't suffering from so-called "male menopause."
Benefits and Risks of Testosterone Hormone Therapy
Bringing testosterone levels back to normal can boost energy, muscle mass, bone density, and concentration. It can also help with erectile dysfunction. Hormone therapy may even alleviate symptoms of depression. But it's not without risks.
Testosterone hormone replacement therapy may encourage prostate growth and increase your risk of prostate cancer. Testosterone also lives up to its red-blooded reputation by driving red blood cell production. According to Brannigan, this can make the blood too thick and increase the risk for stroke. Other less-serious side effects include unwanted body hair, acne, breast enlargement, and fluid retention.
Low T Treatment Options
Several vehicles deliver the right amount of testosterone to replacement therapy patients:
- Injections, usually once every two to three weeks
- Daily patches worn on the body or scrotum
- Topical gels applied daily to the shoulders, arms, or abdomen
It takes at least eight weeks for testosterone therapy to take effect, and because there's no cure for Low T, men generally require ongoing treatment, Brannigan says. Because of the risks of testosterone therapy, you'll need to follow up with your doctor regularly.