Testosterone therapy: Potential benefits and risks as you age
Considering testosterone therapy to help you feel younger and more vigorous as you age? Know the risks before you make your decision.
By Mayo Clinic Staff
The promise of testosterone therapy may seem enticing, but there are a lot of misconceptions about what the treatment can and can't do for you. As you get older, testosterone therapy may sound like the ultimate anti-aging formula.
Yet the health benefits of testosterone therapy for age-related decline in testosterone aren't as clear as they may seem. Find out what's known — and not known — about testosterone therapy for normal aging.
What is testosterone?
Testosterone is a hormone produced primarily in the testicles. Testosterone helps maintain men's:
- Bone density
- Fat distribution
- Muscle strength and mass
- Facial and body hair
- Red blood cell production
- Sex drive
- Sperm production
What happens to testosterone levels with age?
Testosterone levels generally peak during adolescence and early adulthood. As you get older, your testosterone level gradually declines — typically about 1 percent a year after age 30 or 40. It is important to determine in older men if a low testosterone level is simply due to the decline of normal aging or if it is due to a disease (hypogonadism).
Hypogonadism is a disease in which the body is unable to produce normal amounts of testosterone due to a problem with the testicles or with the pituitary gland that controls the testicles. Testosterone replacement therapy can improve the signs and symptoms of low testosterone in these men. Doctors may prescribe testosterone as injections, pellets, patches or gels.
Does a naturally declining testosterone level cause the signs and symptoms of aging?
Not necessarily. Men can experience many signs and symptoms as they age. Some may occur as a result of lower testosterone levels and can include:
- Changes in sexual function. This may include reduced sexual desire, fewer spontaneous erections — such as during sleep — and infertility.
- Changes in sleep patterns. Sometimes low testosterone causes insomnia or other sleep disturbances.
- Physical changes. Various physical changes are possible, including increased body fat, reduced muscle bulk and strength, and decreased bone density. Swollen or tender breasts (gynecomastia) and body hair loss are possible. You may have less energy than you used to.
- Emotional changes. Low testosterone may contribute to a decrease in motivation or self-confidence. You may feel sad or depressed, or have trouble concentrating or remembering things.
Some of these signs and symptoms can be caused by various underlying factors, including medication side effects, obstructive sleep apnea, thyroid problems, diabetes and depression. It's also possible that these conditions may be the cause of low testosterone levels, and treatment of these problems may cause testosterone levels to rise. A blood test is the only way to diagnose a low testosterone level.
April 01, 2015
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- Bhasin S, et al. Testosterone therapy in men with androgen deficiency syndromes: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism. 2010;95:2536.
- Garnick MB. Testosterone replacement therapy faces FDA scrutiny. Journal of the American Medical Association. 2014;E1.
- Longo DL, et al. Disorders of the testes and male reproductive system In: Harrison's Principles of Internal Medicine. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.com. Accessed Feb. 4, 2015.
- Synder PJ. Overview of testosterone deficiency in older men. http://www.uptodate.com/home. Accessed Feb. 2, 2015.
- AUA position statement on testosterone therapy. American Urological Association. https://www.auanet.org/about/testosterone-therapy.cfm. Accessed Feb. 4, 2015.
- Vigen R. Association of testosterone therapy with mortality, myocardial infarction, and stroke in men with low testosterone levels. Journal of the American Medical Association. 2013;310:1829.
- FDA adding general warning to testosterone products about potential for venous blood clots. U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/ucm401746.htm. Accessed Feb. 5, 2015.
- Nippoldt T (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 17, 2015.
- Takahaski PY (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 10, 2015.