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What Are the Pros and Cons of Testosterone Therapy?

Is testosterone therapy a boon or a boondoggle for men with low T? Many people remember the HRT disaster for women. What is the story on TRT for men?

Hormone replacement therapy (HRT) has been one of the most controversial and contentious treatments in medicine for decades. Now, TRT (testosterone replacement therapy) is following a similar trajectory. What’s the straight scoop on male hormone research?

New Data Support TRT:

The world of testosterone therapy has been turned upside down because of research published in the New England Journal of Medicine (Feb. 18, 2016). The Testosterone Trials concluded that that men with low testosterone levels “…had a moderate benefit with respect to sexual function and some benefit with respect to mood and depressive symptoms…” after using AndroGel for a year.

FDA Unprepared for Positive Results:

The idea that testosterone therapy might have benefits without scary side effects runs counter to the FDA’s recommendations on testosterone therapy. The agency specifically cautions against treating “low T” in otherwise healthy men. Only those who have a diagnosed medical condition (hypogonadism) are considered eligible for testosterone treatment.

According to the agency, this male hormone is appropriate only for treating disorders of the testicles, pituitary gland or brain that result in failure to produce testosterone. It is not considered appropriate for treating men whose low testosterone levels are caused by aging.

What Are Men to Make of Testosterone Therapy?

Not surprisingly, the new research puts millions of men in a quandary. Those who are suffering symptoms of low testosterone but do not have a clearly defined medical condition, such as a pituitary gland problem, are told that TRT is not for them.

One reader reported this experience:

“About eight years ago I entered into a study for replacement testosterone (trying to reduce erectile dysfunction). Prior to starting the study I was very lethargic and depressed. I had erectile dysfunction, no libido worth talking about, liver spots all over my hands and arms and graying hair. I had basically lost interest in my life and my family and had a really hard time just getting motivated.

“Now, eight years later at age 69, I still take testosterone. I work out at our local gym an hour each day. I have no depression (I don’t take antidepressants of any kind), am full of life and energy and my blotchy liver spots have almost disappeared.

“My libido is the same as when I was in my forties and my ED is pretty much a thing of the past. Through regular blood tests my doctor manages my testosterone levels to where they would be if I was 30 years old.

“About two years ago my doctor thought it would be a good idea to have a heart scan. The results showed that my heart was that of a much younger man with no sign of weakness in the walls or arteries. Many people I meet can’t believe that I am 69 and say that I could easily pass for 50.”

Physicians and patients now have research to support their contention that testosterone therapy can be helpful. Men with low hormone levels (below 275 ng per deciliter) and symptoms of hypogonadism like low libido and depressed mood appear to benefit moderately.

Of course any physician who prescribes testosterone for such a man would be challenging the FDA’s party line that otherwise healthy men with low T should not be allowed access to testosterone therapy.

What About Heart Attacks and Strokes?

The FDA warns that extra testosterone might increase the risk of heart attacks, stroke or death. That’s a scary message and one that would reasonably deter most men from even asked their doctors about TRT.

But research conflicts with the FDA’s stance. A review of the scientific literature in the journal Expert Opinion on Drug Safety (Oct. 2014) concluded that testosterone supplementation did not increase the risk of cardiovascular complications. A study in the European Heart Journal (Oct. 21, 2015) found that normalizing testosterone levels actually reduced heart attacks, strokes and the risk of death in male veterans.

Testosterone is no fountain of youth. And there are still concerns about the possibility that prostate cancer could be accelerated by hormone supplementation. Nevertheless, the new research may force the FDA to reconsider its stance on the role of hormone therapy for men with low testosterone levels.

What’s your Experience With Testosterone Therapy?

We would love to hear from men who have tried TRT. Has it been beneficial or problematic? Share your own experiences in the comment section below.

William in Toronto, Canada offered this:

“I had my testosterone level checked, and found that for my age, 76, I was quite deficient in testosterone. I had suspected this, as I had some symptoms of low T.

I asked my doctor for a trial period with testosterone gel, and he reluctantly agreed. He said the jury was still out as to any detrimental side effects. I have been using the gel for one month now, and have noticed an improvement in my health. I no longer have those days when I have no energy to do anything except lie down, my walking has improved, and my interest in sex as well. I have also experienced an improvement in my general mood and well being.

“In conclusion, my life has improved considerably.”

For men who worry about the potential negative consequences of long-term testosterone therapy, we suggest listening to our interview with John La Puma, MD. Our one-hour radio show, “Boosting Testosterone Naturally” offers alternative approaches for achieving a positive outcome.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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