Testosterone, better known as the “male hormone” is receiving an enormous amount of publicity these days. This is because a significant number of men suffer from testosterone deficiency or low testosterone (“Low T”). Symptoms of this deficiency include low libido, erectile dysfunction, fatigue, loss of muscle mass and even unfavorable changes in cognition. Many of these issues can be alleviated via testosterone replacement treatment. Current scientific evidence now shows that testosterone replacement is not only safe but can have significant positive benefits on men’s well being and overall health.
What exactly is testosterone?
Testosterone (T) is known as a steroid hormone produced mostly by the testicles and to a lesser extent by the adrenal glands. It allows for the development and maintenance of male sexual characteristics and function as well as maintaining muscle mass, energy and libido. Normal levels of testosterone are also correlated to cardiovascular health, with low levels correlated to increased cardiovascular mortality. Raising T levels to normal can also improve metabolism where insulin functions more efficiently and fat cells are redistributed resulting in a smaller waist size. Thus, it behooves men with symptoms suggestive of Low T to have their levels checked (through a simple blood test) and treated if low.
How is Low T treated?
Low T can be treated via many different approaches. The most common products available for T replacement are topical gels applied daily or weekly injections, which can be self administered. Both are acceptable treatments, so it is up to the patient to decide which suits his lifestyle the best. It is important to also note that there are no oral testosterone preparations, so any advertised OTC products cannot reliably increase T levels enough to have a beneficial effect.
The goal of T replacement is to restore T levels to normal and improve the symptoms associated with Low T. Once levels are in the normal range men will experience improved sex drive, better erectile function (and, in a significant number of men, complete resolution of ED), higher energy levels, improved sleep and increased muscle mass with a decrease in body fat. Note that T replacement does not take the place of diet and exercise for weight loss and good cardiovascular health.
What are Low Testosterone Replacement side effects?
There are some side effects to T replacement, but very few men have to discontinue T replacement because of them. These include breast enlargement and tenderness, hair loss, acne, leg swelling and elevation of red blood count. These side effects can be reversed with medication or blood donation in the case of elevated red blood cell count.
It’s also important to monitor the PSA while on T replacement. While T replacement does not cause prostate cancer, a rise in the PSA blood test while on T replacement could indicate the presence of hidden prostate cancer requiring a biopsy to be performed.
Until recently there has been great concern about giving T replacement to men whom have been previously treated for prostate cancer. This was based on the original finding that reducing T levels in men with advanced prostate cancer resulted in shrinkage of the cancer, thereby demonstrating a connection between T and prostate cancer growth. The fear was that giving T replacement to any man with even a remote history of successfully treated prostate cancer could cause a reactivation of the cancer. Thankfully this thinking has been challenged and proven false. In other words, it is safe to give men T replacement that have had treatment for prostate cancer and show no evidence of having it.
Similarly, T replacement does not cause prostate cancer in men. In fact, it’s much safer for men’s overall health to have normal T levels than abnormally low T levels.