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Testosterone is the most important androgen (male sex hormone); by definition, androgens are responsible for development of male sexual characteristics.
Testosterone replacement therapy is traditionally prescribed in cases of male hypogonadism (a condition characterized by low levels of testosterone leading to erectile dysfunction and/or a low sperm count).
What is testosterone?
As stated earlier, testosterone is the main androgen responsible for male sexuality. Physiologically, testosterone plays a crucial role in the expression of male sexual characteristics; these are:
- Primary sexual characteristics – growth and development of testes and sexual organs during fetal life as well as around puberty
- Secondary sexual characteristics – male pattern of distribution of bodily hair including a beard, deepening of voice, improved bone density, improved muscle mass and vigor (also known as libido)
Notwithstanding the immense importance of the above functions, testosterone may have a very crucial role to play in fighting disease as well –
Owing to the supposed adverse effects of testosterone therapy, physicians have always been skeptical to advocate it. Recent research, however, tends to support the safety and effectiveness of testosterone in such metabolic diseases.
If indeed testosterone is as effective and safe as confirmed by some researchers, does it warrant – given that the incidence of obesity (and CVD and DM Type2) has reached pandemic proportions – the use of testosterone as a health supplement on a regular basis?
The need for testosterone supplementation
Traditionally, testosterone therapy is prescribed only to men with low blood levels of testosterone. This condition, known as hypogonadism, is associated with symptoms like erectile dysfunction, oligospermia (reduced sperm count), loss of libido and reduced skeletal muscle mass among others.
Also, much of scientific research has tended to focus around the effectiveness of testosterone in hypogonadal men – in improving sexual functioning (Perleth, 2007), lean mass, bone mineral density and fighting osteoporosis (Wittert et al., 2003). However, benefits of testosterone supplementation are not limited to men with low testosterone levels alone.
Testosterone use in men with normal levels of testosterone also provides benefits – it has been shown to reduce the incidence of osteoporosis (Anderson, Francis, & Faulkner, 1996; Kohn, 2006), fight obesity and enhance feel of well-being.
There is enough scientific basis to suggest that reduced blood level of testosterone is inherently connected to obesity and metabolic conditions like CVD and DM Type 2 (Rodriguez et al., 2007; Mohr, Bhasin, Link, O'Donnell, & McKinlay, 2006; Kaplan, Meehan, & Shah, 2006). Furthermore, an inverse relationship seems to exist between waist circumference and testosterone level (Svartberg, von, Sundsfjord, & Jorde, 2004).
What’s more, such findings seem to be consistent in men of all age groups (Svartberg et al., 2004) and from different races or ethnic backgrounds (Kupelian, Hayes, Link, Rosen, & McKinlay, 2008).
Testosterone use in older men and even in women can afford health benefits (see below).
Testosterone supplementation in older men
Decreased physical functioning and lack of mobility is a very realistic phenomenon in the elderly male. Much of this is due to the normal loss of muscle mass that occurs with advancing age – a process called sarcopenia. Sarcopenia combined with the age-related decline in testosterone – which is even more pronounced in fat, older men (Kaplan et al., 2006) – warrants supplementation with testosterone.
Such men have been shown to benefits immensely from testosterone supplementation – improves plasma levels of testosterone (Lebrasseur et al., 2009) and in combination with physical activity has a potential to improve skeletal muscle mass and therefore physical functioning.
Testosterone supplementation in women
Not many of you would know this but androgens play important physiological roles in women as well. Not surprisingly then, extreme androgen deficiency (especially seen in hypopituitarism or after menopause) may be detrimental to health in women (Ginzburg et al., 2010). In fact, some clinicians recommend adding testosterone to HRT (hormone replacement therapy) in post-menopausal women.
Testosterone supplementation in such women may not only improve sexual functioning, muscle mass and bone health but also psychological well-being and self-esteem.
Although, proven to be quite effective in short-term treatment regimens, more data is needed to prove the effectiveness and safety of testosterone on long-term use in such women (Zang & Davis, 2008).