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Men get attracted towards testosterone replacement therapy as an anti-ageing formula. Its benefits like increase in muscle mass, improved libido, boost in energy level and enhanced concentration seem too good. But does it works or has it some limitations?

Effect on patients suffering from sexual dysfunction

Studies have shown that irrespective of the method of administration, all men suffering from low libido and sexual function because of hypogonadism, wherein the level of testosterone produced is decreased, show an improvement in their sexual function. Researchers are yet to determine the most suitable form of testosterone therapy to treat this condition.

Effect on patients suffering from reduced bone density and muscle strength

In hypogonadal men, the levels of testosterone are low. This leads to a decrease in the bone density and increases the likelihood of fractures. Giving testosterone to such patients stops the bone loss and helps in increasing the bone density. Similarly, treatment with testosterone helps in increasing the lean body mass of men.

Effect on patients suffering from depression and low sense of well being

Men who have received testosterone replacement show an improvement in spatial cognition and both spatial and verbal memory. Hypogonadal men have reported an improvement in their quality of life but no study has proven the effect of testosterone replacement on depression.

Effect on men suffering from HIV and AIDS

It has been seen that many men suffering from HIV and AIDS have low levels of androgens. These patients have reported an improvement in their libido, and an increase in their muscle mass and energy levels. They have also reported an improvement in their mood and a general sense of well-being.

Effect on premenopausal women suffering from hypopituitarism

Hypopituitarism can lead to deficiency of androgens in premenopausal women. Studies have shown that administration of low dose testosterone in such women is associated with an improvement in sexual function, mood and quality of life.

Side effects of testosterone replacement therapy

The mild side effects of testosterone replacement therapy include:

  • Development of skin rash or acne
  • Fluid retention by the body resulting in mild swelling
  • Changes in behavior like increased aggression and mood swings.
  • Stimulation of prostate resulting in symptoms like decreased stream or frequency of urination.

Certain pre-existing health conditions may worsen on testosterone replacement therapy. These conditions include:

  • Benign prostate hypertrophy

Patients suffering from BPH should avoid testosterone replacement as the latter may lead to a further increase in the size of the prostate. This in turn may obstruct the urethra leading to urinary symptoms.

  • Prostate cancer

Men suffering from prostate cancer or at an increased risk of developing it owing to their elevated levels of prostate specific antigen (PSA) should avoid testosterone replacement therapy as it may further stimulate the prostate tissue.

  • Congestive cardiac failure

Men suffering from CCF should avoid testosterone supplements as they may worsen the condition.

  • Sleep apnea

This condition is also believed to worsen with testosterone replacement therapy

  • Polycythemia

Testosterone is believed to stimulate erythropoiesis and is thus beneficial in low dose in men suffering from anemia. However, in men whose hemoglobin level is normal, testosterone replacement therapy can give rise to polycythemia.

In view of these side effects, Experts recommend testosterone replacement therapy only for patients who suffer from serious symptoms arising out of hypogonadism. Taking the therapy in order to prevent future illnesses or to elevate mood and general sense of well=being in otherwise healthy old men is strictly contraindicated.

Comparing testosterone replacement therapy with use of testosterone for performance enhancing

Anabolic steroids taken by body builders and athletes also contain testosterone. However, while in replacement therapy, the dose of testosterone is low, the amount of testosterone in anabolic steroids is unusually high and is often combined with other illegal drugs. While the objective of replacement therapy is to provide relief from certain medical conditions, anabolic steroids are primarily used to increase the muscle mass and act as performance enhancers.

  • “Testosterone Treatments: Why, When, and How?”, by Katherine Margo, et al, published in the May 2006 issue of the journal American Family Physician, accessed on March 11, 2013
  • “How Effective is Testosterone Replacement Therapy in Premenopausal Women with Severe Androgen Deficiency?” by Henry Burger, published in the 2006 issue of the journal Nature Clinical Practice Endocrinology and Metabolism, accessed on March 11, 2013
  • “Testosterone replacement therapy for older men”, by Stephen E Borst, et al, published in the December 2007 issue of the journal Clinical Interventions in Aging, accessed on March 11, 2013.