Does Testosterone Replacement Work?

Men see testosterone replacement therapy as an anti-aging formula. Its benefits like increased muscle mass, improved libido, boosted energy levels and enhanced concentration seem too good. But does it work or does it have some limitations?

What is testosterone replacement therapy?

The levels of testosterone in a man's body reach their peak during adolescence and early puberty and then show a steady decline after the age of 30. A man's testosterone levels decline, on average, at the rate of one percent every year after the age of 30. As the testosterone levels diminish with advancing age, men may experience a reduced sex drive, diminished agility, poor concentration, a reduced sense of well-being, depression and irritability.

On the contrary, men who have received testosterone replacement therapy report that their sex drive has improved, their energy levels have been boosted, and their mood is elevated. These reports have enticed many men to ask their physicians for testosterone replacement once they reach middle age. Statistics reveal that there has been a 500 percent increase in the sale of testosterone supplements in the past few years.

But is testosterone replacement the answer to all your aging problems? According to experts, this is not the case. Testosterone therapy has its own share of side effects. Moreover, the long term effects of this therapy have not been studied well enough yet, either. Therefore, experts suggest that this therapy should be reserved only for those men who have been diagnostically proved to have low testosterone levels and whose symptoms can be attributed to low testosterone levels with certainty.

Not every individual who receives testosterone replacement reports of any significant change in his life. While few of the patients are very happy with the results, an equal number of patients fail to notice any change. Therefore, one should not expect any miracles with a prescription for testosterone replacement therapy.

Different forms of testosterone supplements

Testosterone supplements are available in various forms in the open market or with a prescription. They are:

• A transdermal skin patch. The patch is worn on the upper part of the body once a day.

• Testosterone gels. The gel is applied on to the skin once a day from where it is gradually absorbed through the skin.

• A testosterone mouth patch. The mouth patch comes in the form of a tablet which gets stuck on the gum above the upper incisor. It is used twice a day. The hormone is continuously released into the blood stream through the oral tissue.

• Testosterone injections. The hormone can be directly injected into the muscles from where it is absorbed gradually by the blood stream.

• Testosterone implants. The hormone is implanted in the form of pellets into the soft tissue from where it gets absorbed into the blood.

Testosterone is not administered in the form of oral pills as when taken orally, the hormone passes through the liver, where it is rendered ineffective. Testosterone can be detrimental to the liver tissue. Therefore, other modes of administration are chosen which bypass the liver tissue.

Benefits Of Testosterone Replacement Therapy

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