Is Testosterone Therapy the New Beauty Trend For Men?
Testosterone replacement therapy has become one of the most widely prescribed medications in the United States. While there could be benefits to the treatment for aging men, such as improvement in libido, bone density and quality of life, it also has possible side effects like hair thinning, water weight and shrinking testicles. Receiving testosterone can be a timely and costly commitment that should be discussed thoroughly with a medical professional.
What is low testosterone?
Testosterone, an essential hormone for men, helps power sex drive, reproductive abilities and the development of muscle and bone. The gradual decline in testosterone is natural with age but varies by person. The occurrence of low testosterone increases with aging and may be as high as 20% to 30%. Low testosterone (Low T), a condition where the testicles don’t produce enough testosterone.
Hypogonadism is when testosterone levels get too low. Symptoms often include:
- Lower sex drive and overall energy levels
- An increase in body fat and reduction in muscle mass
- Feelings of moodiness or laziness
- Reduced body and facial hair
- Small testicles, reduced sperm count and infertility
- Increased breast size
- Hot flashes
- Irritability, poor concentration and depression
- Loss of body hair
- Brittle bones and an increased risk of fracture
Low testosterone can be tied to various medical conditions, including autoimmune diseases, obesity, diabetes, pituitary disorders and heart failure. Some men with testosterone deficiency have symptoms or conditions related to their low testosterone that will improve when they take testosterone replacement.
There are times when low testosterone is not a bad thing. The most common example is prostate cancer. Testosterone may stimulate the prostate gland and cause prostate cancer to grow. Men taking testosterone replacement must be monitored carefully for prostate cancer. Although testosterone may make prostate cancer grow, it is not clear that testosterone treatment causes prostate cancer.
Blood tests can reveal if you have lower than normal testosterone levels, and treatment options are available. Physicians may recommend low doses of testosterone to improve your mental, physical and sexual health. The length of the process varies and how bodies may respond to the treatments. There’s still much unknown about testosterone replacement therapy and whether it’s necessary for men as they get older or if younger ones should consider it a new beauty trend.
What is hormone replacement therapy?
The National Cancer Institute says hormone replacement therapy is used when the body does not produce enough of a certain hormone. For example, hormone replacement therapy may be given when the thyroid gland does not make enough thyroid hormone.
It's natural for men’s testosterone levels to decrease as they get older. Hormone therapy is a solution, but it is not one that naturally replaces the missing hormones. Medical experts disagree about the health benefits of hormone therapy used to combat the natural aging process in men, especially given the risks. Most medical guideline organizations do not recommend testosterone therapy unless multiple testosterone levels are significantly low, and the patient is symptomatic.
If your doctor does recommend testosterone therapy, there are several options available:
- Intramuscular testosterone injections: The hormones are injected into specific muscles, and the medication will quickly circulate throughout the body. This method is one of the most common medical procedures administered every one to two weeks.
- Testosterone patches: Testosterone patches are applied daily to the body, like the arm or thigh, to release the dose of gel onto your skin. The patch can cause irritation.
- Topical testosterone gel: Testosterone gel is available by prescription and used to treat adult men with low or no testosterone. The gel can be transferred from your body to others and should be applied to the shoulders or upper arms that should be covered by sleeves. Testosterone may stop bone growth and cause early puberty in children and teenagers. If testosterone is used by a pregnant woman or is breastfeeding, it may harm the baby.
- Gum and cheek testosterone replacement: This treatment delivers testosterone through the gums above your top teeth.
- Nasal gel: Testosterone can be pumped into the nostrils as a gel, reducing the risk of transferring it to another person through skin contact.
- Oral testosterone: This oral testosterone pill is FDA approved and treats men with certain forms of low testosterone.
What are the side effects of testosterone replacement therapy?
Few studies have addressed potential long-term adverse effects associated with testosterone replacement therapy, but some potential negative effects of testosterone treatment include:
- Erythrocytosis: A condition where your body makes too many red blood cells.
- Growth of metastatic prostate cancer: Metastatic cancer spreads from its site of origin to another part of the body.
- Reduced sperm production
- Decrease in testicle size
- Higher risk of blood clots
- Breast swelling
While the data is mixed, men on long-term testosterone therapy may have a higher risk of cardiovascular problems like a heart attack or stroke. In 2010, researchers halted the Testosterone in Older Men study when early results showed that men on testosterone replacement therapy had more heart problems. Also, testosterone therapy can suppress natural hormone production, particularly in older men, making it difficult to stop using it, according to experts.
In 2015, the U.S. Food and Drug Administration made drug companies add a warning to the drug labels for the potential increased risk of heart attack and stroke in men over age 65. For those under age 45, the possible side effects include an increased risk of infertility.
What should I consider before receiving testosterone replacement therapy?
There are natural ways to increase your testosterone levels before getting testosterone replacement therapy. Improving your diet, exercising, getting adequate rest and reducing stress can raise your testosterone. Significant weight loss in obese men has also increased testosterone levels. Approach testosterone therapy with caution if you have other medical concerns. Many experts are cautious about recommending hormone therapy to patients due to inconclusive testing results. Likewise, consider the cost of hormones, which is about $400 a month and are sometimes not covered by insurance. Discuss your health issues or concerns with your doctor before considering any drastic options.
Talk with your endocrinologist to determine if hormone therapy is a good treatment option.