As I have noted, hormone replacement is not just for women anymore. Testosterone therapy is a very hot topic in men’s health these days.
Testosterone is the sex hormone that is largely responsible for the sexual and reproductive development of men. It also plays a role in sperm production, fat distribution, maintenance of muscle strength and mass, and sex drive. Testosterone also plays a huge role in heart health.
Men’s testosterone levels peak in their 30s and then start to decline. As they do, men develop health issues including fatigue, depression, and diminished sex drive.
For years, doctors have been putting men on replacement testosterone, which comes in injections, patches, and gels. In addition to improving sexual function and bone density, and increasing fat-free mass and strength, testosterone replacement has been shown to improve cholesterol profiles, blood glucose levels, and heart performance.
In recent years, however, testosterone replacement therapy has been the subject of an intense advertising campaign, warning men of the horrors of “Low T,” as the ads call it. As a result, annual prescriptions for supplemental testosterone jumped more than fivefold between 2000 and 2011.
Today, testosterone is a billion-dollar industry, outselling even Viagra. But even as ads touted testosterone’s benefits, doubts began to surface. Last November, the Journal of the American Medical Association published research on men — many with underlying heart disease — who had used testosterone replacement. The researchers found these men were at higher risk for a heart attack, stroke, or death.
A pair of other studies found that men using testosterone had doubled the risk for a heart attack. Faced with these results, the FDA in February announced plans to investigate the effects of testosterone therapy.
What should men do in the meantime? First, bear in mind that the studies involved men who were already sick.
In fact, a number of prior studies, including research published in 2011 in the Journal of Clinical Endocrinology & Metabolism, showed positive results. Men who were testosterone deficient but otherwise healthy had a 50 percent lower risk of dying when taking testosterone. Other studies have also shown that men with heart failure may benefit from testosterone. I’ve seen patients feel better and get stronger with testosterone therapy.
But it’s not a magic bullet. See a doctor and have your need evaluated, and also pay attention to the way it’s administered. Methods that restore the body’s testosterone levels carefully, and without wild fluctuations, are preferable to large dose injections, for instance.
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