Despite being widely adopted, TRT is a divisive issue due to uncertain benefits and potential health risks. Years ago, studies indicated a possible association between TRT and a higher risk of cardiovascular disease, causing safety concerns.
Reproductive endocrinologist Dr. Frances Hayes, from the Harvard-affiliated Massachusetts General Hospital, underscores the limitations in some studies.
“For instance, in one study, TRT doses were much higher than what would usually be prescribed, and the subjects tended to be more frail, with other health problems,” she says. “Other studies showed no evidence of increased risk.”
The August 2015 Mayo Clinic Proceedings revealed no association between TRT and blood clots in veins among 30,000 men. “Right now, the jury is still out about TRT’s influence on cardiovascular disease,” says Dr. Hayes.
The relationship between TRT and other health issues is mixed. Despite earlier associations between TRT and a higher risk of prostate cancer, the December 2015 Journal of Urology published a study indicating no increased risk of aggressive prostate cancer with five years of TRT exposure. This finding challenges traditional views and warrants further investigation into TRT’s long-term effects.
TRT’s long-term risks remain unclear due to limited follow-up in many studies. Nonetheless, individuals should not disregard TRT as an option, as it may still be beneficial for certain individuals.
Evaluating testosterone levels typically involves a standard blood test. With the daily fluctuations and the influence of medication and diet, conducting multiple tests becomes necessary. Dr. Hayes mentions, “In about 30% of cases where the initial testosterone test indicates low levels, subsequent tests reveal normal levels.”
Despite low testosterone levels and experiencing various symptoms, testosterone replacement therapy (TRT) might not be the immediate solution. Dr. Hayes recommends, “By uncovering the root cause of declining levels, we can address it and naturally elevate low levels.”
Consider weight gain, for example, frequently the primary trigger for declining levels. “Weight has a more significant impact on testosterone levels than aging. As weight increases, testosterone levels tend to fall,” she stresses. A five-point jump on the body mass index (BMI) scale, such as moving from 30 to 35, equals adding 10 years to your age in terms of testosterone levels.
“Your doctor should also consider any additional factors that could influence levels, such as medication or medical conditions,” recommends Dr. Hayes. In such instances, your doctor might handle the underlying cause or tweak your medication or dosage to sidestep influencing testosterone levels.
Men should understand the constraints of TRT, as it’s frequently praised as a miraculous remedy. “Its outcomes are typically not as astounding as men expect,” Dr. Hayes observes.
As an example, sexual health and vitality are frequently highlighted as benefits of testosterone replacement therapy (TRT). A study in the Feb. 18, 2016 issue of The New England Journal of Medicine delved into how TRT impacted 790 men aged 65 and older. Those administered TRT for a year, as opposed to those on a placebo, noticed enhancements in sexual function, including activity, desire, and erectile function. However, the group experienced only a slight uplift in mood and detected no changes in walking speed, indicating TRT’s limited impact on vitality
Each method provides specific advantages, with gels ensuring consistent testosterone levels. “However, you should be careful to avoid close skin contact for a few hours, especially with women, as testosterone could cause acne or hair growth,” Dr. Hayes advises.
Testosterone levels can temporarily surge post-injection, followed by a decline, leading to mood and energy fluctuations resembling a roller-coaster effect.
Symptom improvement is usually observed within four to six weeks by most men in Alpharetta, though it may take three to six months to see changes in muscle mass.
TRT doesn’t always have to be a lifelong commitment. “If the factor that caused your testosterone drop is resolved, you should try stopping the treatment and be re-evaluated by your doctor,” says Dr. Hayes.