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Even with its growing popularity, testosterone replacement therapy (TRT) continues to be controversial because of its uncertain benefits and potential health risks. Concerns about its safety have emerged in the past, particularly with studies suggesting a possible link between TRT and an increased risk of cardiovascular disease.
Dr. Frances Hayes, a reproductive endocrinologist at the Harvard-affiliated Massachusetts General Hospital, highlights that certain studies were restricted in their scope.
“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 LATEST FINDINGS
Researchers observed that men in good health who underwent testosterone replacement therapy (TRT) did not have a higher risk of heart attack, stroke, or mortality.
Furthermore, the August 2015 issue of Mayo Clinic Proceedings reported a study indicating that TRT showed no link to venous blood clots 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 various health conditions varies widely. Although TRT has been historically linked to higher rates of prostate cancer, research in the December 2015 Journal of Urology found no increased risk of aggressive prostate cancer with five years of TRT use.
The long-term risks of TRT continue to be uncertain, largely due to the limited follow-up in many studies. However, this does not mean TRT should be ruled out completely. For certain men, TRT can still be an appropriate choice.
Who Is a Candidate For TRT In Brighton, MI?
Testosterone levels are typically evaluated using a standard blood test. Because these levels can fluctuate from day to day due to factors like medication and diet, several tests are often necessary. Dr. Hayes mentions, “In 30% of instances where the first testosterone test indicates low levels, subsequent tests show normal levels.”
Low testosterone levels and multiple symptoms do not automatically mean that testosterone replacement therapy (TRT) will be the initial treatment choice.”Identifying the underlying cause of declining levels allows us to address it and naturally boost low levels,” states Dr. Hayes.
Weight gain, often a leading cause of reduced testosterone levels, should be taken into account. “Weight exerts a more substantial influence on testosterone levels than aging. As weight increases, testosterone levels decrease,” she explains. A five-point jump on the BMI scale, like moving from 30 to 35, equates to an additional 10 years of aging regarding its effect on testosterone levels.
“Your doctor should also assess any additional factors that could impact levels, such as medication or medical conditions,” advises Dr. Hayes. When facing such issues, your doctor might work on addressing the underlying cause or modify your medication or dosage to avoid impacting testosterone levels.
It’s important for men to understand that TRT is not just a quick-fix solution. “Its results are often less remarkable than many men envision,” notes Dr. Hayes.
Sexual health and vitality are commonly cited benefits of TRT. According to a study published in the February 18, 2016 issue of The New England Journal of Medicine, TRT was tested on 790 men aged 65 and older. Participants who underwent TRT for one year demonstrated improvements in sexual function—activity, desire, and erectile function—compared to those receiving a placebo. Nonetheless, there was minimal mood enhancement and no change in walking speed, which gauges vitality.
Using TRT
Each approach has its own benefits, with gels often leading to more consistent testosterone levels. “However, you must avoid close skin contact for a few hours, especially with women, as the testosterone can cause acne or hair growth,” advises Dr. Hayes.
Testosterone injections may cause levels to surge for several days following administration, then slowly decrease. This fluctuation can result in mood and energy levels peaking and then dropping, creating a roller-coaster effect.
Most men in Brighton, MI, typically see symptom improvement within four to six weeks, although enhancements like increased muscle mass might take three to six months.
Moreover, TRT does not always need to be a lifelong therapy. “If the cause of your low testosterone levels resolves, you should try stopping treatment and get re-evaluated by your doctor,” says Dr. Hayes.