Despite its widespread adoption, testosterone replacement therapy (TRT) remains a topic of controversy due to uncertain benefits and potential health risks. Previous studies have raised concerns about a possible association between TRT and increased cardiovascular disease risk, prompting safety concerns.
Dr. Frances Hayes, a Reproductive Endocrinologist at Massachusetts General Hospital affiliated with Harvard, has pointed out the shortcomings in certain 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.”
Similarly, the August 2015 issue of Mayo Clinic Proceedings reported no association between TRT and 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 other health concerns is inconsistent. While previous research suggested a potential link between TRT and an elevated risk of prostate cancer, a study published in the December 2015 issue of the Journal of Urology found no increased risk of aggressive prostate cancer after five years of TRT exposure. This challenges conventional wisdom and emphasizes the necessity for further investigation into the long-term effects of TRT.
The long-term risks of TRT are still uncertain due to limited follow-up in numerous studies. Nevertheless, individuals should weigh TRT as a potential solution, particularly in specific cases.
Measuring testosterone levels usually involves a standard blood test. Due to daily variations and the effects of medication and diet, conducting multiple tests is essential. Dr. Hayes elaborates on this protocol, “In around 30% of cases where the initial testosterone test indicates low levels, subsequent tests show normal levels.”
Low testosterone levels and the presence of various symptoms do not always require testosterone replacement therapy (TRT) as the immediate solution, Dr. Hayes suggests. “By understanding the underlying cause of declining levels, we can address it and naturally enhance low levels,” she says.
TRT is often highlighted for its potential benefits to sexual well-being and vitality. A study published in the February 18, 2016 issue of The New England Journal of Medicine examined 790 men aged 65 and older to evaluate TRT’s effects. Those receiving TRT for one year reported improvements in sexual function such as activity, desire, and erectile function compared to those on a placebo. However, the group saw only marginal improvements in mood and noted no changes in walking speed, a measure of TRT’s impact on vitality.
“Your doctor should also consider any additional factors that could influence levels, such as medication or medical conditions,” suggests Dr. Hayes. In such situations, your doctor might tackle the root cause or modify your medication or dosage to sidestep influencing testosterone levels.
It’s important for men to recognize the limitations of TRT, often marketed as a rapid remedy. “Its outcomes are typically not as astounding as men expect,” Dr. Hayes observes.
The focus on sexual health and vitality as advantages of testosterone replacement therapy (TRT) is underscored by a study outlined in the February 18, 2016 edition of The New England Journal of Medicine. This research examined 790 men aged 65 and older, finding that participants who underwent TRT for one year reported enhancements in sexual function, such as activity, desire, and erectile function, compared to those given a placebo. However, the group observed only a slight improvement in mood and detected no changes in walking speed, which measures TRT’s impact on vitality.
Both methods offer unique 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.
After receiving an injection, testosterone levels may spike temporarily before declining, leading to mood and energy fluctuations resembling a roller-coaster ride.
Many men in Fort Mitchell often experience symptom relief within four to six weeks, with changes in muscle mass potentially occurring over three to six months. Understanding that TRT isn’t always a lifelong obligation is important. “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.
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