Even with its broad acceptance, TRT remains a contentious matter owing to its uncertain benefits and potential health risks. Years ago, studies indicated a possible association between TRT and increased cardiovascular disease risk, leading to 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.”
Findings in the August 2015 Mayo Clinic Proceedings revealed no connection 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.
TRT’s connection to other health issues is mixed. Although previous studies linked TRT to a higher risk of prostate cancer, the December 2015 Journal of Urology published a study showing no increased risk of aggressive prostate cancer with five years of TRT exposure. This challenges conventional understanding and calls for more research into TRT’s long-term effects.
TRT’s long-term risks remain uncertain due to limited follow-up in many studies. Nevertheless, individuals should not overlook TRT as a potential solution, as it may still be appropriate for certain individuals.
Employing a standard blood test is a common approach to evaluate testosterone levels. With the daily fluctuations and the impact of medication and diet, conducting multiple tests becomes crucial. Dr. Hayes points out, “In roughly 30% of cases where the initial testosterone test indicates low levels, subsequent tests demonstrate normal levels.”
Despite low testosterone levels and presenting with different symptoms, testosterone replacement therapy (TRT) may not be the immediate remedy. Dr. Hayes advises, “By uncovering the root cause of declining levels, we can address it and naturally elevate low levels.”
Take weight gain, for instance, often the top cause of decreasing levels. “Weight plays a larger role in testosterone levels than aging. As weight increases, testosterone levels tend to fall,” she emphasizes. A five-point increase on the body mass index (BMI) scale, like progressing from 30 to 35, equates to 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 could tackle the root cause or adjust your medication or dosage to avoid affecting testosterone levels.
Men should be aware of 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.
An illustration of this can be seen in the frequent emphasis on sexual health and vitality as benefits of testosterone replacement therapy (TRT). A study detailed in the Feb. 18, 2016 release of The New England Journal of Medicine investigated the effects of TRT on 790 men aged 65 and older. Participants who received TRT for one year, compared to those on a placebo, observed enhancements in sexual function, including activity, desire, and erectile function. However, the group only experienced a marginal improvement in mood and detected no alterations in walking speed, a measure of TRT’s effect on vitality.
Both methods offer unique benefits, with gels maintaining stable 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 might experience a temporary spike following an injection, followed by a gradual decline, leading to mood and energy fluctuations akin to a roller-coaster.
Symptom improvement is often seen within four to six weeks by most men in North Hollywood, though it may take three to six months to see changes in muscle mass.
TRT isn’t always required for life. “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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