Testosterone Replacement Therapy: Myths and Facts

Testosterone replacement therapy (TRT) is one of the most popular treatments for men experiencing low testosterone levels, but it’s far from perfect. Many myths surrounding TRT make people think it’s a magic bullet for improving their sex life, building muscle, and even reversing aging. Here are some truths about TRT that might help clear up concerns.

Can testosterone replacement therapy make me feel more energetic?

The testosterone hormone is critical to a man’s health. Low levels can cause fatigue, depression, decreased libido, and lack of energy. Men who take testosterone replacement therapies (TRTs) routinely report increased energy, better mood, and enhanced sexual interest. These benefits have been attributed to the hormone rather than a placebo effect. 

Testosterone is also felt to promote muscle growth and improved strength. One of the early changes that patients notice following TRT is increased weight. This increase in weight is felt to arise from the immediate result of the engorgement of muscle tissues as they enter a growth phase. However, other researchers have questioned the potential negative impact of TRT on bone density. In one study, researchers reported men taking TRT might have a lower bone mineral density (BMD). Studies have also suggested that TRT may accelerate bone loss in older men. But more recent studies have not verified any changes in BMD in men taking TRT. Finally, others have reported an increased risk of prostate cancer, heart attack, strokes, blood clots, and even death. So, what is the verdict regarding TRT, which makes men feel, look, and live better?

Are there risks to testosterone replacement therapy?

Testosterone replacement therapy has been reported to have several side effects. Less concerning side effects have included headaches, fatigue, mood swings, decreased sex drive, increased appetite, weight gain, muscle loss, acne, and hair loss. More concerning are reports of increased risk of heart attacks, strokes, high blood pressure, liver disease, prostate cancer, and diabetes. Fortunately, all of these reports have been anecdotal and not definitive. Furthermore, TRT is intended to normalize your testosterone levels and not increase them to abnormally high levels.

To begin with, TRT is recommended for men who have low testosterone levels. Additionally, men with a history of prostate or breast cancer are generally ineligible for treatment. The decision to start testosterone therapy is up to each patient. However, discussing the benefits and risks of testosterone therapy with your doctor before making a final decision is essential.

Should I avoid testosterone replacement therapy if I have certain conditions?

According to a recent study published in JAMA Internal Medicine, prostate cancer patients should not be administered testosterone replacement therapy (TRT). This report concluded that while TRT might benefit men with low testosterone levels, it could cause harm in some situations. For example, men with obstructive sleep apnea syndrome should not receive TRT. Researchers have claimed that TRT may increase the risk of death in clients with obstructive sleep apnea. The American Cancer Society has dissuaded patients from being administered TRT if they are prostate cancer survivors.

Furthermore, the National Institutes of Health warns that TRT might increase the risk of heart disease and stroke. However, more recent studies have not verified these concerns and even presented evidence that the effects of normal testosterone levels may result in beneficial effects that are protective against heart disease. Many more doctors have recently conceded that TRT may benefit patients who suffer from decreased energy, depressive symptoms, low libido, and erectile dysfunction. The positive effects of TRT on improved muscle mass and its inhibition of cortisol levels have persuaded doctors even to recommend TRT for patients with a diagnosis of diabetes. 

Can testosterone replacement therapy treat ED?

Testosterone replacement therapy (TRT) may help restore erections in some men with erectile dysfunction (ED). Erectile dysfunction (ED), sometimes called impotence, occurs when you cannot achieve or maintain an erection long enough for intercourse. It affects about 30 million American adults. About half of those affected with ED are older than 50. The causes of ED are numerous. Physical causes of ED include thyroid disorders, liver disease, kidney failure, prostate cancer, diabetes, high cholesterol, heart disease, and obesity. Diabetes may compromise the small vessels of the penile shaft and also affect the health of nerves responsible for feelings of sexual arousal necessary for an erection. Recreational drugs and several medications used to treat mental health conditions and other illnesses may also affect the ability to have an erection. Finally, psychological factors may promote ED, including stress, depression, anxiety, anger, fear, guilt, and relationship problems. 

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