In general, due to the current lack of long-term safety studies on testosterone therapy, testosterone replacement therapy in older men should be used with caution. To do this, they make a small incision in the skin and use a special tool to implant 10 balls of testosterone. Most testosterone binds to proteins; proteins control the amount of active testosterone in the body and prevent tissues from using the hormone right away. At our TRT Clinic in Hopkins MN, testosterone replacement therapy (TRT) involves an injection, patch, or gel of the hormone testosterone to bring the level back to normal. Before prescribing testosterone, your doctor should check your testosterone levels and make sure that your low testosterone level isn't due to something else, such as an illness.
Overall, testosterone treatment appears to have diverse effects, with modest improvements in a relatively healthy population with low serum testosterone levels, and some potentially adverse effects in the population of older men with pre-existing cardiovascular diseases. Some experts warn against them because they say that the doctors who administer them often prescribe too much testosterone and are not usually specialists in urology or endocrinology (the study of hormones). If your doctor suspects that your testosterone levels are low, he or she will do a blood test, probably first thing in the morning. Serum levels of total and free testosterone in men, after peaking in the second and third decades of life, gradually decline with age. After the scarcity of data on the effects of testosterone replacement therapy in older adults, a substantial discrepancy has also been observed in the effects of testosterone on physical function and muscle strength.
Guidelines from the American College of Physicians indicate that testosterone therapy may slightly improve sexual function in some men, but there is little evidence that it improves other functions, such as vitality and energy. Testosterone treatment in older men with low testosterone levels improves general sexual activity, sexual desire, and erectile function; improves areal and volumetric bone density, as well as estimated bone strength in the spine and hips; corrects unexplained anemia caused by aging; increases skeletal muscle mass, strength, and power, self-reported mobility, and some measures of physical function; and modestly improves depressive symptoms. Use caution when letting children or their loved ones touch the treated area or unwashed clothing that was in contact with the gel, as testosterone may be transferred to them. While some men believe that they feel younger and more vigorous if they take testosterone medications, there is little evidence to support the use of testosterone in otherwise healthy men. For older men, it is important to determine if a low testosterone level is due to normal aging or if it is due to a disease (hypogonadism).
It is important to mention that most clinical trials of testosterone replacement therapy in older men in which beneficial effects were reported did not provide data on cardiovascular risk factors, such as blood pressure, coagulation factors and inflammatory markers.
