Testosterone Replacement Therapy

As men age, levels of the hormone testosterone can decrease over time. Unfortunately, reductions in testosterone levels can result in emotional, physical, and sexual changes. Men who want to counteract these changes and eliminate the chance of erectile dysfunction, which often goes hand-in-hand with hormonal imbalances due to testosterone reduction, can consider testosterone replacement therapy. However, it is important to first understand what testosterone replacement therapy can accomplish, what low testosterone levels can affect, the types of replacement therapy available, and the various pros and cons of testosterone replacement therapy.

What Is Testosterone Replacement Therapy and What Does It Accomplish?

Although reduced levels of testosterone are a natural byproduct of the aging process in men, many individuals want to resist these changes for as long as possible. To do so, the naturally diminishing levels of testosterone in the body have to be supplemented. Whether through patches or gels, the objective is the same: to achieve testosterone in the amounts that a young man in his 20s or 30s might naturally have.

Testosterone is a steroid hormone present in both men and women, and it serves as the primary male sex hormone. Although females do secrete testosterone from their ovaries, males tend to have eight times as much of the hormone in their bodies.

Low testosterone can result in several changes in men. Testosterone levels generally peak in men at age 30, and they can reduce by as much as 1% each year thereafter. Lower testosterone levels can trigger physical changes like an increase in body fat, a loss of hair, reduced energy, and a lower sex drive. Reductions in testosterone can also lead to emotional changes like an increase in sadness, a decrease in confidence, or trouble feeling motivated to take on everyday challenges.

Advantages of Testosterone Replacement Therapy

The primary reason that men consider testosterone replacement therapy is simply to counteract the natural reduction of the hormone with age. While it is not a panacea for all physical, sexual, and emotional problems, it can certainly help to make many users look and feel better. By identifying the advantages, potential patients can better understand the typical changes.

• Higher Energy Levels: One of the most noticeable benefits of testosterone replacement therapy is a marked increase in energy levels. Many men start to naturally feel more sluggish as they age, and they may even believe that lower energy levels are a natural thing in middle age and beyond. However, testosterone replacement therapy can feel like turning back the clock when it comes to energy. Many users report that they sleep better at night, feel more alert when at work, and want to stay active rather than napping or watching television on the couch at the end of the day.

• Better Sexual Health: Another major benefit of testosterone replacement therapy is an increase in overall sexual health. Many men find that increasing their testosterone levels also increases their libido as well as the quality and duration of their erections. Men over the age of 40 who believed that erectile dysfunction was a natural byproduct of middle age might be surprised at just how effective testosterone can be. Some men even report that their orgasms are more powerful than they have been in years, further increasing their sexual desire for their partner.

• Reduction in Body Fat: Replacing testosterone in the body may also change the way a man looks physically. Higher levels of testosterone are linked to reductions in insulin sensitivity, which can lead to lower body fat levels, a decreased desire for sugar and carbohydrates, and even a reduction in stomach fat. With an increase in energy, higher testosterone levels can also lead to better workouts and an increase in muscle mass. These changes translate to a leaner, fitter, and overall healthier physical appearance, which is a big advantage to most men.

• Increase in Average Life Expectancy: A serious benefit of testosterone replacement therapy is that it has the potential to increase your overall life expectancy. Research shows that men with higher testosterone levels in middle age generally live longer than those who have lower testosterone levels at the same age. Although it is not completely understood what the cause of this connection is, there is no doubt that it makes testosterone replacement therapy an appealing option for men of any age.

• Reduced Irritability and Lower Rates of Depression: Although many men focus on the physical and sexual benefits of testosterone replacement therapy, it is important to note that there are many emotional benefits as well. Increasing a man’s testosterone can often help to reduce moodiness or irritability. Men who are suffering from depression may notice that after testosterone replacement therapy, their depressed states are less common and perhaps even less intense. Some men even report that the increased levels of testosterone help them to feel more confident and in control of their lives, their careers, and their relationships.

Disadvantages of Testosterone Replacement Therapy

Unfortunately, not everything about testosterone replacement therapy is positive. There are some drawbacks involved, and there are also some risk factors that potential candidates should be aware of before beginning treatment.

• Skin Irritation: By far the most common drawback of testosterone replacement therapy is skin irritation. Generally, this occurs in the spots where the testosterone patch or gel came into direct contact with the skin. As many as half of the men who receive testosterone replacement therapy may complain of rashes, swelling, redness, or other irritation at the site where testosterone enters or touches the body. However, any irritation generally disappears altogether when the therapy is stopped.

• Reduced Fertility: Many of the men interested in pursuing testosterone replacement therapy already have children, so reduced fertility may be less of a concern for them. However, men who are planning to have children in the future need to be aware that artificially raising testosterone levels in the body can result in low sperm counts that can make fertility a challenge.

• May Worsen Sleep Apnea: Although testosterone replacement therapy can help with sleep problems, energy levels, and obesity, all of which are linked to sleep apnea, it can still cause problems for men who already have sleep apnea. Men with sleep apnea should undergo polysomnography, or sleep study, to determine the severity of their condition. If testosterone replacement therapy is selected as a course of action, they will need to be vigilant about monitoring their sleep apnea and may even need to rely on a continuous positive airway pressure machine at night.

• Can Cause Prostate Cancer to Worsen: There is a strong link between rising rates of prostate cancer and testosterone replacement therapy. Specifically, it can cause men who already have prostate cancer to see rapid growth, which is certainly a negative. However, men who have no history of prostate cancer and who don’t have an elevated prostate-specific antigen are not generally affected by testosterone replacement therapy in this regard.

• Risk of Contamination: Men who live with a female partner or children may also run the risk of contamination, specifically if they use a form of testosterone replacement therapy that is liquid or gel in nature. Residue from testosterone creams, for example, could find its way onto the skin of the people who live in your home. While testosterone is a natural hormone already present in the bodies of men and women, too much of it can be harmful. Accidental testosterone exposure can lead to premature growth of pubic hair, premature genital development, advanced bone aging, and aggressive behavior. Adults using testosterone replacement therapy should always take care not to expose it to women or children in the home or anyone they come into contact with throughout the day.

Types of Testosterone Replacement Therapy

There are several different types of testosterone replacement therapy. Every man interested in increasing his testosterone levels should consider the various options and learn as much as possible before choosing the right treatment.

• Transdermal Patches: One of the most common ways to increase testosterone in the body is with a transdermal patch. This small square patch is stuck to the arm, or any other location on the upper body that is convenient to the wearer, and releases testosterone over 24 hours. It is an affordable option, but users have to remember to replace the patch once each day or deal with hormonal inconsistencies.

• Testosterone Gels: Another popular and unobtrusive means of conducting testosterone replacement therapy is through a gel. These clear gels come in small tubes and are applied to the skin once each day. Although generic versions contain a small amount of testosterone, prescription versions can have testosterone levels tailored to a patient’s specific age, weight, or hormone levels.

• Mouth Patches: Similar to transdermal patches, mouth patches are disposable and designed to be replaced regularly. The most common types of mouth patches for testosterone replacement therapy are meant to be worn for 12 hours, and the wearer will need to remove and replace the patch twice a day. The patch sticks to the upper gums and should not interfere with talking or eating, although some wearers note that they are initially uncomfortable.

• Injections: For men who only want to worry about testosterone replacement therapy once every few weeks, an injection may be ideal. Testosterone, in a liquid form, will be administered via an injection into the bloodstream. This allows the body to absorb the proper amount of testosterone. These testosterone injections can only be administered by a healthcare professional in a clinical setting.

• Implants: The least common method of testosterone replacement therapy is an implant inserted into the soft tissue of the body. This implant is small and shaped like a pellet, and it will release testosterone for approximately six months. Pellet implants don’t need to be removed as they dissolve in the body over time. However, patients will need to receive a new implant roughly every six months to continue with their testosterone replacement therapy.

Who Should Consider Testosterone Replacement Therapy?

Although increased levels of testosterone can affect sexual health, emotional health, and physical appearance, it is not right for everyone. Many men can see drastic changes simply by adjusting their diet and exercise routine. Before taking testosterone replacement therapy, men should ensure that their lack of energy, weight gain, or depression is not caused by an unknown medical condition that needs to be addressed directly.

Generally, testosterone replacement therapy is not recommended for men under the age of 30. With some exceptions, men below the age of 30 already have normal levels of testosterone, and increasing those levels may cause harm rather than providing the boost patients expect. Men with severe sleep apnea, a history of prostate cancer, or concerns about blood clots should also avoid testosterone replacement therapy or speak with a medical professional before proceeding with treatment.

Men who should consider testosterone replacement therapy include those over the age of 50 who are noticing a natural reduction in energy and stamina with age. While not a cure-all, testosterone replacement therapy might be able to increase physical fitness, sexual confidence, and emotional stability over time.

Although testosterone levels naturally decrease in men over the age of 30, replacement therapy for the hormone can be a way to counteract that change. While testosterone replacement therapy can be incredibly advantageous to the right candidates, it also has some drawbacks, and men should carefully consider them all before choosing to undergo this therapy.


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