Low Testosterone Therapy: Risks and Benefits
"Today, we recognize, based on dozens of studies, its importance relative to health issues such as diabetes, obesity, metabolic syndrome, and osteoporosis," Morgentaler says.
Testosterone may also play a role in how long men live. Recent studies, Morgentaler says, show a link between low testosterone and shorter life expectancy.
"Men with low T die sooner than men with normal levels of testosterone," he says.
It's not clear if low testosterone, by itself, makes earlier death more likely. Many other factors could also be involved. It's also not clear if boosting testosterone to normal levels will impact longevity.
The link, though, makes sense to Morgentaler. "On testosterone, we see that fat mass goes down while muscle mass goes up," he says. "We know that that is good for overall health."
Morgentaler also says that treating low T can strengthen a man's bones and help prevent osteoporosis. Some evidence also suggests that treatment can also aid blood sugar control, which is important for the prevention and control of diabetes.
Testosterone is also tied to heart health, says Eisenberg, who discloses that he has received a grant from Endo Pharmaceuticals to study the association between testosterone and health.
"Lower testosterone levels have been linked to higher risk of cardiovascular problems," Eisenberg says. Again, it's not clear if low testosterone levels actually cause heart problems.
Both Eisenberg and Morgentaler say that testosterone therapy can dramatically affect a man's quality of life. Besides its sexual benefits, TRT can improve a man's mood and energy level while reducing irritability and anger.
What Are the Risks?
There are some cautions men should know about.
Testosterone therapy can raise a man's risk for blood clots and stroke. Eisenberg says that men can offset that risk by occasionally donating blood.
Uncommon side effects include sleep apnea, acne, and breast enlargement. All such side effects go away if treatment is stopped.
Men who use a testosterone gel should wash their hands thoroughly after applying a dose and make sure that no one else touches the spots where they medicate. If a woman or child comes into contact with testosterone gels, it can cause side effects in them, including hair growth and premature puberty.