Testosterone therapy: Can it help older men feel young again?

Some men are interested in testosterone therapy even if their testosterone levels are considered normal. Find out whether testosterone therapy could be helpful for you.

The possibilities of testosterone therapy are enticing — increase your muscle mass, sharpen your memory and mental focus, boost your libido, and improve your energy level. As you get older, testosterone therapy may sound like the ultimate anti-aging formula. But health benefits from testosterone therapy aren't quite so clear-cut.

Before you buy into the tempting claims, find out what's known — and not known — about testosterone therapy so that you can make the best decision for your long-term health.

What is testosterone?

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The influence of testosterone

Men's bodies produce the hormone testosterone in their testes. In men, testosterone helps maintain:

Bone density
Fat distribution
Muscle mass
Muscle strength
Red blood cell production
Sex drive
Sperm production

Your doctor can prescribe a synthetic version of testosterone. Testosterone therapy using testosterone replacement medications may be necessary for men who have very low levels of testosterone (hypogonadism). Testosterone therapy medications are available as injections, patches and gels.

What happens to your testosterone level as you age?

Your body's testosterone level peaks during adolescence and early adulthood. Starting around age 40, your body produces less testosterone. For most men, testosterone levels decline modestly.

Does a naturally declining testosterone level cause the signs and symptoms of aging?

It's not clear that naturally falling testosterone levels cause any signs and symptoms in men. Studies of men who have very low levels of testosterone due to diseases and treatments may offer some clues to the role testosterone plays in a man's body as he ages. According to those studies, testosterone deficiency can have several effects on the body, including:

Decreased sexual function
Loss of bone density
Loss of muscle mass
Increase in fat mass
Reduced muscle strength
Memory loss
Mood changes and depression

Some men experience these signs and symptoms, but don't have unusually low levels of testosterone. Others may have low levels of testosterone, but don't experience any signs and symptoms that would prompt them to seek treatment.

What could testosterone therapy do for men with normal testosterone levels?

Some men believe that taking testosterone medications may help them feel younger and more vigorous as they age. But while studies show that testosterone therapy can restore your testosterone level to that of your youth, it isn't clear that there's any benefit to this. And it isn't clear if a higher testosterone level can help you live longer.

Few rigorous studies have examined testosterone therapy in men with healthy testosterone levels. Some small studies have revealed unclear results. For instance, studies found that healthy men who take testosterone medications saw their muscle mass increase, but in most studies the men weren't any stronger after testosterone therapy.

What are the risks of testosterone therapy?

Not enough study has been done to determine the risks of testosterone therapy in men with normal testosterone levels. In theory, a higher than normal testosterone level could increase a man's risk of prostate cancer or an enlarged prostate (benign prostatic hyperplasia). But studies haven't determined whether testosterone therapy could cause these complications.

Studies show testosterone therapy can cause sleep apnea in some men. This condition causes you to continually start and stop breathing as you sleep. Testosterone therapy may also cause your body to make too many red blood cells (polycythemia), which can increase your risk of heart disease.

Consider these pros and cons when evaluating testosterone therapy:

Potential benefits	Potential risks
Improve muscle mass and strength Increase bone mineral density Thicken body hair and skin Improve sexual desire Boost energy Decrease irritability and depression Improve cognitive function	Cause skin reactions Cause fluid retention Cause baldness Cause or aggravate sleep apnea Stimulate noncancerous growth of the prostate and cause or worsen urinary symptoms Stimulate growth of prostate cancer that's already present Enlarge breasts Stimulate growth of breast cancer that's already present Cause testicle shrinkage Limit sperm production Stimulate excess blood production Cause acne

Potential benefits

Potential risks

Improve muscle mass and strength
Increase bone mineral density
Thicken body hair and skin
Improve sexual desire
Boost energy
Decrease irritability and depression
Improve cognitive function

Cause skin reactions
Cause fluid retention
Cause baldness
Cause or aggravate sleep apnea
Stimulate noncancerous growth of the prostate and cause or worsen urinary symptoms
Stimulate growth of prostate cancer that's already present
Enlarge breasts
Stimulate growth of breast cancer that's already present
Cause testicle shrinkage
Limit sperm production
Stimulate excess blood production
Cause acne

Should you talk to your doctor about testosterone therapy?

If you're concerned that you might have a hormone deficiency, talk to your doctor. A decline in testosterone that falls below normal values may be a reason to take supplemental testosterone. There is some controversy about whether testosterone therapy should be used in men who have naturally lower testosterone levels as a result of aging. It remains unclear whether restoring the testosterone levels to those of youth benefits older men.