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Testosterone therapy: Key to male vitality?

Considering testosterone therapy to help you feel younger and more vigorous as you age? Know the risks before you make your decision.

By Mayo Clinic staff

The possibilities of testosterone therapy are enticing — increase your muscle mass, sharpen your memory and concentration, boost your libido, and improve your energy level. As you get older, testosterone therapy may sound like the ultimate anti-aging formula. Yet the health benefits of testosterone therapy for age-related declines in testosterone aren't as clear as it may seem. Find out what's known — and not known — about testosterone therapy for normal aging.

What is testosterone?

Testosterone is a hormone produced primarily in the testes. For men, testosterone helps maintain:

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

If you have an unusually low level of testosterone (hypogonadism), your doctor may prescribe a synthetic version of testosterone. You may be able to choose from testosterone injections, patches or gels.

What happens to testosterone level with age?

Testosterone peaks during adolescence and early adulthood. As you get older, your testosterone level gradually declines — typically about 1 percent a year after age 30.

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

Some men have a lower than normal testosterone level without signs or symptoms. For others, low testosterone may cause:

  • Changes in sexual function. This may include reduced sexual desire, fewer spontaneous erections — such as during sleep — and infertility.
  • Changes in sleep patterns. Sometimes low testosterone causes insomnia or other sleep disturbances.
  • Physical changes. Various physical changes are possible, including increased body fat, reduced muscle bulk and strength, and decreased bone density. Swollen or tender breasts (gynecomastia) and hair loss are possible. You may experience hot flashes and have less energy than you used to.
  • Emotional changes. Low testosterone may contribute to a decrease in motivation or self-confidence. You may feel sad or depressed, or have trouble concentrating or remembering things.

It's important to note that some of these signs and symptoms are a normal part of aging. Others can be caused by various underlying factors, including medication side effects, thyroid problems, depression and excessive alcohol use. A blood test is the only way to diagnose a low testosterone level.

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References
  1. Tostain JL, et al. Testosterone deficiency: A common, unrecognized syndrome. Nature Clinical Practice Urology. 2008;5:388.
  2. Amore M, et al. Partial androgen deficiency, depression and testosterone treatment in aging men. Aging Clinical and Experimental Research. 2009;21:1.
  3. Baum NH, et al. Testosterone replacement in elderly men. Geriatrics. 2007;62:15.
  4. Emmelot-Vonk MH, et al. Effect of testosterone supplementation on functional mobility, cognition, and other parameters in older men: A randomized controlled trial. JAMA. 2008;299:39.
  5. Perheentupa A, et al. Aging of the human ovary and testis. Molecular and Cellular Endocrinology. 2009;299:2.
  6. Harman SM. Endocrine changes with aging. http://www.uptodate.com/home/index.html. Accessed Dec. 18, 2009.
  7. Snyder PJ. Decline in testicular function with aging. http://www.uptodate.com/home/index.html. Accessed Dec. 18, 2009.
MC00030 April 10, 2010

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