Does Testosterone Help Aging Men?
Around 40% of men over 45 have testosterone levels below 300 nanograms per deciliter (ng/dL), which can make it hard to perform everyday activities.
Many older men experience reduced sexual function, bone fractures, low muscle mass, and anaemia as they age. These issues are thought to be related to low testosterone levels that often occur with ageing.
To address this, some doctors prescribe testosterone replacement therapy (TRT). This treatment involves taking synthetic testosterone to restore normal levels. As a result, symptoms of low testosterone begin to improve.
TRT use has grown significantly over the years. According to a Clin Endocrinol (Oxf) article, testosterone prescriptions in the UK increased by 90% from 2000 to 2010 and have continued to rise since then.
While TRT is helpful for younger men, there's debate about whether it’s equally effective for older men.
In this article, we’ll look at the results of 6 testosterone trials (T trials) conducted by the National Institute on Aging to determine if TRT can benefit ageing men.
Do You Have the Features of Testosterone Deficiency?
The Androgen Deficiency in Aging Males (ADAM) questionnaire is an easy way to answer questions about your sexual health, which can help to see if you need your testosterone level checked.
It is an internationally accredited assessment tool which is often used by doctors when making the assessment and diagnosis of Testosterone Deficiency. A positive result does not necessarily mean that you have a low testosterone level or require treatment, but can be a helpful guide when discussing your symptoms with your doctor.
ADAM Questionnaire
Please answer the questions below.
What Are Testosterone Trials (T Trials)?
The T trials are a large study conducted at 12 sites across the United States. The goal was to see how testosterone affects men over 65 with low testosterone levels below 250 ng/dL.
In these trials, 790 men were randomly given either a placebo or testosterone gel. They applied the gel daily to their upper arms, shoulders, and abdomen for a year.
Their testosterone levels were checked every 30 days for the first 3 months, then again at 6, 9, and 12 months. Their dose was adjusted if their levels weren't between 500 and 800 ng/dL.
Findings Of T Trials
Sexual Function Trial
Men with low testosterone often have trouble getting and maintaining an erection. Their sperm count and sex drive also decrease.
The results of the Sexual Function Trial, published in 2016 in the New England Journal of Medicine, showed that increased testosterone levels improved erectile function and sexual activity in men who used testosterone gel.
Physical Function And Vitality Trials
Low testosterone is believed to cause depression, reduce energy, and increase fatigue.
The results of the Physical Function and Vitality Trials showed significant improvement in participants' depressive symptoms, energy levels, and mood. However, there was no noticeable change in their ability to walk.
Anemia Trial
Anaemia, or low haemoglobin, is when the red blood cell count drops, causing tissues and cells to receive less oxygen. It is common in older men but is often hard to diagnose.
Anemic people often feel tired, weak, dizzy, and get headaches. It can range from mild to severe, and long-lasting anaemia can damage the brain and other vital organs.
The results of the Anemia Trial, published in 2017, showed that testosterone gel significantly increased red blood cell production in older men with anaemia.
Bone Trial
Men with low testosterone often have weaker bones and lower bone density, leading to more frequent bone breaks.
In the Bone Trial, researchers used DEXA scans to check bone density and CT scans to analyse bone strength in older men on testosterone therapy. By the end of the study, participants had stronger bones and higher bone density, especially in the spine, compared to the hip.
Cognitive Function Trial
Older men often experience a decline in cognitive function. Since testosterone levels also drop with age, some experts think there might be a link between low testosterone and poor cognitive health.
However, the Cognitive Function Trial results showed no improvement in memory for participants who used testosterone gel for a year.
Cardiovascular Trial
As men age, their risk of heart disease increases.
The results of the Cardiovascular Trial showed that testosterone might increase the risk of heart problems in older men.
What’s The Results?
The results of the 6 trials show that testosterone therapy has some benefits for older men with low T, but it also comes with some risks. However, the benefits are greater than the downsides.
Researchers think that more long-term studies are needed to understand how effective the treatment is fully.
Should You Consider Taking Testosterone?
Deciding whether to take testosterone should be done by you and your doctor.
Each case of low T is different. You should discuss your medical history and current health with your doctor so they can understand your condition and decide if TRT is right for you.
TRT has helped many older men improve their low T and live healthier lives. If you are considering starting TRT, talk to your doctor first, get their advice, and then choose the best treatment option for your condition.
What TRT Options Do You Have?
TRT comes in different forms, giving older men various options. You can find testosterone in pellets, injections, pills, gels, and patches. You might wonder which form to take. The answer depends on your preferences and lifestyle.
If you're afraid of injections, you might prefer other options. People who like oral medications over gels, pellets, and injections choose testosterone pills.
Each form has its own pros and cons.
Testosterone Gels/Creams
Pros: Easy to apply on a daily, providing steady testosterone levels.
Cons: You must wait for the gel to dry before touching anything. There is a risk of transferring testosterone to others through skin contact.
Testosterone Injections
Pros: One shot a week can maintain your testosterone levels, so you don't have to take it daily. Injections are very effective and work within a few hours.
Cons: You might feel mild soreness at the injection site, and visiting your healthcare provider for a shot can be time-consuming.
Oral Medication
Pros: Easy to swallow and painless compared to injections.
Cons: It is not as effective as injections and gels and has poor absorption in the body. You may need to take 3 to 4 pills a day to maintain testosterone levels.
Testosterone Pellets
Pros: Placed under the skin, lasts 4 to 6 months, providing a long-term solution.
Cons: It can leave a permanent scar where the pellet is placed, and incorrect insertion can cause infection.
Testosterone Patches
Pros: Easy to apply and remove.
Cons: It may cause skin irritation.
What Roles Does Testosterone Play In The Body?
Testosterone is an important male hormone, and when levels drop, men can experience various issues. Here are some common roles of testosterone in men’s bodies:
- It controls the maturation of the testicles and penis.
- It regulates and maintains sperm production.
- It affects sexual desire and libido.
- It increases muscle mass and helps with body fat distribution.
- It encourages the growth of facial and body hair.
- It strengthens bones and increases bone mineral density.
As testosterone levels decline with age, you might notice a reduction in bone density, muscle mass, sexual desire, and sperm count.
Conclusion
Testosterone replacement therapy (TRT) offers several benefits for older men, such as increased bone density, reduced anaemia, improved mood, and enhanced sexual desire.
If you're considering testosterone replacement therapy, talk to a healthcare provider about its pros and cons. They will likely measure your testosterone levels, review your symptoms, and evaluate your medical history before recommending TRT.
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