Do I need testosterone?
What’s the Tea on Testosterone?
Everything you’ve wanted to know about testosterone.
What is testosterone?
Testosterone is a vital hormone that plays a central role in the development of male growth and masculine characteristics. From the deepening of the voice during puberty to the appearance of facial and pubic hair, muscle size and strength, bone growth and sex drive, testosterone is crucial for numerous physiological functions in men. However, it's not just men who rely on this hormone; women also produce testosterone in smaller amounts, and it affects ovarian function, bone strength, and sexual behavior.
While testosterone is essential for both genders, in this blog post, we'll focus on testosterone replacement therapy (TRT) for men, its appropriate use, and the symptoms of low testosterone.
Is it normal for testosterone levels to decrease with aging?
As men age, testosterone levels drop very gradually, about 1% to 2% each year Symptoms of testosterone deficiency in adult men include:
reduced body and facial hair
loss of muscle mass
low libido, impotence, small testicles, reduced sperm count and infertility
increased breast size
hot flashes
irritability, poor concentration and depression
loss of body hair
brittle bones and an increased risk of fracture
cognitive issues
So if I have these symptoms, I must have low testosterone, right?
It's essential to recognize that some of these symptoms can also be caused by other medical conditions, such as direct injury, radiation treatment, chemotherapy, tumors, medications (especially anabolic steroids), alcoholism, or lifestyle factors, so it's crucial to undergo a proper evaluation by a healthcare professional before considering testosterone replacement therapy.
So how can I determine what my testosterone level is?
Checking testosterone levels is as easy as having a blood test. The difficult part is interpreting the result. The optimal amount of testosterone is far from clear and normal ranges can even vary among different labs. A total testosterone lab test measures both "free" (unbound) testosterone and the amount of hormone bound to blood proteins. It's possible to have normal total testosterone levels but low “free” testosterone. Levels vary over the course of the day, so it’s best to measure free testosterone levels in the morning. Even with an abnormally low level that is replicated on a repeat test, it is still important to have a careful conversation with your doctor.
When should testosterone replacement be considered?
Testosterone replacement therapy can be appropriate for men with confirmed low blood testosterone levels AND symptoms that are likely caused by the low level AND not be high risk for prostate cancer.
How is testosterone therapy administered?
Artificial testosterone can be administered orally, through injections, gels, creams, skin patches, implants, and topical creams.
Is there such a thing as having too MUCH testosterone?
Having too much naturally-occurring testosterone is not a common problem among men. The problems can come in if you artificially increase testosterone to supraphysiolgic ranges, which include:
low sperm counts, shrinking of the testicles and impotence
heart muscle damage and increased risk of heart attack
prostate enlargement with difficulty urinating
acne
fluid retention with swelling of the legs, ankles and feet
weight gain, perhaps related in part to increased appetite
high blood pressure and cholesterol
insomnia
headaches
stunted growth in adolescents
uncharacteristically aggressive behavior (although not well studied or clearly proven)
mood swings, euphoria, irritability, impaired judgment, delusions.
disturbed breathing while sleeping
high red blood cell counts, which could increase the risk of blood clots.
Testosterone and prostate cancer
Although testosterone may make prostate cancer grow, it is not clear that testosterone treatment actually causes cancer. However, because prostate cancer is so common, doctors tend to be leery of prescribing testosterone to men who may be at higher than average risk of having undiagnosed prostate cancer.
Conclusion
Treating normal aging with testosterone therapy is not advisable. However, for men with low blood testosterone levels and symptoms most likely caused by a low level, the benefits of hormone replacement therapy may outweigh potential risks. If you don't have a medical condition that's contributing to your decline in testosterone levels, your doctor might suggest natural ways to boost testosterone, such as losing weight and increasing muscle mass through resistance exercise.
Remember, maintaining overall health and well-being is essential, and addressing any concerns with the guidance of medical professionals can lead to a happier and healthier life.
Dr. Sarina Phatak can help you decide if testosterone is right for you. Schedule a free 15 minute consult today!
