Both men and women produce testosterone (in men, testosterone is produced in the testicles and in women, it is created by the ovaries) but levels are much higher in men. Testosterone is an important hormone. It is the hormone that promotes the growth of masculine characteristics. This includes the growth of facial hair, a deeper voice and higher muscle mass. It can also affect bone density, mood and thinking ability.
Testosterone Replacement Therapy, or TRT, is used to increase testosterone levels in men when they are unnaturally low. TRT is available through private providers in the UK, as well as on prescription from the NHS. It can have a range of benefits and address a range of problems stemming from low testosterone levels, although there can be some side effects.
During adolescence, testosterone levels become up to 30 times higher than they were previously. Production then drops a little every year after early adulthood. After the age of 30, there may be a 1% decline every year. Sometimes, men under the age of thirty can experience low levels. Hypogonadism is the technical term for low testosterone. Reasons for seeking TRT may include low levels of testosterone or treatment for other conditions. Testosterone treatments can come as injections, gels or patches. Injections are most common.
Symptoms and Causes of Low Testosterone
Common symptoms of low testosterone include:
- Baldness
- Muscle loss
- Fat Gain
- Erectile dysfunction
- Infertility
- Disturbed sleep
- Fatigue
- Depression
There is no evidence that taking extra testosterone when your levels are normal can lead to additional benefits.
Factors that contribute to hypogonadism include high blood pressure and cholesterol, being overweight, and excessive drinking or drug use. Some prescription medications can contribute, as can illegal drugs and anabolic steroids.
Other medical conditions associated with low levels of testosterone include injuries to or inflammation of the testicles, such as that caused by mumps in childhood. Pituitary or hypothalamic diseases or tumours, AIDS, diabetes, liver disease, radiation and chemotherapy used in cancer treatments and inherited conditions such as Down syndrome, Kallman’s syndrome, Klinefelter syndrome and Prader-Willi syndrome may all be contributory factors.
Benefits of Testosterone Replacement Therapy (TRT)
One risk of having low testosterone levels is cardiovascular damage. Testosterone works through the bone marrow to help the production of red blood cells. Recent studies suggest that returning testosterone levels to normal can decrease the risk of heart attacks or strokes. A study of 83,000 men suggested testosterone replacement therapy reduced the risk of heart attack by 24% and stroke by 36%. The evidence is less clear on the effect of TRT on heart disease or angina.
If combined with exercise, TRT can help decrease fat and increase muscle mass. TRT also increases bone density, which reduces the risk of osteoporosis. Stronger bones will help support the rest of your body, which again will help with improving fitness.
There is also research to suggest that Alzheimer’s disease is less common in men with higher levels of testosterone. Testosterone can also improve thinking speed, verbal memory and spatial memory. Men with hypogonadism (as opposed to naturally decreasing testosterone as they age) are more likely to experience fatigue, depression and irritability.
Sexual arousal increases levels of testosterone. Older men with reduced levels of testosterone may struggle with their libido. Low testosterone levels are only one potential cause of erectile dysfunction, and other conditions should be considered before seeking treatment. As the positive effects of testosterone on libido have a maximum level, testosterone replacement therapy without hypogonadism may not improve your sexual performance.
Side Effects of TRT
There are potential side effects to TRT. Some depend on the delivery method. Injections have been known to cause mood swings. Skin can be irritated by patches. The gel cannot be shared with others. More general side effects include increases in acne, aggression and urination. Fluid retention and breast enlargement are also possible. TRT may decrease the sperm count and size of the testicles. It may also increase sleep apnoea in older patients. Men with breast or prostate cancer should not take TRT.
Testosterone replacement therapy should not be taken without a prescription so talk to your doctor first. A blood test should identify if you have hypogonadism or another underlying condition. Sometimes, changes in lifestyle can help testosterone levels without resorting to TRT. You should still eat healthily and exercise regularly whilst taking TRT, and make sure your responses to the treatment are monitored.