You may consider hormone replacement therapy (HRT) to be a women's-only concern, but it's not. Men's testosterone levels peak in their late teens, and begin a gradual but steady decline of about 1 percent a year around age 30 (Mayo Clinic, 2012).
Because testosterone is required for proper male sexual development and reproductive function—as well as muscle bulk, red blood cell level, and bone density—many men worry about the natural decline of this hormone produced by the testicles. Yet medical experts disagree about the significance of this decline, and whether the health benefits of HRT outweigh the risks.
Do I Need HRT?
If testosterone levels decline naturally with age, do men need HRT? This has been a difficult question for researchers to answer. Not many studies have observed the effects of testosterone therapy in men with healthy levels of the hormone—and studies that have were smaller and yielded unclear results.
HRT can help symptoms of low testosterone in men who suffer from a disease called hypogonadism (Mayo Clinic, 2012). This is a dysfunction of the testicles that results in the body being unable to produce the right amount of testosterone. But what's less certain is whether testosterone therapy can benefit healthy men whose testosterone decline is simply due to aging.
What Type of HRT Are Available?
If your doctor suggests that you need testosterone therapy due to hypogonadism, there are a number of options available, for example:
- Testosterone replacement can be given through muscular injections every two to three weeks.
- Daily testosterone patches worn on the body may be rotated between the back, arms, buttocks, or abdomen.
- Testosterone gels can be applied topically to the shoulders, arms, or abdomen.
According to the Cleveland Clinic, no pills (oral medications) are available on the U.S. market that can provide men with a sufficient level of testosterone replacement (Cleveland Clinic, 2009).
What Are the Risks of HRT?
Side effects are a primary drawback of using HRT. While some of the side effects associated with HRT are relatively minor, others are more serious.
Potential minor side effects of HRT include:
- fluid retention
- increased urination
More serious potential side effects include:
- breast enlargement
- decreased testicle size
- worsening of sleep apnea in patients who have this sleep disorder
- changes in the amount of cholesterol in your body
- increases in your red cell count
- decrease in sperm count
Additionally, HRT can cause prostate growth in men, which could stimulate the growth of prostate cancer if an early stage of the disease is already present. The Cleveland Clinic thus recommends avoiding testosterone replacement therapy if you have prostate cancer (Cleveland Clinic, 2009).
Weigh Your Choice
Harvard Medical School (HMS) notes that although an increasing number of men in the United States have started HRT to try to reverse the natural age-related decline of testosterone, it may not be the wisest choice (HMS, 2004).
Safer alternatives to fight aging include exercising to build muscle mass and walking to keep your heart strong. If in doubt about whether you need testosterone therapy, talk to you doctor first before jumping to conclusions.