According to the Centers for Disease Control and Prevention (CDC), the life expectancy at birth for men increased from 46 to 75 years from 1900 through 2007 (CDC, 2010). Regular exercise, a healthy diet, and adequate rest all help maintain energy and vitality. As men redefine what it means to be 50, 60, and even 70 years old or more, they're likely to seek out the most advanced anti-aging solutions—like testosterone therapy.
Over the last decade, testosterone use among middle-aged and senior men has exploded. The hormone reportedly helps boost energy levels, increase muscle mass, and restore sexual prowess. However, scientists caution that we don't know enough yet to determine the safety of regular testosterone supplementation. Fortunately, there are other options.
What Is Testosterone?
Testosterone is the hormone responsible for the development of the male external genitalia and secondary sexual characteristics. It's produced by the testicles and is important for maintaining muscle bulk, bone density, and red blood cells. Adequate testosterone also supports sexual and reproductive function and contributes to a man's sense of vitality and well-being.
As men age, their bodies gradually produces less testosterone. This natural decline starts around age 30, then continues throughout the rest of a man's life. Scientists still aren't sure about the significance of this decline, or whether testosterone therapy is the best way to counteract it (Cleveland Clinic, 2009).
Some men have a true testosterone deficiency, called male hypogonadism. This is a condition in which the body doesn't produce enough testosterone. It may be caused by problems in the testicles, hypothalamus, or pituitary gland.
Symptoms of male hypogonadism in adulthood include:
- erectile dysfunction
- decrease in muscle mass
- loss of bone mass (osteoporosis)
- decrease in beard and body hair growth
- development of breast tissue
- difficulty concentrating
- decreased sex drive
Treatments for Male Hypogonadism
Doctors can determine whether or not you have male hypogonadism through physical exams and blood tests. If you have low testosterone levels, your doctors may perform additional tests to determine the cause.
Treatment typically includes testosterone replacement therapy (TRT) in the form of injections, patches, and gels. Most men with hypogonadism experience increased energy, sex drive, and well-being when taking TRT.
TRT for Healthy Men?
Many men experience changes as they age that are similar to the symptoms of hypogonadism, but may not be related to any disease or injury. Some of these symptoms are considered a normal part of aging, such as:
- changes in sleep patterns and sexual function
- increased body fat
- reduced muscle
- decreased motivation or self-confidence
Whereas scientific studies have shown that TRT helps men with hypogonadism, the results are not as clear when it comes to otherwise healthy men. A 1996 study published in The Journal of Clinical Endocrinology & Metabolism showed that men with hypogonadism who took TRT felt less angry, sad, and tired (Wang et al., 1996). They also experienced more energy, friendliness, and well-being.
However, a later study published in the Annals of Internal Medicine showed that testosterone combined with Viagra in otherwise healthy men worked no better than a placebo in improving erectile dysfunction (Spitzer et al., 2012). On the other hand, an earlier study from the University of Pennsylvania School of Medicine found that testosterone-treated healthy men experienced decreased fat mass and increased lean mass, particularly in the arms and legs (Snyder et al., 1999).
Risks of Testosterone Therapy
Overall, studies are mixed on whether or not TRT is beneficial for normal men as they age. Some research has brought up some serious risks with the therapy—particularly when taken long-term—that has led many doctors to be particularly cautious about recommending it:
- A 2010 large meta-analysis of 51 studies concluded that current evidence about the safety of TRT is of "low quality" and fails to tell us about any potential long-term effects (Fernández-Balsells et al., 2010).
- A 2005 study concluded that higher levels of testosterone are associated with an increased risk of prostate cancer. Researchers suggested that men receiving TRT should be regularly monitored for the disease (Parsons et al., 2005).
- A meta-analysis of 17 trials by Mayo Clinic Proceedings reported only small improvements with erectile dysfunction in men taking TRT and moderate improvements in libido. Researchers cautioned that there were "inconsistent results" across the trials (Boloña et al., 2007).
The Mayo Clinic notes that TRT also may:
- contribute to sleep apnea
- cause acne or other skin reactions
- limit sperm production
- cause testicle shrinkage
- enlarge the breasts
- increase the risk of heart disease (Mayo Clinic, 2012)
Currently, the National Institute of Aging is conducting trials on 800 men to give us a clearer picture of the benefits and risks of TRT, but the results won't be completed until 2014.
Other Methods for Increasing Testosterone
While there may be some risks to TRT, there are risks to low testosterone levels as well. These include a higher risk of stroke, heart attack, and hip fracture. Therefore, it's best to check with your doctor. If you have male hypogonadism or a truly low testosterone level, TRT may be the best option for you.
If you don’t have hypogonadism, but you’re interested in feeling more energetic and youthful, talk to your doctor about your risks. Think about the following alternative methods for increasing testosterone, and then make the decision you feel is best for you:
- Maintain a healthy weight. Overweight men are more likely to have low testosterone levels, but losing weight can bring testosterone back up.
- Exercise regularly. Sedentary men tend to have reduced levels of testosterone, as the body doesn’t need it as much. Weightlifting can stimulate testosterone production, but the key is regularly moving your body and using your muscles.
- Sleep 7-8 hours a night. Lack of sleep affects the hormones in your body.
- Try vitamin D supplements. A 2011 study indicated that supplementing with vitamin D (about 3,300 IU a day) increased testosterone levels (Pilz et al., 2011).
- Get more zinc. Zinc deficiency in men is associated with hypogonadism. A study from the Wayne State University School of Medicine found that six months of zinc supplementation in marginally zinc-deficient elderly men resulted in an increase in testosterone levels (Prasad et al., 1996).
- Eat more nuts and beans. They're rich in D-aspartic acid, which promotes the production of testosterone. Try adding more almonds, eggs, soybeans, lentils, and salmon to your diet (Topo et al., 2009).
- Grab the garlic. Animal studies show that garlic increases testicular testosterone (Oi et al., 2001).
Enjoy your morning coffee. The caffeine in coffee increases testosterone—by about 20 percent, according to one study (Beaven et al., 2008).