Many men with low testosterone report improved energy levels, sex drive, and mood after testosterone treatment. If testosterone is low, why not replace it?
Not so fast. A low testosterone level by itself doesn’t need treatment. Testosterone replacement therapy can have side effects, and the long-term risks and benefits aren’t known. Only men with symptoms of low testosterone and blood levels that confirm this as the cause of symptoms should consider testosterone replacement. Talking with your doctor is the only way to know if testosterone therapy is right for you.
The symptoms of low testosterone are sometimes obvious, but they also can be subtle. Testosterone levels decline naturally in men as they age over decades. But certain conditions can also lead to an abnormally low level. Symptoms of low testosterone include:
- Low sex drive (libido)
- Erectile dysfunction
- Fatigue and poor energy level
- Decreased muscle mass
- Body and facial hair loss
- Difficulty concentrating
- Depression
- Irritability
- Low sense of well-being
If men have symptoms of low testosterone and tests show they have an abnormally low testosterone level, a doctor may suggest treatment. For millions of men who have low testosterone levels but no symptoms, no treatment is currently recommended. It has also not been approved for treating men with low levels because of aging.
Forms of Testosterone Supplements
Testosterone replacement therapy is available in several forms. All can improve testosterone levels:
- Skin patch (transdermal): Androderm is a skin patch worn on the arm or upper body. It’s applied once a day.
- Gels: AndroGel and Testim come in packets of clear testosterone gel. Testosterone is absorbed directly through the skin when you apply the gel once a day. AndroGel, Axiron, and Fortesta also come in a pump that delivers the amount of testosterone prescribed by your doctor. Natesto is a gel applied inside the nose.
- Mouth patch:Striant is a tablet that sticks to the upper gums above the incisor, the tooth just to the right or left of the two front teeth. Applied twice a day, it continuously releases testosterone into the blood through the oral tissues.
- Injections and implants: Testosterone can also be injected directly into the muscles, or implanted as pellets in the soft tissues. Your body slowly absorbs the testosterone into the bloodstream.
Why not a simple testosterone pill? Oral testosterone is available. However, some experts believe oral testosterone can have negative effects on the liver. Using other methods, such as skin patches, gels, orally disintegrating tablets, or injections, bypasses the liver and gets testosterone into the blood directly.
Benefits of Testosterone Therapy
What can you expect from testosterone treatment? It’s impossible to predict, because every man is different. Many men report improvement in energy level, sex drive, and quality of erections. Testosterone also increases bone density, muscle mass, and insulin sensitivity in some men.
Men also often report an improvement in mood from testosterone replacement. Whether these effects are barely noticeable, or a major boost, is highly individualized. Learn more about the best testosterone boosters in 2020 and beyond.
Risks of Testosterone Therapy
Testosterone replacement therapy side effects most often include rash, itching, or irritation at the site where the testosterone is applied.
However, there is also evidence of a possible increased risk of heart attack or stroke associated with testosterone use. Experts emphasize that the benefits and risks of long-term testosterone therapy are unknown, because large clinical trials haven’t yet been done.
Testosterone Replacement vs. Performance-Enhancing Steroids
Isn’t taking testosterone replacement basically the same as taking steroids, like athletes that “dope”? It’s true that anabolic steroids used by some bodybuilders and athletes contain testosterone or chemicals that act like testosterone.
The difference is that doses used in testosterone replacement only achieve physiologic (natural) levels of hormone in the blood. The testosterone forms some athletes use illegally are in much higher doses, and often combined (“stacked”) with other substances that boost the overall muscle-building (anabolic) effect.