Testosterone therapy: Can it help older men feel young again?

The possibilities of testosterone therapy are enticing — increase your muscle mass, sharpen your memory and mental focus, boost your libido, and improve your energy level. As you get older, testosterone therapy may sound like the ultimate anti-aging formula. But health benefits from testosterone therapy aren't quite so clear-cut.
Before you buy into the tempting claims, find out what's known — and not known — about testosterone therapy so that you can make the best decision for your long-term health.

What is testosterone?

Men's bodies produce the hormone testosterone in their testes. In men, testosterone helps maintain:

• Bone density
• Fat distribution
• Muscle mass
• Muscle strength
• Red blood cell production
• Sex drive
• Sperm production

Your doctor can prescribe a synthetic version of testosterone. Testosterone therapy using testosterone replacement medications may be necessary for men who have very low levels of testosterone (hypogonadism). Testosterone therapy medications are available as injections, patches and gels.

Does a naturally declining testosterone level cause the signs and symptoms of aging?

It's not clear that naturally falling testosterone levels cause any signs and symptoms in men. Studies of men who have very low levels of testosterone due to diseases and treatments may offer some clues to the role testosterone plays in a man's body as he ages. According to those studies, testosterone deficiency can have several effects on the body, including:

• Decreased sexual function
• Loss of bone density
• Loss of muscle mass
• Increase in fat mass
• Reduced muscle strength
• Memory loss
• Mood changes and depression

Some men experience these signs and symptoms, but don't have unusually low levels of testosterone. Others may have low levels of testosterone, but don't experience any signs and symptoms that would prompt them to seek treatment.

What could testosterone therapy do for men with normal testosterone levels?

Some men believe that taking testosterone medications may help them feel younger and more vigorous as they age. But while studies show that testosterone therapy can restore your testosterone level to that of your youth, it isn't clear that there's any benefit to this. And it isn't clear if a higher testosterone level can help you live longer.
Few rigorous studies have examined testosterone therapy in men with healthy testosterone levels. Some small studies have revealed unclear results. For instance, studies found that healthy men who take testosterone medications saw their muscle mass increase, but in most studies the men weren't any stronger after testosterone therapy.

What are the risks of testosterone therapy?

Not enough study has been done to determine the risks of testosterone therapy in men with normal testosterone levels. In theory, a higher than normal testosterone level could increase a man's risk of prostate cancer or an enlarged prostate (benign prostatic hyperplasia). But studies haven't determined whether testosterone therapy could cause these complications.
Studies show testosterone therapy can cause sleep apnea in some men. This condition causes you to continually start and stop breathing as you sleep. Testosterone therapy may also cause your body to make too many red blood cells (polycythemia), which can increase your risk of heart disease. And it is important to remember that it is not necessary to postpone the visit to the doctor, because only a good specialist can recommend the correct treatment and a healthy drug.