Reprints
A single copy of this article may be reprinted for personal, noncommercial use only.
Testosterone therapy: Key to male vitality?
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/testosterone-therapy/MC00030
Sexual health basics (5)
- Sex therapy
- Sex headaches
- Compulsive sexual behavior
- see all in Sexual health basics
STD prevention (3)
- STD testing: What's right for you?
- Sexually transmitted diseases (STDs)
- Condoms
Women's sexual health (21)
- Women's sexual health: Talking about your sexual needs
- Combination birth control pills
- Morning-after pill
- see all in Women's sexual health
Men's sexual health (16)
- Penis-enlargement products: Do they work?
- Delayed ejaculation
- Erectile dysfunction
- see all in Men's sexual health
Sex and aging (3)
- Testosterone therapy: Key to male vitality?
- Senior sex: Tips for older men
- Sexual health and aging: Keep the passion alive
Talking to kids about sex (5)
- Teens and sex: Protecting your teen's sexual health
- Sex education: Talking to your school-age child about sex
- Sex education: Talking to toddlers and preschoolers about sex
- see all in Talking to kids about sex
Free
E-newsletter
Subscribe to Housecall
Our weekly general interest
e-newsletter keeps you up to date
on a wide variety of health topics.
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
Testosterone therapy: Key to male vitality?
Considering testosterone therapy to help you feel younger and more vigorous as you age? Know the risks before you make your decision.
By Mayo Clinic staffThe possibilities of testosterone therapy are enticing — increase your muscle mass, sharpen your memory and concentration, boost your libido, and improve your energy level. As you get older, testosterone therapy may sound like the ultimate anti-aging formula. Yet the health benefits of testosterone therapy for age-related decline in testosterone aren't as clear as they may seem. Find out what's known — and not known — about testosterone therapy for normal aging.
What is testosterone?
Testosterone is a hormone produced primarily in the testicles. Testosterone helps maintain men's:
- Bone density
- Fat distribution
- Muscle strength and mass
- Red blood cell production
- Sex drive
- Sperm production
Hypogonadism is a disease in which the body is unable to produce normal amounts of testosterone due to a problem with the testicles or with the pituitary gland that controls the testicles. Testosterone replacement therapy can improve the signs and symptoms of low testosterone in these men. Doctors may prescribe testosterone as injections, pellets, patches or gels.
What happens to testosterone levels with age?
Testosterone peaks during adolescence and early adulthood. As you get older, your testosterone level gradually declines — typically about 1 percent a year after age 30. It is important to determine in older men if a low testosterone level is simply due to the decline of normal aging or if it is due to a disease (hypogonadism).
Does a naturally declining testosterone level cause the signs and symptoms of aging?
Not necessarily. Men can experience many signs and symptoms as they age, and some may occur as a result of lower testosterone levels and can include:
- Changes in sexual function. This may include reduced sexual desire, fewer spontaneous erections — such as during sleep — and infertility.
- Changes in sleep patterns. Sometimes low testosterone causes insomnia or other sleep disturbances.
- Physical changes. Various physical changes are possible, including increased body fat, reduced muscle bulk and strength, and decreased bone density. Swollen or tender breasts (gynecomastia) and hair loss are possible. You may experience hot flashes and have less energy than you used to.
- Emotional changes. Low testosterone may contribute to a decrease in motivation or self-confidence. You may feel sad or depressed, or have trouble concentrating or remembering things.
It's important to note that some of these signs and symptoms are a normal part of aging. Others can be caused by various underlying factors, including medication side effects, thyroid problems, depression and excessive alcohol use. A blood test is the only way to diagnose a low testosterone level.
Can testosterone therapy promote youth and vitality?
Testosterone therapy can help reverse the effects of hypogonadism, but it's unclear whether testosterone therapy would have any benefit for older men who are otherwise healthy.
Although some men believe that taking testosterone medications may help them feel younger and more vigorous as they age, few rigorous studies have examined testosterone therapy in men who have healthy testosterone levels — and some small studies have revealed mixed results. For example, in one study healthy men who took testosterone medications increased muscle mass but didn't gain strength.
What are the risks of testosterone therapy for normal aging?
Testosterone therapy has various risks. For example, testosterone therapy may:
- Contribute to sleep apnea — a potentially serious sleep disorder in which breathing repeatedly stops and starts
- Cause your body to make too many red blood cells (polycythemia), which can increase the risk of heart disease
- Cause acne or other skin reactions
- Stimulate noncancerous growth of the prostate (benign prostatic hyperplasia) and possibly stimulate growth of existing prostate cancer
- Enlarge breasts
- Limit sperm production or cause testicle shrinkage
Should you talk to your doctor about testosterone therapy?
If you wonder whether testosterone therapy might be right for you, talk with your doctor about the risks and benefits. A medical condition that leads to an unusual decline in testosterone may be a reason to take supplemental testosterone. However, treating normal aging with testosterone therapy is not currently advisable.
- Tostain JL, et al. Testosterone deficiency: A common, unrecognized syndrome. Nature Clinical Practice Urology. 2008;5:388.
- Amore M, et al. Partial androgen deficiency, depression and testosterone treatment in aging men. Aging Clinical and Experimental Research. 2009;21:1.
- Baum NH, et al. Testosterone replacement in elderly men. Geriatrics. 2007;62:15.
- Emmelot-Vonk MH, et al. Effect of testosterone supplementation on functional mobility, cognition, and other parameters in older men: A randomized controlled trial. JAMA. 2008;299:39.
- Bassil N, et al. Late-life onset hypogonaddism: A review. Clinics in Geriatric Medicine. 2010;26:197.
- Harman SM. Endocrine changes with aging. http://www.uptodate.com/home/index.html. Accessed Jan. 19, 2012.
- Snyder PJ. Decline in testicular function with aging. http://www.uptodate.com/home/index.html. Accessed Jan. 19, 2012.
- Traish AM, et al. Testosterone deficiency. The American Journal of Medicine. 2011;124:578.
Find Mayo Clinic on