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Testosterone therapy: What every man over 39 should know



For years, male gym rats have been advocating the importance of testosterone in achieving optimal muscle growth. And over the last two decades, there has been a significant increase in prescriptions for testosterone therapy (also known as TRT). This rise can be attributed to direct-to-consumer campaigns promoting its benefits not only for physical appearance but also for overall health, sex drive, and mood.

The marketing efforts have successfully broadened the appeal of testosterone therapy beyond just building muscle mass and focused on its potential to improve various aspects of life. As a result, we’re seeing an increasing number of men looking to have their testosterone levels tested. But while the hormone testosterone decreases with age, the drop might not be significant for all men, so not everyone will need it. 

Also, taking testosterone comes with risks – especially to heart health – if you’re the wrong candidate. 

Before considering testosterone therapy (TRT), there are several important factors and considerations that every man should be aware of:

Not Everyone Needs It: While testosterone levels naturally decline with age, not all men will require TRT. It’s crucial to undergo medical testing and evaluation to determine if your testosterone levels are genuinely low before starting any treatment.

Balanced Hormone Levels: TRT is not about becoming an over-sexed bodybuilder. When used under a doctor’s supervision and if medically necessary, it aims to restore testosterone levels to normal. This can help improve muscle development, mood, sex drive, and other bodily functions.

Mood and Cognitive Effects: Testosterone also plays a role in mood, memory, and focus. Restoring hormonal balance can have positive effects on your mental well-being and cognitive abilities.

Symptoms of Low Testosterone: Symptoms of low testosterone can vary but often include a decrease in mental sharpness, mood changes (irritability, grumpiness), decreased motivation, concentration issues, reduced muscle gain, increased body fat, persistent tiredness, and erectile dysfunction.

Male Menopause  (Andropause): Unlike menopause in women, not all men experience significant symptoms of low testosterone. Symptoms can be subtle, and the decline in testosterone can vary from person to person.

Symptoms to Watch For: If you suspect low testosterone, pay attention to changes in your mood, body composition, energy levels, and sexual function.

The absence of ‘morning wood’ can be a red flag for low testosterone.

Prevalence: Studies show that around 12% to 25% of men may have low testosterone. However, not everyone with low testosterone requires treatment, so it’s crucial to consult a doctor if you experience symptoms.

Testing: You can get tested for testosterone levels at your GP or a private clinic. Ensure that your doctor understands the nuances of total testosterone vs. free testosterone, as free testosterone is the active form that regulates mood, libido, and muscle mass

Factors Affecting Testosterone Production: Age is the primary factor, but other factors such as obesity, Type 2 diabetes, alcohol consumption, smoking, certain medications, and medical conditions can influence testosterone production.

Bone Health: Testosterone conversion to estrogen is necessary for maintaining bone density. Low testosterone can lead to brittle bone disease.

Weight Changes: Initial weight gain might occur when starting TRT due to water retention. Over time, most men reduce body fat and increase muscle mass, which can lead to higher body weight but better physical shape.

Sleep and Testosterone: Quality sleep is essential for natural testosterone production. Sleep deprivation can disrupt this process, so maintaining a regular sleep pattern is crucial.

Fertility: TRT can decrease fertility, but fertility-preserving treatments can be used in conjunction with TRT.

Prostate Cancer: TRT itself doesn’t cause prostate cancer, but it’s important to get tested for prostate cancer before starting treatment, as it could stimulate the growth of existing cancer cells sensitive to testosterone.

Risks: Excessive testosterone can lead to thickening of the blood, increasing the risk of clotting, strokes, and heart attacks. Regular monitoring by a doctor is essential when on TRT.

Methods of Administration: TRT can be administered through topical gels/creams or injectables. The choice of method depends on individual preferences and needs.

Dosage Adjustment: Finding the right dosage is essential to avoid mood swings. Too little or too much testosterone can lead to irritability.

Lifestyle: For some, lifestyle changes like weight training, losing weight, and improving sleep can naturally increase testosterone levels.

Avoid Buying Online: It’s strongly advised against buying testosterone from sources without proper medical checks and supervision.

In summary, if you suspect you have low testosterone or are considering TRT, consult a knowledgeable healthcare professional who can properly evaluate your condition and guide you through the treatment process to ensure your safety and well-being.

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