4/4/2014 Testosterone therapy: Key to male vitality? - Mayo Clinic

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Healthy Lifestyle

Sexual health

The possibilities of testosterone therapy are enticing — increase your muscle mass, sharpenyour memory and concentration, boost your libido, and improve your energy level. As you getolder, testosterone therapy may sound like the ultimate anti-aging formula. Yet the healthbenefits of testosterone therapy for age-related decline in testosterone aren't as clear as theymay seem. Find out what's known — and not known — about testosterone therapy for normalaging.

Testosterone is a hormone produced primarily in the testicles. Testosterone helps maintainmen's:

Bone densityFat distributionMuscle strength and massRed blood cell productionSex driveSperm production

Hypogonadism is a disease in which the body is unable to produce normal amounts oftestosterone due to a problem with the testicles or with the pituitary gland that controls thetesticles. Testosterone replacement therapy can improve the signs and symptoms of lowtestosterone in these men. Doctors may prescribe testosterone as injections, pellets, patchesor gels.

Testosterone peaks during adolescence and early adulthood. As you get older, your

Considering testosterone therapy to help you feel younger and more vigorous as youage? Know the risks before you make your decision.

By Mayo Clinic Staff

4/4/2014 Testosterone therapy: Key to male vitality? - Mayo Clinic

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testosterone level gradually declines — typically about 1 percent a year after age 30. It isimportant to determine in older men if a low testosterone level is simply due to the decline ofnormal aging or if it is due to a disease (hypogonadism).

Not necessarily. Men can experience many signs and symptoms as they age. Some mayoccur as a result of lower testosterone levels and can include:

Changes in sexual function. This may include reduced sexual desire, fewerspontaneous erections — such as during sleep — and infertility.Changes in sleep patterns. Sometimes low testosterone causes insomnia or othersleep disturbances.Physical changes. Various physical changes are possible, including increased body fat,reduced muscle bulk and strength, and decreased bone density. Swollen or tenderbreasts (gynecomastia) and body hair loss are possible. You may experience hot flashesand 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 orremembering 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 todiagnose a low testosterone level.

Testosterone therapy can help reverse the effects of hypogonadism, but it's unclear whethertestosterone therapy would have any benefit for older men who are otherwise healthy.

Although some men believe that taking testosterone medications may help them feelyounger and more vigorous as they age, few rigorous studies have examined testosteronetherapy in men who have healthy testosterone levels — and some small studies haverevealed mixed results. For example, in one study healthy men who took testosteronemedications increased muscle mass but didn't gain strength.

Testosterone therapy has various risks. For example, testosterone therapy may:

Contribute to sleep apnea — a potentially serious sleep disorder in which breathingrepeatedly stops and startsIncrease your risk of a heart attackCause acne or other skin reactionsStimulate noncancerous growth of the prostate (benign prostatic hyperplasia) and growthof existing prostate cancerEnlarge breasts

4/4/2014 Testosterone therapy: Key to male vitality? - Mayo Clinic

http://www.mayoclinic.org/healthy-living/sexual-health/in-depth/testosterone-therapy/art-20045728?p=1 3/4

Limit sperm production or cause testicle shrinkage

If you wonder whether testosterone therapy might be right for you, talk with your doctor aboutthe risks and benefits. A medical condition that leads to an unusual decline in testosteronemay be a reason to take supplemental testosterone. However, treating normal aging withtestosterone therapy is not currently advisable.

Apr. 01, 2014

Original article: http://www.mayoclinic.org/healthy-living/sexual-health/in-depth/testosterone-therapy/art-20045728

References1. Tostain JL, et al. Testosterone deficiency: A common, unrecognized syndrome. Nature Clinical Practice

Urology. 2008;5:388.

2. Amore M, et al. Partial androgen deficiency, depression and testosterone treatment in aging men. AgingClinical and Experimental Research. 2009;21:1.

3. Baum NH, et al. Testosterone replacement in elderly men. Geriatrics. 2007;62:15.

4. Emmelot-Vonk MH, et al. Effect of testosterone supplementation on functional mobility, cognition, and otherparameters in older men: A randomized controlled trial. JAMA. 2008;299:39.

5. Bassil N, et al. Late-life onset hypogonaddism: A review. Clinics in Geriatric Medicine. 2010;26:197.

6. Harman SM. Endocrine changes with aging. http://www.uptodate.com/home/index.html. Accessed Jan. 19,2012.

7. Snyder PJ. Decline in testicular function with aging. http://www.uptodate.com/home/index.html. Accessed Jan.19, 2012.

8. Traish AM, et al. Testosterone deficiency. The American Journal of Medicine. 2011;124:578.

9. Finkle WD, et al. Increased risk of non-fatal myocardial infarction following testosterone therapy prescription inmen. PLOS One. 2014;9:1.

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