Battling Testosterone Decline: Should you consider synthetic testosterone replacement drugs?

by Russ Klettke

After a decade of erectile dysfunction pharmaceuticals – which collectively had worldwide sales of more than $2.7 billion last year – the next frontier is testosterone replacement therapy. Why? A guy’s gotta be a guy, and when “T” levels go into decline, it can be a pretty disconcerting situation.

The fact of the matter is that testosterone in the general male population naturally declines after age 25. But what makes it worse is modern lifestyles. Alcohol, fatty food and inactivity make that decline worse. It can be described as a circular, negative loop cycle: as T levels decline, energy, mood and libido suffer. With less energy, you might work out less. No exercise means no endorphin hormones to lift your mood, so you might eat and drink more to get some kind of kicks. With weight gain, you lose your mojo and with lower testosterone your libido only goes further south. Viagra might help a bit, but if you aren’t really all that fired up an erection is like a snow shovel in Miami: you got it, you just have little interest in using it.

So will testosterone replacement therapy reverse this death spiral and get you back in the game? Yes…but. Doctors are able to prescribe it to just about anyone who reports low testosterone symptoms (appropriately confirmed with a proper blood serum test). But as with most medications, particularly those that trick the endocrine system (your hormones), there can be side effects:

• Acne
• Hair loss
• Sleep apnea
• Hemoglobin increase (polycythemia, good at a moderate level but bad when too high)
• Fluid retention
• Breast enlargement and tenderness
• Liver toxicity (bad if you have had hepatitis or take other medications that have an adverse effects on the liver)
• Enlarged prostate

Most ominously, there are no studies on the effects of testosterone therapy over time. According to Michael Werner, MD a Purchase, NY board-certified urologist who studies male sexual dysfunction, “it may promote the growth of cancerous prostate cells…the second most common cause of cancer deaths in older men.” Further, he warms that “long-term data is as yet not available” with regard to negative side effects of T therapy.

There are other ways to improve testosterone levels other than a pharmaceutical product. Yup, you guessed it: smart diet, exercise and other lifestyle choices (moderate alcohol, no tobacco and smart sleep habits). We’ll cover those in the next series of blogs.