It is normal for testosterone to decline as a man ages, about 1% per year once a man has reached middle age. Most men never notice the drop. But some middle-aged and older men feel symptoms when their level has reached a certain point. Symptoms include a decline in sex drive, a lack of energy, moodiness, erectile dysfunction, an inability to lose weight, and in extreme cases loss of muscle and bone mass. Some clinicians call this age-related hypogonadism. Others deny that the condition even exists. Practitioners in the first camp had been prescribing testosterone replacement therapy (TRT).Lots of their patients said it has rejuvenated them, restoring their energy, giving them a more positive attitude, and returning their sex drive to them.
Two previous studies have shown an increase in cardiovascular events associated with TRT. The fear was that an increase in testosterone would ramp up red blood cell production, leading to atherosclerosis or blood clots, the fear being one may get lodged in an artery. It could cause a heart attack or stroke if this occurs in a blood vessel leading to the heart or the brain. But now ever more comprehensive studies are showing just the opposite that TRT is safe and in many cases beneficial.
Researchers at Brigham and Women’s Hospital in Boston just finished up a three year study on TRT, led by Shalender Bhasin, MD. Bhasin’s team found no increased risk of blood clots among older men with low to borderline low testosterone. A large, observational study soon to be published in the European Heart Journal actually showed a decreased risk of heart attack and stroke in conjunction with TRT. In March of this year, the FDA placed warning labels on TRT products about the risks. Now the agency is urging pharmaceutical companies to chip in on a comprehensive study to determine what if any risks exist. For those men experiencing the symptoms associated with low testosterone, it is advised that you speak to a doctor or an urologist, perhaps even an endocrinologist. There may be several conditions which have these exact same symptoms. So it is important to have a licensed doctor determine the cause.