Testosterone Therapy and Overall Health

by Jay Motola, M.D. Health Professional

Listen Up Men, The Benefits of Testosterone Therapy May Be More Than You Think

Testosterone is a hormone that is made by the testicles and the adrenal gland. It is an androgen, and this group of hormones is associated with growth of muscle mass, increase strength, increased bone density, maturation of the male sex organ, deepening of the voice, growth of facial and axillary hair. Testosterone also is crucial for sperm production. This hormone also controls male libido.

The Attention Around Testosterone Therapy

Recently there has been a huge amount of attention placed on testosterone replacement therapy. A day does not go by without seeing an advertisement from a law firm looking for patients who have received testosterone replacement therapy and have suffered heart attacks or strokes. In 2015 the FDA required a change in labeling of testosterone replacement products clarifying the approved uses of these medications as well as including information about a possible increased risk of heart attacks and strokes. Anybody considering testosterone replacement therapy must discuss these risks with their physicians prior to beginning any replacement therapy.

The Dangers of Low Testosterone

Low testosterone levels are associated with a loss in sex drive, erectile dysfunction, fatigue, and depression. Decreases in bone density may also be seen in those with low testosterone and may lead to higher rates of fracture. Low levels however may not always be associated with these symptoms.

Interestingly, in 2007, a study from the United Kingdom identified an inverse relationship between naturally occurring testosterone levels and cardiovascular disease and cancer. Those with lower testosterone levels had increased risks of death related to cardiovascular disease and cancer. Studies like these have led many to begin the use of testosterone replacement therapy for those demonstrating testosterone deficiency.

How Does Testosterone Therapy Help?

Although there are conflicting results regarding this association, studies such as this do provide evidence that testosterone is associated with overall male health. Satisfactory testosterone levels are associated with decreased lean body mass, decreased visceral fat mass, decreased total cholesterol and better control of blood sugars.

Why You Should Work Closely With A Doctor When Considering Testosterone Therapy

Testosterone is closely related to male hair loss. Dihydrotestosterone (DHT) is a byproduct of testosterone and causes hair follicles to regress and die over time. This causes male premature balding. Excessive levels of testosterone can result in increased levels of DHT, and this can accelerate the balding process. DHT is also the substance that results in the enlargement of the prostate. However studies demonstrate that although lower levels of testosterone may be seen in patients with male pattern balding, they tend to have the same amount of DHT, leading us to believe that genetics play the bigger role. Testosterone replacement therapy will not cause you to lose your hair.

Testosterone replacement therapy can certainly be beneficial, however it must be carefully used. Side effects such as enlargement of the breasts may be seen. Increases in red blood cell production may be seen and this needs to be closely monitored. This undesirable side effect is most likely the cause of some of the cardiovascular side effects that we are encountering. I have seen many patients who have received the benefit that they were seeking with regards to an increase in sexual desire once they were placed on replacement therapy, only to have to stop using the medication as a result of a significant rise in their blood counts.

Testosterone Therapy And Its Role In Male Health

Testosterone replacement therapy in patients who demonstrate deficiency can definitely help with more than just improving one’s sexual drive. Mood, weight and overall concentration can also benefit. Those who are trying to conceive need to be under the care of a Urologist as replacement can turn off the body’s natural ability to produce testosterone and can affect sperm production.

Jay Motola, M.D.
Meet Our Writer
Jay Motola, M.D.

Jay Motola, MD, is a board-certified urologist and attending physician, Department of Urology, Mount Sinai West, and Assistant Professor of Urology, Icahn School of Medicine at Mount Sinai. Dr. Motola is a summa cum laude, Phi Beta Kappa graduate of Boston University, and earned his medical degree at the State University of New York at Stony Brook.