When you think of hormone replacement therapy, you might think it’s only for women; however, hormone replacement therapy may also be recommended for men in certain instances. Similar to women, male hormones gradually decrease with age.
According to Harvard Medical School, male hormones start to decrease as early as the 30s. Depending on how low levels of testosterone drop and whether symptoms are present, male hormone replacement therapy may be recommended. However, you may want to discuss the pros and cons of male hormone replacement therapy with your doctor before undergoing this treatment plan.
What Is It?
Testosterone is the main male hormone responsible for both development of the testes and the secondary male sexual characteristics. When levels become low, whether it’s due to aging, injury or a medical condition, symptoms may develop. Hormone replacement therapy for men is the administration of testosterone to restore levels to within normal ranges.
If a testosterone deficiency is suspected, a blood test to measure total testosterone levels will be performed. According to the University of Rochester Medical Center, a normal testosterone level in men ranges between 300 and 1,000 nanograms per deciliter (ng/dl). Levels below 250 ng/dl are considered low and hormone therapy may be recommended, especially if symptoms are present.
A deficiency in testosterone is the main indication for hormone replacement therapy in men. Although a gradual decrease occurs with aging, other conditions can cause a younger male to have a low testosterone level. According to The Cleveland Clinic, side effects from chemotherapy, renal failure, injury to the testicles and stress can all lead to a testosterone deficiency. Klinefelter’s Syndrome, which is a genetic disorder, also causes low testosterone levels.
Symptoms of low testosterone in men include a decrease in muscle mass and body hair. Increased body fat may develop along with mild anemia. Some men may also develop osteoporosis. A decrease in sex drive and erectile dysfunction may also occur with a testosterone deficiency. In addition to physical symptoms, concentration and memory can be affected, and depression can develop.
For men who have symptoms due to low testosterone, there are several benefits with taking male hormone replacement therapy. Although hormone therapy is not a treatment for all causes of erectile dysfunction, it may restore sexual function in some men. Increasing levels of testosterone to normal will also usually increase sex drive.
Therapy can also improve memory and mood in some men. Male hormone replacement therapy may also prevent bone loss, and some evidence suggests it may lower cholesterol levels. Some men also have an increase in their energy levels. Although testosterone therapy won’t usually improve strength, it can help a man become leaner.
Cons: Side Effects
Although hormone replacement therapy may be recommended in men with a deficiency, there can be side effects. Sleep problems, acne and fluid retention can develop. Some men may also have low sperm counts, which can lead to infertility. An increase in red blood cell counts may also occur.
Hormone replacement therapy in men can also stimulate prostate tissue growth. An enlarged prostate may lead to symptoms, such as trouble urinating or frequent urination. In men who already have an enlarged prostate, testosterone replacement therapy may not be recommended.
Testosterone therapy should never be taken by men diagnosed with prostate cancer. Although testosterone therapy does not appear to cause prostate cancer, it may make it worse by increasing tumor growth.
How Is It Taken?
Men who are prescribed hormone replacement therapy have three main options for administration. Each method has advantages and disadvantages, which need to be discussed with a doctor. The options include:
- Injection: Hormone replacement therapy taken by injection causes a higher fluctuation in testosterone levels than with other methods of administration. For instance, testosterone levels are highest in the body immediately after the injection and low levels are present when the next injection is due.
- Patch: A patch containing testosterone is worn daily on the arms, back or abdomen. A patch is also available, which can be worn on the scrotum. An advantage to using the patch is, if it is worn daily as prescribed, levels of testosterone are kept steady. One disadvantage is the patch can cause skin irritation.
- Gel: A testosterone gel is also available, which needs to be applied daily. Similar to the patch, testosterone is absorbed through the skin after the gel is applied. Although the gel can cause skin irritation, it appears to occur less often than with the patch. One disadvantage is patients have to remember to apply the gel every day in order to keep testosterone levels steady.
Men who have symptoms of a testosterone deficiency should speak with their doctor about the pros and cons of male hormone replacement therapy. Although not all men with low levels of testosterone will have symptoms, for some it interferes with their health and quality of life. It is crucial that men understand the possible side effects and weigh the risks with the benefits before starting male hormone replacement therapy.