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2017 Update: Testosterone Replacement Therapy

Testosterone replacement therapy may not deliver the benefits it advertises and potentially carries risks for cardiovascular health, according to new research published in February 2017.

Testosterone replacement therapy emerged as a way to boost testosterone in men with decreasing levels of the hormone (a state informally known as “Low-T”). This can be caused by aging, or it can occur in younger men due to a variety of medical conditions.

Testosterone replacement therapy has been marketed to men as a possible way to offset negative effects of aging, preserve muscle mass and stamina, and even strengthen mental acuity. These products, which are sold in multiple forms, such as injections, gels, and pills, have been aggressively marketed to older men, promising a renewed vitality, but with scarce mention of any potential health risks.

There has been considerable debate as to whether or not these medications provide benefits as advertised, or indeed whether or not “Low-T” should be considered a illness. Multiple studies over the past few years have set out to determine the merits of the products’ claims and to weigh any potential hazards. After early warnings that testosterone therapy caused cardiovascular health problems in older men, the FDA issued began investigations into the treatments.

Five concurrent studies published in February 2017 in the Journal of American Medicine and JAMA Internal Medicine show that testosterone treatment provides benefits for men over the age of 65 in the form of improved bone density and mitigated the effects of anemia. But they also showed that those who had taken the treatment had increased levels of plaque buildup in their coronary arteries. However, separate studies have shown testosterone replacement therapy is correlated with fewer cardiac events, such as heart attacks.

As to the products’ assertion that they can strengthen mental faculties, the researchers found no change in memory or cognitive function in any respect.

Previous studies have presented a dubious picture of the treatments’ ostensible benefits for men whose testosterone levels are a natural consequence of age. In a study published in July 2015 in the Journal of Clinical Endocrinology & Metabolism, men whose low testosterone was due to aging and not medical conditions did not experience sexual function improvements as a result of using the drugs.

In an FDA safety announcement in March 2015 the agency cautioned that testosterone therapy carried a possible increased risk of heart attack and stroke. The agency advised that the products be used only in cases where men have low testosterone levels due to a medical condition – and not from aging. In the announcement, the FDA said that “the benefit and safety of these medications have not been established for the treatment of low testosterone levels due to aging, even if a man’s symptoms seem related to low testosterone.”

If you have used a testosterone product and experienced negative side effects – or did not experience the health benefits that were advertised – you should speak to your doctor.