When men reach their 40s, their testosterone levels typically start to drop, about 1% per year. Many men have turned to testosterone supplements as a way to reverse or slow age-related changes, such as a drop in sexual performance, and muscle loss. But are supplements effective, or safe?
This subject is full of controversy in the medical world, but despite that, testosterone supplements have become a multi-billion dollar global market for men seeking a possible fountain-of-youth. Serious research results have reached conflicting results. Some have concluded that supplements improve sexual functioning,and muscle mass, but others report the opposite.
While not as much recently, experts have long warned of possible risks of prostate cancer or cardiovascular disease from from these supplements, but other researchers claim that the real risk to the heart is low testosterone. So the subject has been very messy in the medical literature, more so even than estrogen replacement in women.
In an attempt to resolve these questions, the National Institutes of Health (NIH; USA) has undertaken 7 studies to analyze whether or not supplementation is helpful, in the following areas: physical performance, sexual functioning, energy, thinking ability, bone density, atherosclerotic plaque formation in the heart, and anemia.
Each study is being carried out using the best possible methods, using the “gold standard” of research: ½ of the men receive the real testosterone medication (a gel to put on the upper arm), and the other ½ receive the same gel, but without the hormone. Neither the men nor the researchers know who is receiving the real drug until the study is completed at the end of one year. The first three studies—regarding sexual functioning, physical performance, and energy level—have just been published in the New England Journal of Medicine.
Results of testosterone supplementation
The results showed that men who received the testosterone did not have better energy levels than the men receiving the placebo, but men receiving the real medication did show mild improvements in physical functioning. They also showed mild improvements in their mood and were less likely to be depressed. The biggest benefit was that the testosterone group reported mild to moderate improvements in sexual functioning, including more sexual desire and better erections.
Note however that, at least as far as erections are concerned, that medications such as Viagra or Cialis work better, and the authors cautioned that testosterone gel cannot be considered a “panacea”. It was however good news that the studies did not show any significant side effects in the men receiving testosterone, such as a higher risk of prostate cancer or heart attacks (though longer-term studies are needed).
The authors caution that since the studies were carried out only in men age 65 and older, and who had documented low testosterone levels at the start of the study (below 275 nanograms per deciliter), that the results may not pertain to younger men, or men who don’t have low testosterone.
The results of the other four NIH studies are expected within a year, and we will report the results here. In the meantime, men wondering if testosterone supplementation would be good for them should discuss the pros and cons with their doctor, preferably an endocrinologist (which you can find here on ProcuraMed).
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