Testosterone: A Love Affair in its Honeymoon Phase

Posted on by Paul Turek, MD

You’re feeling it. Falling asleep more often after dinner. Not as strong or quick on the court anymore. A tad grumpier than you used to be. Maybe the sex drive is a bit flatter than you remember it being or the memory bank is fading a bit. Is this normal with age?

Suck it Up or…Don’t

Maybe it is, and therefore you should suck it up and realize that you’re not the man you used to be. But maybe it isn’t. Maybe it’s due to having an abnormally low level of the male hormone testosterone, which can be remedied. T levels peak in men in the 30s and then start to fall, by about 1% a year, in their 40s. As men approach their 50s and 60s, they may begin to have symptoms. One real problem is that these symptoms of feeling worn out and weathered can also be due to a host of other medical conditions like diabetes, cancer, sleep apnea, thyroid issues, medications, malnutrition, obesity, and adrenal and mood disorders, to name a few. So, do yourself a favor and see a good doctor before you jump on the vitamin T bandwagon. It may not be the Holy Grail you think for staying young forever.

Honeymooning It

Another real problem is that the jury is still out on whether testosterone can reliably help these age-related symptoms. Many studies have tried to address this but they have not been big enough, long enough or good enough to nail down the answer. Not only that, the safety of T replacement has recently come into question in a series of papers that have looked at heart attacks and strokes in older men taking testosterone. The point here is that when it comes to drug studies, benefits are usually observed early on, but risks and complications take longer to elucidate. In essence, what we now understand about T replacement in older men is still in its “honeymoon” phase.

More, Better, Now

A jewel of a study was published recently that sheds more light on how testosterone can help older men. This multicenter randomized study screened 51,000 men aged 65 or over to find 790 with just the right look: relatively healthy and saddled with testosterone levels below 275 ng/dL. Nobody in their right mind would argue that this is a low T level. They provided testosterone gel (or placebo) to raise T levels to that found in younger men. After a year, the findings were analyzed and the following observed:

  • Men on testosterone reported more sexual activity
  • Men on testosterone reported higher sex drive
  • Men on testosterone reported better erections (but not as good as with erection pills)
  • Men on testosterone reported less depression and a better mood
  • Men on testosterone walked farther than those on placebo
  • There was no difference in “vitality” scores between men on and off testosterone

So, in fact there may be real sexual health benefits in retirees taking testosterone. Hey that’s good news, because, in the words of cigar-chomping-comedian George Burns: “You can’t help getting older, but you don’t have to get old.”