TRT Benefits vs Risks

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Did you know that nearly 8% of men who are between 41 and 50 years old are developing testosterone deficiency?
According to multiple studies, low testosterone can lead to numerous health problems and a significant decrease in life quality.
Testosterone deficiency is also known as hypogonadism. Although it can affect numerous men of an elderly age, it can be addressed using testosterone replacement therapy (TRT).
TRT involves administering testosterone into the body in various ways such as by injections, creams, gels, pellets, etc. This treatment can significantly improve the health of aging men.

What is Testosterone?

Testosterone is one of the most important male sex hormones.
It’s responsible for giving men drive and energy as well as sexual desire and confidence. Athletes usually have high levels of testosterone and enjoy a better quality of life.
On the other hand, low levels of testosterone can lead to numerous health problems including anxiety and depression.
The normal range of testosterone in men is between 300ng/dL and 1,000ng/dL. This range can vary depending on various factors such as age, body mass index, fitness level, sleep quality, stress, and other factors.

Signs of Testosterone Deficiency

Low testosterone can have a dramatic impact on men's and women's health and quality of life. For example, here are the most popular signs of having low T levels:

  1. Low sex drive - men with low T are not in the mood for sex, and they might have difficulties maintaining an erection

  2. Hair loss problems - men with testosterone deficiency, tend to lose their hairs quickly, even to the point of complete baldness

  3. Excessive fatigue - feeling tired after a long day at work is normal. However, being constantly tired and having difficulties perform basic tasks might be a sign of low testosterone levels

  4. Loss of muscle mass - testosterone plays a vital role in the development of muscle mass. When the T levels are low, muscles will shrink fast since they need a constant supply of testosterone to maintain their size

  5. Increased fat percentage - another common side effect of low T levels consists of gaining weight and having a high body fat percentage

  6. Decreased bone density - testosterone plays an important role when it comes to the strength of your bones. Fractures and bone problems are common in men who have low testosterone levels

  7. Mood swings - testosterone is known to influence mental capacity and emotions. A lack of this hormone can cause negative emotional changes and mood swings


How TRT Works?

Testosterone replacement therapy is the go-to treatment for men who want to increase the levels of their testosterone.
This treatment is usually prescribed for men who are 40 years old or older. This time is the point in life when drops in testosterone levels cause the symptoms.
It’s important to speak with your doctor about TRT to find out its benefits and risks. TRT is not a magic bullet, but it can help a lot of men and improve their quality of life.
TRT involves introducing more testosterone into the body in various ways. For example:

  • Testosterone injections - usually administered directly into the deltoid (shoulder muscle) or quadriceps muscle

  • Testosterone gels - these can be applied directly on the skin

  • Testosterone pellets - a pellet can be inserted under the skin by a medical professional. It will release testosterone into the bloodstream slowly

  • Testosterone tablets - these are usually applied on the upper gum, and they are increasingly popular among men

Choosing one administration method over the other can have a big impact on your progress with TRT. For example, some people don’t like injections, and they might prefer going with testosterone gels or pellets instead.
At the same time, testosterone is absorbed differently by the body, depending on the administration method. Make sure that you discuss your options with your TRT doctor for more details.

Benefits of TRT

Testosterone replacement therapy has been proven to be successful in treating testosterone deficiency in men for over 50 years.
This therapy is highly beneficial when done correctly and monitored properly. The list of benefits is long, and they’ll be enumerated in greater detail below.

TRT Can Reduce Vascular and All-Cause Mortality in Men

It is known that testosterone deficiency can be associated with an increased risk of mortality. A testosterone level of less than 300 ng/dL is low. Many doctors treat men with low testosterone if they show low T symptoms and present with total testosterone blood levels under 450 ng/dL.
Studies show that men who have low serum testosterone levels have a higher incidence of all-cause mortality in comparison with men who have high serum testosterone levels. In certain cases, low testosterone can even predict a higher chance of developing cardiovascular disease at some point in the future.
On top of that, a Veteran Administration study discovered that men who were treated for testosterone deficiency using TRT had a 39% smaller risk of mortality, in comparison with people who didn’t undergo TRT.
This study was based on a group of more than 1000 veterans who were older than 40 years and had low testosterone levels. After administering TRT to nearly 400 of these men, the mortality was nearly 10%. On the other hand, the veterans who didn’t receive TRT had a mortality rate of more than 20%.
A study performed on more than 83,000 veterans revealed a similar situation. These men had documented low testosterone levels, and some of them were treated using TRT. At the end of the study, researchers have discovered that those who received TRT had a lower risk of developing myocardial infarction or stroke in comparison with those who didn't receive the treatment.
Another study suggests that low testosterone, free and bioavailable testosterone are associated with a higher risk of developing cardiovascular disease.
TRT seems to benefit people who have type 2 diabetes mellitus as well. A study performed on 857 men with type 2 diabetes revealed shocking results. A group of these men was treated with TRT for several years.
The researchers have found out that the risk of mortality decreased significantly for the people who received TRT in comparison with the group who didn’t receive TRT. This means that TRT can independently reduce the risk of mortality in men with type 2 diabetes mellitus.
These are just a few of the most important studies performed on men with testosterone deficiency. When performed correctly, TRT can significantly reduce all-cause mortality in men, and that’s why it has become so popular in the last years.

TRT Can Increase Insulin Sensitivity and Reduce the Risk of Diabetes Type 2

A study conducted by Per Bjornstrom revealed that TRT could increase insulin sensitivity in men who have testosterone deficiency. This therapy can also improve blood glucose levels in men of all ages.
Men who have diabetes type 2 can greatly benefit from undergoing TRT. This treatment options can reduce the HOMA index which improves fasting insulin sensitivity. Another study performed by Heufelder revealed that TRT combined with proper diet and a well-designed exercise regimen could provide excellent glycemic control in men who have low testosterone.
This study took place over 52 weeks, and it also showed a marked improvement in patients who had metabolic syndrome.
Other studies also suggest that testosterone therapy can ameliorate metabolic syndrome, reduce blood pressure, enhance insulin sensitivity and reduce inflammation in men of all ages.
It has been discovered that TRT can increase lean body mass up to 4.8 kilograms over one year in men who have low testosterone levels. Lean body mass is associated with a higher quality of life, improved fitness levels, and better health.

TRT Can Improve Body Composition

Body composition stands for fat or lean mass a person has in his or her body.
It is characterized by several indicators such as lean body mass, fat mass, etc. A plethora of studies indicates that TRT can improve body composition in men who have low testosterone levels. This data means increasing the amount of lean body mass while reducing the amount of fat mass in the body.
Another study performed on testosterone-deficient men revealed that testosterone treatment could produce a consistent loss of weight if it’s administered over a long period.
This fact might make TRT a good treatment option for obese men. It is also known that people who are overweight usually have lower testosterone levels than those with normal weight, so TRT can both increase testosterone levels while helping to lose weight.
TRT patients who have used this treatment for a long period experienced a massive improvement in their BMI numbers as well as a drastic reduction in waist circumference.
A study performed by Saad and other researchers over 8 years using TRT revealed massive weight reduction in 411 obese men. This improvement was not seen in a different group of obese men who didn't benefit from TRT which confirms the efficiency of TRT in weight loss.
Men with frailty can also benefit from TRT. Studies performed by Saad show that people of an elderly age who have sarcopenia or a different type of physical decline can experience improved bone density, muscle strength and stamina when treated with testosterone. TRT also improved their physical function, mood, and self-esteem.

TRT Improves Bone Mineral Density

With the passing of years, bone density tends to decrease in both men and women.
This makes the skeletal structure more fragile and predisposed to fractures and other types of health problems. Osteoporosis is a common bone ailment which affects mostly women but sometimes men too.
With that being said, TRT is efficient in improving bone mineral density in men of all ages.
A study performed by Wang and his colleagues revealed that testosterone therapy, particularly when administered as gels, can be efficient in improving bone density. TRT can improve the structural and mechanical properties of the skeletal system, making bones less predisposed to damage and more likely to heal in the case of damage.
A study done over 6 years on testosterone-deficient men who also had osteoporosis revealed shocking results. 89% of the study participants who received TRT experienced significantly improved testosterone levels. When tested for osteoporosis again after six years, doctors said that they no longer fulfilled the criteria for this bone disease.

TRT Can Improve Anemia

Anemia is a condition in which the body doesn’t have enough red blood cells to transport oxygen to cells and tissues.
This can be caused by different problems such as a lack of iron in the body. Anemia is characterized by excessive fatigue and sometimes swelling of the feet and hands.
People of an elderly age are more predisposed to this health condition as they progressively lose their vitality and energy with the passing of years. This has been documented by Ferrucci in an extensive study on seniors.
TRT has been shown to significantly improve the symptoms of anemia in people who had testosterone deficiency. For example, an observational study revealed that the prevalence of anemia decreased from nearly 30% to 10% over 54 weeks in men who had low testosterone levels.
This means that TRT can make you less likely to develop anemia at some point in the future and deal with its consequences. Similarly, another placebo-controlled study revealed that TRT could improve the recovery of patients who had anemia, whether the causes of this disease were known or unknown.
This study showed how hemoglobin concentration increased in testosterone-deficient patients after administering TRT for several months.

TRT Can Improve Sexual Function

It is commonly known that people who have low testosterone levels experience a lack of sexual desire, poor-quality erections, lower sex drive, and less stamina.
This can be treated with different types of ED pills such as Viagra or Cialis. However, TRT can also improve sexual function in testosterone-deficient men, especially when it’s administered over many years.
A study performed by Bhasin and his colleagues looked at the relationship between testosterone levels and sexual activity in young men who had normal testosterone levels. The results were recorded before and after treating the study participants with TRT. It has been discovered that both sexual activity and function increased markedly after administering TRT.
Another study revealed that men who have low levels of bioavailable testosterone are three times more likely to develop ED in comparison with men who have normal levels of bioavailable testosterone.
Other placebo-controlled and comprehensive study revealed the improvements in sexual function and quality of erection after administering TRT in people of elderly age. The study was done on 790 men who had low testosterone levels, to begin with.
After administering TRT, they experienced significant improvement in sexual function, sexual desire, and stamina.
A long-term study done over 8 years revealed that testosterone therapy could offer marked improvements on all erectile function domains such as intercourse satisfaction, orgasmic function, sexual desire, and overall satisfaction levels. These results were corroborated with other recent studies performed by researchers on people who have low testosterone levels.

TRT Can Improve Depressive Symptoms and Quality of Life

The levels of testosterone in your body can significantly influence your mood, confidence, and self-esteem.
It has been discovered that low T levels can seriously hurt one’s confidence and lead to emotions such as depression and anxiety. This is true in both men and women.
With that being said, it is normal to assume that TRT can also improve energy levels, moods and overall quality of life. There are numerous studies which confirm this theory.
For example, a study done by Wang over 3 years revealed that TRT could significantly reduce negative thoughts and moods in people who have low testosterone levels. The improvement was gradual and experienced by most study participants.
Another study done on nearly 800 men who were testosterone-deficient revealed a 22% reduction when it comes to fatigue scores. This study took place over 6 months, and it shows how TRT can improve energy levels and overall quality of life. The study participants were using testosterone gel 1% which is a pretty common method of administering testosterone.
Other studies performed on nearly 1000 men revealed a drastic improvement in positive emotions and moods in people who were testosterone deficient, after administering TRT. There are numerous other similar studies which reveal the efficiency of TRT when it comes to improving the emotional system, cognitive function, and mood.

Potential Risks Of TRT

Although there are numerous of TRT, no treatment option is without risks.
There are several disadvantages of undergoing TRT and they vary from individual to individual. Some people might experience no side effects at all while others might go through the full spectrum of disadvantages.

The Risk of Cardiovascular Disease

One study done by Basaria over a period of 6 months reveals some risks of getting cardiovascular disease as a result of TRT. The study involved 209 who were 65 years old or older. They had frailty issues and were unable to climb a flight of stairs due to decreased mobility.
In the group which received TRT, there were 23 cardiovascular events, in comparison with the control group which didn’t receive TRT and had just five events in total.
However, these types of events included abnormal EKG results, pedal edemas or something similar. In most cases, these are not life-threatening problems, and the researchers considered more serious events called major adverse cardiovascular events (MACE). In this study, there was only 4 MACE, and they took place in the TRT group.
There was another study performed in 2014 when Finkle et al. discovered an increase in myocardial infarction in men who received a prescription for testosterone. The increase was up to 36% in comparison with 12 months before receiving the prescription.
Although more studies are necessary to determine whether TRT can pose a serious risk of cardiovascular disease, it’s important to speak with your doctor while doing TRT to monitor your health status along the way.

The Risk of Prostate Cancer

Another common risk that many people assume with TRT is represented by prostate cancer.
It has been believed for decades that TRT injections can cause prostate cancer or worsen its effects in patients who already have it. There are multiple studies which contradict these beliefs.
For example, a study done in 2351 individuals revealed that TRT doesn't cause prostate cancer. This was a placebo-controlled study, and it's corroborated by other similar studies which reveal similar results.
Another study shows that there is no association between exposure to testosterone and high-grade prostate cancer in men who already have prostate cancer. The study was done on nearly 52,000 individuals, and it shows that TRT doesn’t cause an advancement in prostate cancer when administered over a long period.
Thanks to the latest studies done on multiple groups of people over long periods, it can be seen that testosterone replacement therapy doesn't cause prostate cancer or degradation of prostate tissue.

Other TRT Risks

There are other side effects and risks associated with poor management of TRT.  For a table of the most common ones, see this testosterone side effect management table.

Wrapping It Up

If you’re thinking about trying TRT, you’re making a good decision, but you also need a good doctor to monitor your progress.
Testosterone replacement therapy can significantly improve your life, but you need to make sure you’re doing it correctly. Start by getting a testosterone test which can be purchased online at an affordable price.
This will give you an idea regarding your testosterone levels and whether you have low testosterone or not. Then, talk to a TRT doctor and ask plenty of questions to have more peace of mind when going this route.
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