8 Things to Know About Testosterone Therapy

  • Male doctor with male patient
    A Natural Male Hormone
    Your doctor might suggest testosterone therapy if blood tests and symptoms show that you have low testosterone (low T). Testosterone is the natural male hormone. It's made in the testicles. To treat low T, doctors can prescribe a drug to replace the natural hormone. The goal is to raise your testosterone level from low to the middle range. Here are answers to common questions about low T therapy.

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    Who Needs Low T Treatment?
    About 40% of men over age 45 may have low T. Levels start to go down after age 30. That's normal. Symptoms of low T can include less interest in sex, weak erections, less muscle and more fat, low moods, loss of body hair, less energy, brain fog, shrinking testicles, and hot flashes. Many men have low T and no symptoms. Without symptoms, low T does not need treatment. If you do have symptoms, ask your doctor if treatment is likely to help ease your symptoms.

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    How Do You Take Testosterone?
    Testosterone comes as a gel or patches put on the skin or as an injection. Most men choose the gel form. You rub it under an arm or on a shoulder once a day after a shower. To use a patch, you put it on your upper body, belly or thigh each night. Men who choose injections get them one or two times a month.

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    Are There Side Effects?
    Each low-T therapy can cause side effects. Injections can cause swelling and soreness where the needle goes in the body. They also can cause testosterone levels to rise and fall without warning. Patches and gels can irritate the skin. Also, gels can rub off on other people. This can be dangerous for women and children. All three methods can cause acne, breast enlargement, and prostate enlargement. They also can affect your blood count, liver enzymes, and cholesterol levels.

  • Male Doctor talking with Male Patient
    Who Should Not Take Testosterone?
    Testosterone does not cause prostate cancer or breast cancer in men. But it can make these cancers grow faster. Do not take testosterone if you have prostate cancer or breast cancer. If you have an enlarged prostate, testosterone therapy may cause your prostate to become larger. Testosterone can also make sleep apnea worse. Sleep apnea causes loud snoring with brief periods when you do not breathe.

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    What About Heart and Stroke Risks?
    Low T therapy may cause problems with your heart and blood vessels. In 2014, the U.S. Food and Drug Administration (FDA) alerted men and their doctors about two new studies. One showed that men about 60 years old who were on testosterone were 30% more likely to have a stroke or heart attack than men not taking the drug. The other study found that men 65 and older had higher rates of heart attack within 90 days of starting low T treatment. The FDA says men should talk about these risks with their doctors when deciding if treatment would be right for them.

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    Are There Other Precautions?
    Your doctor should check your breasts and prostate for cancer before you start treatment. You should have a blood test called a PSA (prostate specific antigen). Once treatment starts, see your doctor every few months to check your testosterone level and your PSA level. Your doctor also will want to check your prostate with a rectal exam every few months. The doctor may also do blood tests to check your red blood cells, cholesterol, and liver. These are important steps to take to make sure the treatment remains as safe for you as possible.

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    What Benefits Can You Expect from Treatment?
    With treatment, you should see an improvement in your energy level, your sex drive, and your mood. Over time, you may also see a decrease in body fat and an increase in muscle. Low T can cause bones to thin. So, treatment may reduce your chances of breaking a bone. If you have erectile dysfunction (ED), you could see some improvement in your ability to achieve and keep an erection. If you still have ED, taking testosterone may make it more likely that a drug like Viagra will work for you.

  • Doctor with Male Patient
    Do the Benefits Outweigh the Risks?
    It’s difficult to answer this question. There’s no clear answer that's right for every man. Researchers need to do more studies, especially on the possible risks of heart attack and stroke. You and your doctor must decide on treatment together after weighing your treatment options. Plus, don’t forget to ask about natural, proven ways to safely boost testosterone. These include losing weight, sleeping well, exercising, not smoking, drinking alcohol only in moderation, and avoiding stress as much as possible.

8 Things to Know About Testosterone Therapy

About The Author

  1. What is Low Testosterone (Hypogonadism)? Urology Care Foundation. http://www.urologyhealth.org/urologic-conditions/low-testosterone-(hypogonadism)
  2. Prevalence, Diagnosis and Treatment of Hypogonadism in Primary Care Practice. Boston University School of Medicine. http://www.bumc.bu.edu/sexualmedicine/publications/prevalence-diagnosis-and-treatment-of-hypogonadis...
  3. Treatment & Procedures. Cleveland Clinic. http://my.clevelandclinic.org/health/treatments_and_procedures
  4. FDA Drug Safety Communication: FDA cautions about using testosterone products for low testosterone due to aging; requires labeling change to inform of possible increased risk of heart attack and stroke with use. U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/ucm436259.htm
  5. Testosterone and the heart. Harvard Medical School. http://www.health.harvard.edu/fhg/updates/testosterone-and-the-heart.shtml
  6. Maintaining Testosterone Levels Naturally. University of Wisconsin Integrative Medicine. http://www.fammed.wisc.edu/files/webfm-uploads/documents/outreach/im/handout_testosterone.pdf
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 7
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.