As men age, their testosterone levels naturally dip — potentially ushering in a host of negative effects including decreased sex drive and muscle mass. Testosterone therapy has risen over the last few decades to fill the gap, but many men wonder when it is time to worry and what the drawbacks of such treatments could be. We asked Michael Werner, MD, the medical director at the Purchase-based Maze Men’s Sexual and Reproductive Health when testosterone replacement is truly necessary and what it really entails.
According to Werner, there are a host of symptoms to watch out for when you are worried you may have low levels of the hormone. “Men should seek medical help when they [exhibit] some of the symptoms of low testosterone,” he says. “These include decreased interest in sex, worsening erections, decreased energy, lack of mental focus or fogginess, and difficulty taking off fat and putting on muscle” However, Werner insists that “the decision of whether or not a man needs testosterone replacement should be made with his doctor.”
Werner adds that once the diagnosis that an individual’s testosterone levels are low has been made, the patient is then in a place to decide with his doctor which treatment is best for him and his lifestyle. Before seeking treatment, It is also important to note that “every patient on testosterone replacement therapy needs to do so under a doctor’s care and get regular checkups to watch for elevated hematocrit (red blood cell) levels and to make sure his body is not making too much estrogen,” explains Werner.
So, what happens once a patient starts receiving the treatment? “The first signs the testosterone is doing its job may be increased energy and improved mental acuity,” says Werner. “In a few months, body fat tends to diminish and men will notice improved exercise performance.” According to Werner, it can take six months for men to notice an improvement in erectile function, and nine months for an improvement in libido. He also notes that, for many men, cholesterol levels will improve and overall heart health can get better.
However, the therapy has been linked to serious maladies in the past. “The two major concerns that physicians have had were that testosterone replacement therapy could increase the incidence of prostate cancer, or cardiovascular disease,” he explains. “The vast preponderance of medical evidence does not support these concerns, at all, and the views in the medical community are slowly changing.”
As for negative effects, Werner says that some men might notice temporary acne, although most notice no negative effects of being on the treatment. “Testosterone replacement therapy can be as inexpensive as $60 for a 3-month vial for self-injection, or hundreds of dollars for implanting pellets which last three months,” says Werner. “Most insurance companies cover testosterone replacement therapy medication and treatment, when it is medically indicated.”