How Safe Is Testosterone Therapy

Testosterone is a male hormone, which plays a vital role in all the sexual functions in men. Testosterone is a crucial male sex hormone that is mainly responsible for immune function, fertility, production of red blood cells. Testosterone hormone is found in both men and women but in males, it performs a key role in the development of male reproductive tissues and promotes sexual characteristics. Testosterone is an essential androgen found in humans. Those steroids that have anabolic and masculinizing effects in both males and females are known as androgens.


Production Of Testosterone


The Leydig cells in the testis synthesize testosterone in men. In men, testosterone levels are generally present in adequate amounts. In females, the production of testosterone is naturally low and is synthesized by the ovaries and the adrenal glands. The hypothalamus which is present in the pulses releases GnRH (Gonadotropin-releasing hormone), which is responsible for regulating the secretion of testosterone. GnRH releases luteinizing hormone (LH) and follicle-stimulating hormone through the anterior pituitary. The enzymatic conversion of cholesterol into testosterone occurs in the Leydig cells because of the LH. In addition to this, all the steroid hormones of the human body begin with cholesterol. 


The production and normal serum amount of testosterone levels are variable in different persons. The average testosterone levels found in men range from 230-1000 mg/dL. In females, the testosterone levels are low and range from 28-80 mg/dL. 


A slight proportion of testosterone circulating is converted into the form of estrogen known as estradiol. Testosterone levels significantly increase as males hit puberty, but it conversely decreases with increasing age. As men start aging, they produce low testosterone and as a result, they produce low levels of estradiol, as well. This results in testosterone deficiency in men whose leading cause is the decline of estradiol. 


The Massachusetts General hospital initiated research based on testosterone and estradiol levels on 400 men, aged between 20-50. The result of the research showed that the dose of testosterone given to men in order to produce variable effects in the body varied widely in each case. The study also found that obesity and increased body weight were also a cause in the decline of estradiol. 


Low Testosterone


Testosterone has several advantageous effects like it increases bone strength and density, driving sexual function and libido, increases muscle strength, and induces hematopoietic. But with increasing age, men often experience low testosterone. A blood test known as serum testosterone test is used to understand the level of circulating testosterone. This is called Testosterone Deficiency Syndrome (TD) or Low Testosterone (Low-T). By saying testosterone deficiency, it implies that the body does not have enough amounts of substance than needed. 


According to the American Urology Association (AUA), low testosterone is diagnosed when levels of testosterone are less than 300 nanograms per deciliter (ng/dL), according to the Food and Drug Administration. Those males who have low testosterone may experience the following symptoms :


  • Low sex drive
  • Fatigue
  • Erectile Dysfunction
  • Decreased lean muscle mass
  • Depression
  • Irritability
  • The lower energy level and physical strength
  • Poor memory and focus
  • Loss of body hair
  • Obesity


Having one of the symptoms mentioned above does not mean that you may have Testosterone Deficiency. But if you experience a combination of the symptoms mentioned above, you may want to consult your doctor about it. For instance, low sex drive alone does not imply that you have a Testosterone deficiency, but if you also experience erectile dysfunction, fatigue, or symptoms of depression, then you should talk to your doctor.




Males can develop Testosterone Deficiency because of the following reasons :


  • Aging
  • Low Testosterone 
  • Metabolic Syndrome 
  • Chemotherapy or radiation
  • Damaged testicles due to injury
  • Removal of testicles
  • Infection
  • Other reason may include some disease in the pituitary gland which can affect the production of testosterone resulting in TD


Some males may have Testosterone Deficiency since birth due to the following health issues :


  • Noonan syndrome
  • Ambiguous genitalia
  • Klinefelter syndrome 


The need for Testosterone Therapy


A decline in testicular production of testosterone and an increase in sex hormone-binding globulin can be seen as men age. Both of them are responsible for decreasing the naturally available testosterone levels. The beneficial and advantageous effects of testosterone could be decreased with the slow and gradual decline of testosterone levels and thus, can negatively affect the physical and psychological health of males. 

Also Read: Possible Factors That Contributes To Hypogonadism

Males with low testosterone levels or testosterone deficiency and symptoms of hypogonadism (failure of gonads, testis in males) can be treated with the help of 

Testosterone Replacement Therapy (TRT). When the therapy of replacement is done, the positive effects of testosterone are recovered. But, the long term data doesn't say much about the safety of Testosterone Replacement Therapy. Males with the dysfunction of hypogonadism have an unnaturally low level of testosterone. Testosterone replacement therapy can be proved helpful for those who have hypogonadism, but there is no certainty about whether testosterone replacement therapy can be of some benefit for those males whose testosterone count is declining because of aging.


Types of Testosterone Therapy


  • Gels ( Androgel and Testim)
  • Injections (Depotestosterone)
  • Patches ( Androderm )
  • Capsules ( Methyltestosterone and Android )
  • Testosterone Replacement Therapy (Hormone Therapy)


Is Testosterone Therapy Safe? 


Those males who have more than one disorder that prevents Testosterone Replacement Therapy must be made aware of all the risk factors involved. Such diseases include male breast cancer, deteriorating benign prostatic hyperplasia (BPH), the disintegration of prostate cancer, a high chance of obstructive sleep apnea and polycythemia. All of these factors must be considered when allocating testosterone therapy to a person. The patient must be introduced to all the risk factors involved with testosterone therapy.


It is very essential to understand the potential risks involved with testosterone therapy. The patient must be introduced with all the alternatives before going for testosterone therapy. If the testosterone levels of a man are genuinely low or below normal, testosterone replacement therapy hormone supplements can be of great help to boost the testosterone levels.


Risk Factors :

  • In rare cases, the immediate side effects of TRT are experienced. These side effects include breathlessness while sleeping, acne, swelling on the breast, or ankles. 
  • Those males who use testosterone therapy on a long term basis have an increased risk of heart attacks, strokes, and other cardiovascular diseases. According to research conducted back in 2010, which revealed that men on testosterone therapy had noticeably more heart problems as compared to those who weren't on the therapy. 
  • According to some doctors, testosterone therapy could enable the growth of the cancer cells that can give rise to prostate cancer. 
  • Testosterone therapy can also increase the risk of blood clots. 
  • Enlargement of breasts.
  • Sometimes, red blood cell production is increased in an excessive amount which can consequently result in a blood clot. 

Talk To Your Doctor 


Since the past few years, the number of men going for testosterone therapy has nearly tripled. But with the rise, the risk factors regarding the therapy have become a major concern.


If you are not sure about testosterone therapy or have any kind of confusion regarding it, you must talk to your doctor. Doctors will likely measure your testosterone levels more than two times, in order to refer or suggest testosterone therapy to you.


If you have a medical condition that is causing a significant decline in the testosterone levels, therapy can be helpful. But if the decline is due to aging, then there are many natural ways like physical activities, losing weight, or increasing muscle mass by which the level of testosterone can be boosted. 

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