What is testosterone?

Testosterone is the hormone responsible for the development of male external genitalia and secondary sexual characteristics. It’s produced by the testicles.

Testosterone is important for maintaining:

• muscle bulk
• bone density
• red blood cells
• sexual and reproductive function

Testosterone also contributes to vitality and well-being.

As men age, their bodies gradually produce less testosterone. This natural decline starts around age 30 and continues throughout the rest of a man’s life.

Why does Testosterone decrease with age?

Your body naturally produces less testosterone as you age. The average male’s T production goes down by about 1 to 2 percent each year.

This is all part of a completely natural process that starts in your late 20s or early 30s:

• As you age, testicles produce less testosterone.
• Lowered testicular testosterone causes the hypothalamus to produce less gonadotropin-releasing hormone.
• Lowered GnRH causes your pituitary gland to makes less luteinizing hormone (LH).
• Lowered LH results in lowered overall testosterone production.

Does a naturally declining testosterone level cause the signs and symptoms of aging?

Men can have many signs and symptoms as they age. Some that might occur as a result of lower testosterone levels can include:

• Changes in sexual function. This might include reduced sexual desire, fewer spontaneous erections — such as during sleep — and infertility.
• Physical changes. Various physical changes are possible, including increased body fat, reduced muscle bulk and strength, and decreased bone density. Swollen or tender breasts (gynecomastia) and body hair loss are possible. You might have less energy than you used to.
• Emotional changes. Low testosterone can contribute to a decrease in motivation or self-confidence. You might feel sad or depressed, or have trouble concentrating or remembering things.

Some of these signs and symptoms can be caused by other factors, including medication side effects, obstructive sleep apnea, thyroid problems, diabetes, and depression. It’s also possible that these conditions cause low testosterone levels, so treatment might result in an increase in testosterone levels.

A blood test is used to diagnose a low testosterone level.

How do I know if I have low T?

The only way to know whether you truly have low T is by seeing a healthcare provider for a testosterone level test. This is a simple blood test, and most providers require it before prescribing TRT.

You may need to do the test several times because T levels are affected by various factors, such as:

• diet
• level of fitness
• time of day the test is done
• certain medications, like anticonvulsants and steroids

What is TRT?

TRT is an abbreviation for testosterone replacement therapy, sometimes called androgen replacement therapy. It is mainly used to treat low testosterone (T) levels that can occur with age or as a result of illness.

Nowadays, testosterone replacement therapy is used for:

• increased sexual activity
• reaching higher energy levels
• muscle building for bodybuilding
• increased libido
• improved sense of well-being
• reduced body fat and increased lean body mass
• increased bone density

Research shows that TRT can actually help you achieve these goals.

Testosterone replacement therapy is a treatment in which additional testosterone is added to a man’s body (e.g. by injecting medicines that contain testosterone), to increase the concentration of testosterone in his body. The aim of testosterone replacement therapy is to increase blood testosterone concentrations to normal levels. In doing so, it can also restore the man’s sex drive and expression of male sex characteristics (e.g. deep voice, body hair).
Improvements in blood testosterone levels and libido generally occur within the first week of treatment, and other benefits usually occur within two months.

Dosage

Most adult men begin receiving replacement testosterone at a dose sufficient for restoring blood testosterone to normal levels in men aged < 40 years. In boys who have not yet reached puberty and elderly men, lower doses are usually used at the beginning to avoid excessive increases in libido or energy, which may be dangerous. Once treatment has started, the doctor will monitor the man’s blood testosterone levels and symptoms and may need to adjust the dose depending on how these change.

How is testosterone administered?

Testosterone can be administered in various ways, depending on the person. Most men will first receive treatment in the form of testosterone injections every two weeks. Men who cannot receive injections (e.g. those with bleeding disorders) will receive different modes of testosterone treatment. The doctor may also change the type of testosterone administered if the man is dissatisfied with the current treatment. A doctor will try to prescribe a type of testosterone therapy that suits the patient in terms of cost, response, and convenience, and individuals should talk to their doctor if they have concerns about any aspects of treatment.

Forms of Testosterone Supplements

Testosterone replacement therapy is available in several forms. All can improve testosterone levels:

• injections
• patches
• gels

Benefits of testosterone replacement therapy

Effective testosterone therapy has numerous immediate and long term benefits. These include:

• Physical

Increased energy;
Increased bone density;
Reduced risk of obesity, diabetes, and metabolic syndrome;
Reduced risk of cardiovascular disease;
Reduced risk of osteoporosis;
Reduced body fat;
Reduced risk of anemia; and
Increased lean body mass and muscle strength.

• Sexual

Increased libido;
Increased sexual enjoyment;
Increased satisfaction with erections; and
Increased sexual activity.

• Psychological

Improved mood and sense of wellbeing; and
Improved cognition and memory function.

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