A few months ago two articles were printed in a prominent medical journal regarding the use of testosterone supplements in older men. Testosterone levels in men decrease naturally over time. A low testosterone level may cause not just sexual dysfunction but also tiredness, weakness, and muscle wasting. Testosterone replacement therapy can be given to men either by injection or by using a gel that is applied to the skin. There have been a number of studies done on the harms and benefits of testosterone replacement therapy in older men and the results have been both variable and conflicting.
Both of the studies that I am referring to were done at the University of Pennsylvania in Philadelphia. In the first study the authors tested the theory that testosterone treatment in older men slows the progression of heart disease. The study group consisted of men age 65 and older who had both low testosterone levels and symptoms consistent with a low testosterone level. To assess heart disease, they used CT scans, which measured the amount of coronary artery plaque. Plaque is the term for fatty deposits that line the inside of blood vessels causing them to narrow. The study participants were divided into two groups. One group received testosterone gel and the other group, a placebo gel. The participants were followed for one year. The findings of the study were actually the opposite of the theory they were looking to confirm. They found that coronary plaque volume in the group that received testosterone increased significantly as opposed to the control group. While coronary artery plaque volume does not in and of itself confirm heart disease, there is a strong correlation between the two.
The second study was done by the same authors of the first study. Most cognitive (thinking, memory, attentiveness, etc.) functions decline with age. Some prior studies have suggested that testosterone treatment may slow or reverse that natural decline in brain function. In this study, a different group of men age 65 and over with low testosterone levels and symptoms consistent with low levels were divided into two groups, with one group using testosterone gel and one group placebo. This group was also followed for one year. Cognitive function was assessed with standard tests of visual memory, executive function, and spatial ability. The authors found that testosterone treatment was not associated with improved memory or cognitive functions.
Both study groups were relatively small and participants were only followed for a year so both study results should not be taken as gospel. More research is obviously needed. It is becoming clear however that the use of testosterone supplements does have potentially serious side effects including possibly prostate cancer and heart disease and the use of these supplements should be carefully considered and monitored.
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