Testosterone is a naturally and synthetically produced hormone, primarily found in males but also occurring in smaller amounts in females. Testosterone plays a role in muscle tone and mass, calcium retention, masculinizing effects, mood, red blood cell production and other essential functions. Men undergo testosterone replacement therapy for testosterone deficiencies caused by aging, injury to the testicles, chronic illness, genetic abnormalities, stress, alcoholism and other diseases. Testosterone replacement therapy brings benefits, side effects, risks and complications.
Benefits and Desired Effects
Testosterone replacement therapy has several benefits and desired effects. In the June 2009 issue of "Therapeutics and Clinical Risk Management," Dr. Nazem Bassil and associates stated that testosterone replacement therapy results in improved sexual desire and function; increased bone mineral density; improved mood, energy and quality of life; improved body composition and muscle mass; and improved cognitive function. The study reported that men with age-related erectile dysfunction experienced significant increases in erections and quantity and quality of sexual acts. Bone mineral density is increased significantly with testosterone replacement therapy, which may lead to a reduction in bone fractures from falls. Cognitive improvements from testosterone replacement therapy include memory improvement, reduced rates of Alzheimer's disease, increased response speed and improved time and space orientation in clinical tests.
Side Effects
Testosterone replacement therapy may result in side effects. Testosterone gel resulted in dose-dependent adverse reactions in clinical trials, according to Drugs.com. The most common side effect seen was acne, occurring in around 8 percent of patients. Other common side effects included application-site reactions, abnormal prostate tests, headache, abnormal blood tests, male breast growth and high blood pressure. Long-term clinical trials resulted in 11 percent of men having an enlarged prostate; 9 percent having abnormal lab tests, including liver, blood or cholesterol tests; and 3.7 percent having urinary problems. Post-marketing reports have included nausea, moodiness, hostility, anxiety, hair loss, rash and prolonged erections.
Risks and Serious Complications
Testosterone replacement therapy may also result in several risks and serious complications. In the January 2004 issue of the "New England Journal of Medicine," Dr. Ernani Rhoden and Dr. Abraham Morgentaler stated that testosterone replacement therapy may result in cardiovascular risks, prostate problems, liver dysfunction and sleep problems. Cardiovascular risks include coronary artery disease, increases in cholesterol and excess levels of red blood cells, which may result in high blood pressure and blood clots. Prostate problems may include enlarged prostate and the development of prostate cancer. Increased liver enzymes and tumors usually only occur from taking oral testosterone, because it must be metabolized by the liver.
References
- "Therapeutics and Clinical Risk Management"; The Benefits and Risks of Testosterone Replacement Therapy; Dr. Nazem Bassil et al.; June 2009
- Drugs.com: AndroGel
- Cleveland Clinic: Testosterone Replacement Therapy
- The New England Journal of Medicine: Risks of Testosterone-Replacement Therapy and Recommendations for Monitoring
