Testosterone, a hormone involved in maintaining muscle mass, bone density, red blood cell production, sex drive and sperm production in males, slowly declines with age or may be deficient due to certain medical conditions. Low testosterone levels may lead to unwanted physical and emotional changes. Testosterone replacement therapy may reverse low testosterone levels and is generally considered safe, but risks are associated with therapy.
Enlarged Prostate
Testosterone stimulates the growth of the prostate. Individuals with prostate cancer should not undergo testosterone replacement therapy, as it may stimulate the growth of cancerous prostate cells. A prostate screening is recommended before starting testosterone therapy. Benign prostatic hyperplasia -- a noncancerous, enlarged prostate gland -- may occur in any male, but testosterone therapy may further stimulate prostate growth. An enlarged prostate may put pressure on the bladder, causing changes in urination. In more severe cases, an enlarged prostate leads to urinary tract infections, bladder or kidney disease and bladder stones, according to the National Kidney and Urologic Diseases Information Clearinghouse.
Polycythemia Vera
Overproduction of red blood cells, also known as polycythemia vera, may develop during testosterone therapy, leading to increased blood mass, according to MedlinePlus. This can lead to a variety of symptoms, such as shortness of breath, dizziness, headache, facial flushing and fatigue. More importantly, it increases the risk of blood clots, which may lead to heart disease, stroke and heart attack.
Infertility
Sperm production occurs in the testes and is dependent on natural testosterone production. Testosterone therapy may reduce or completely stop the production of testosterone by the testes, resulting in decreased sperm production, according to Dr. Michael Werner, andropause and male menopause specialist. This may cause infertility and may be a major problem in younger men interested in having a child. However, the effects are usually reversible upon quitting testosterone therapy.
Sleep Apnea
Testosterone therapy may contribute to or worsen sleep apnea, a condition in which an individual stops breathing repeatedly for short periods of time while sleeping. The relationship between sleep apnea and testosterone is still unclear, but it should be discussed with a doctor before beginning therapy. According to an article in "Clinical Endocrinology," testosterone may affect throat muscle relaxation during sleep, the mechanism by which sleep apnea develops.
References
- MayoClinic.com: Men's Health: Testosterone therapy: Key to male vitality?
- Palo Alto Medical Foundation: Testosterone Replacement Therapy
- MedlinePlus: Polycythemia vera
- Michael A. Werner, M.D.: Negative Effects of Testosterone Replacement Therapy
- "Clinical Endocrinology"; Testosterone Therapy in Hypogonadal Men
- National Kidney and Urologic Diseases Information Clearinghouse: Prostate Enlargement: Benign Prostatic Hyperplasia
