Annually almost 2% of males in the US resort to androgen replacement therapy. Commonly known as testosterone therapy, hormone therapy is a procedure approved by the FDA for certain conditions. Opinion is divided about the safety and benefits of the procedure, with many touting the benefits alone, while others remain focused on the long-term complications. We will take a factual and balanced look at the therapy and explain in detail all about testosterone therapy side effects. This will help individuals make an informed decision before opting for the therapy.
Overview – what is hormone therapy?
What is testosterone?
Before we take a look at testosterone therapy side effects it is important to learn more about the hormone therapy itself. Testosterone is responsible for manifestation of male attributes – muscularity, sexual characteristics, bone density & growth, and red blood cell count. Produced in the testicles, testosterone is linked to many vital functions and characteristics.
The reason behind reduction in testosterone levels?
With advancing age, the level of testosterone decreases in the body – for most individuals, the reduction commences from age 30 while for others this starts a bit later. Additionally, testosterone levels are also known to reduce as a result of infection or trauma to the testicles. Other conditions include individuals who have undergone radiation therapy for cancer. Low levels of testosterone are known as hypogonadism, and this may require therapy to restore testosterone levels. As a result of hypogonadism, males end up with low sperm count, in addition to commonly known side effects. The average adult male is expected to have a normal total testosterone level in the range of 280 to 1,100 ng/dl (nanograms per deciliter).
Certain medical conditions also contribute to the reduction in testosterone levels. For instance, pituitary gland dysfunction excessive iron in the body and individuals with genetic conditions such as Klinefelter’s Syndrome also have lesser levels of testosterone. Males with chronic kidney ailments, cirrhosis of the liver, individuals living in highly stressed conditions, obese individuals and alcoholics are also at risk of having lower levels of testosterone. Finally, certain medications used in the treatment of prostate cancer can impact the hormone levels.
When is therapy recommended and common testosterone therapy side effects?
Men are known to suffer from erectile dysfunction that is attributed to one of various reasons. When erectile dysfunction is caused due to lowered levels of testosterone, men are recommended to undergo hormone therapy. Similarly, when testosterone levels are low, males are recommended therapy for the purpose of fixing the imbalance. Therapy is intended to treat the symptoms or the outcomes of lower testosterone levels. The therapy does not claim to treat the underlying reasons for lower testosterone levels. Males in lower age groups who wish to understand the reason behind the condition may require additional medical diagnosis. Typically, the underlying causes are common in nature and are almost always attributed to lifestyle issues. Low testosterone levels do not always require to be treated – for instance, individuals facing a reduction that is attributed to advancing age are advised to avoid therapy. The therapy is best suited for males with low testosterone levels as a result of abnormalities or medical conditions. This will also avoid testosterone therapy side effects.
What are the commonly discernible symptoms that indicate low testosterone levels?
Individuals with low levels of testosterone may lose interest in sexual activities, apart from erectile dysfunction. Men are known to enter into some form of depression, which results in a lowering of self-esteem. Many find it challenging to concentrate, as a result of the impaired or altered state of well-being. There are other effects that physically manifest in the body, including a decrease in the muscle mass, with a corresponding increase in body fat levels. This can be easily mapped with aged related increase in body fat and reduction in muscle mass. Individuals with lower hormone levels are also known to suffer from osteoporosis, where the bones turn fragile. Cholesterol levels and lipid levels undergo a change, the amount of hair on the body reduces and individuals end up with a decrease in hemoglobin levels.
What are the benefits of therapy for restoring testosterone levels?
While there is a possibility of testosterone therapy side effects, multiple benefits are attributed to the treatment for restoring testosterone levels. This includes a clearly recognizable increase in sexual ability and desire. Males witness an increase in overall strength and a discernible change in lean muscle mass. Cognitive functions are known to improve significantly as a result of testosterone therapy. Males who are vulnerable to osteoporosis as a result of low testosterone will have relatively lesser risk of the condition. The overall mood of the individual is also impacted as a result of normal or near normal testosterone levels.
Commonly known testosterone therapy side effects
For most individuals, testosterone therapy side effects may be negligible, especially among males who diligently follow the recommendations of medical specialists. However, it is incorrect to rule out the possibility of side effects and other manifestations. Some of the commonly known side effects or complications include a sudden increase in cardiovascular related issues. Consequently, individuals who undergo therapy may find themselves at higher risk of complications. Another side effect of the therapy is the deterioration of symptoms or conditions experienced in the lower urinary tract. Among possible testosterone therapy side effects, poycythemia warrants swift medical attention. A rare form of blood cancer, the condition results in the production of excessive red blood cells by the bone marrow. As a result of the excessive count of red blood cells, blood ends up thickened, and this impacts blood flow. There is also the possibility of blood clots forming due to this condition. A related condition is the possibility of venous thrombosis, where blood clots form in the veins.
Other testosterone therapy side effects include allergic reactions and possible difficulties in breathing as a result of the therapy. Symptoms of allergic reactions include rashes on the skin and a dizzy sensation. An increase in blood pressure levels is another possibility that is attributed to testosterone injections. Individuals who experience this increase may end up with elevated risk levels of a heart attack or stroke. It is therefore necessary for males with pre-existing conditions to exercise complete caution while opting for testosterone therapy. For instance, individuals with a history of strokes, high levels of blood pressure and heart related ailments need to seek specific medical advice before opting for the therapy.
Fluid retention is likely to increase in individuals undergoing the therapy. Similarly, there is a possibility of a change in skin conditions, with the skin turning oily with possible acne outbreak. Males are at heightened risk of experiencing abnormalities in the prostate, in addition to other symptoms linked to urination. For instance, there could an impact in the volume of urine that is streamed out, or the frequency of urination. Other testosterone therapy side effects includes the decrease in size of the testicles as a result of the therapy. Males undergoing the therapy are also known to exhibit some kind of aggression or a sudden change in mood that is not attributed to other reasons. Sleep disorders are a possibility – for instance individuals with pre-existing sleep apnea, may find the condition deteriorating. The disorder refers to the habit of falling asleep during the day, and the resultant inability to enjoy deep sleep during the night.
Indications of possible testosterone therapy side effects
Indications of possible testosterone therapy side effects include the following, and individuals are advised to seek intervention at healthcare facilities at the earliest. Sudden pain in the chest is a possible indication of an adverse reaction, especially in individuals with a history of cardiovascular conditions. Similarly, shortness of breath or difficulty in breathing normally also warrants medical intervention. Other abnormal feelings that are not attributed to other conditions also require medical attention. For instance, a dizzy feeling, or pain the arms, in the jaw, or in the back and neck are also indications of possible adverse reactions. Individuals who experience difficulty in speaking properly or if the speech is slow or slurred also need medical attention. Any numb feeling or general weakness in the arms or legs also need to be checked.
Categories of individuals advised to stay away from hormone replacement therapy
Considering the above testosterone therapy side effects, it is essential for certain categories of individuals to stay from the therapy. For instance, individuals with prostate cancer are advised to avoid the therapy. Males with pre-existing urinary tract conditions are also advised to avoid hormone therapy as the injections are likely to complicate the condition further. This could cause acute discomfort and upset routines. Similarly, individuals with sleep apnea that has not been treated or resolved are also recommended to avoid the therapy. The therapy is advised only after the condition has been treated or if treatment is ongoing with desired outcomes. Without exception, all men intending to undergo the therapy are advised to be screened for prostate cancer, as this will help avoid complications during the course of the therapy.
Why is testosterone therapy typically not advised for females?
While testosterone therapy is recommended for a small category of females, it is generally not recommended or all women. Testosterone therapy side effects include masculinizing effects, wherein females end up with characteristics that are masculine in nature. Typically, the desired average testosterone levels in females are in the range of 15-70 ng/dl (nanograms per deciliter). When the testosterone levels drop, there is a possibility of vaginal dryness, and this could impact sexual ability and desire. Additionally, women could experience irregular periods as a result of low testosterone levels. Presently, readily approved formulations are not available for testosterone therapy for women, and consequently, women need prescriptions depending on the actual levels.