New look at Testosterone therapy

Testosterone replacement therapy (TRT) has surged in popularity over the past decade. Millions of older men have turned to TRT to restore hormone levels in hopes of refueling energy and reigniting their sex drive.
Dr. Frances Hayes, a reproductive endocrinologist with Harvard-affiliated Massachusetts General Hospital, points out that some of these studies had limitations.
“For instance, in one study, TRT doses were much higher than what would usually be prescribed, and the subjects tended to be more frail, with other health problems,” she says. “Other studies showed no evidence of increased risk.” Recent research has supported this position. A study reported at the 2015 American Heart Association Scientific Sessions involved 1,472 men ages 52 to 63 with low testosterone levels and no history of heart disease. Researchers found that healthy men who received TRT did not have a higher risk of heart attack, stroke, or death.
The bottom line is that the long-term risks of TRT are still unknown, as many of these studies have limited follow-ups. That does not mean you should avoid TRT. For a selected subgroup of men, the therapy can be a viable option.
The No. 1 contributor to falling levels is weight gain. “Weight has a bigger impact on testosterone levels than aging. As weight goes up, testosterone levels go down,” she says. A five-point increase on the body mass index scale, for instance, going from 30 to 35, is equivalent to adding 10 years to your age in terms of testosterone levels.