When it comes to men’s bodies, testosterone is a marker of youth. Levels of the sex hormone tend to peak during the teen years through early adulthood and then decline gradually as men age.
The consequences of this loss can be harsh: sleep disturbances, physical changes (such as increased body fat, weakened muscles and hair loss) and a decline in sexual desire. While the idea of replacing testosterone with gel, patches and injections may sound tempting, there haven’t been a lot of studies on the subject. Those that have been published have shown mixed results, leaving many physicians confused about the risks vs. the benefits of testosterone replacement therapy, or TRT.
A new study that involved 83,000 veterans provides evidence supporting TRT. In a paper published in the European Heart Journal, researchers found that patients with low testosterone levels who received TRT might be at lower risk for heart attack or stroke.
The study — the largest to date on TRT and the one with the longest follow-up period — looked at men who were treated between December 1999 and May 2014 at the Kansas City VA Medical Center. Only 63 percent achieved normal testosterone levels with TRT, and that group had significantly fewer deaths and cardiovascular events than the group that did not.
“This is the first study to demonstrate that significant benefit is observed only if the dose is adequate to normalize the testosterone levels,” said Rajat Barua, a cardiologist who is a co-author of the paper.
The researchers emphasized that their study does not draw any definitive conclusions about TRT and that further long-term follow-up is needed. Previous studies have shown that testosterone therapy can increase the risk of heart attack or stroke; TRT has also been linked to other scary effects such as blood clots and sleep apnea, and causing faster-growing prostate cancers.
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