Benefits and Risks of Testosterone Therapy

Although widely known as the male hormone, taking testosterone is becoming increasingly popular even for women. Known for increasing libido and sex drive in men, it can also do the same for women, along with easing menopausal symptoms. Here we look at the increase in its popularity, the drop in male levels of testosterone, and the benefits and downsides – to both sexes.

Now becoming mainstream and popping up on Instagram, TikTok, and Facebook, testosterone replacement therapy (TRT) in the UK through the NHS has increased by 15% since 2021. Both men and women are using it in an attempt to improve health and vitality. In particular, more menopausal women are seeking out testosterone prescriptions alongside more traditional HRT therapies. This is in part down to media and celebrity endorsement, particularly from Davina McCall.

Do Women have testosterone?

Although testosterone is primarily considered a male hormone, it is also an essential part of women’s health. In both sexes, a lack of it can lead to low libido, tiredness, less muscular strength, and difficulty concentrating.

Why would men need more testosterone?

Underlying the trend of increasing use of testosterone is a decline in the production of testosterone, particularly in men. Although levels naturally decline, usually from around the age of 30 in both men and women, globally there has been a fall in average levels in men of all ages since the 1970s. They have fallen by 1% annually since the mid-2000s. For example, a 65-year-old man in 2002 had on average 15% less testosterone than his equivalent-aged peer in 1987. Recent research also shows a further decline over the past decade. A recent US study reported testosterone deficiency in 20% of young men. Although the causes remain open to debate, both science and logic presume that processed food, stress, increasing rates of obesity, and the increasing amount of plastic in the food chain (which disrupts our hormonal systems) are the most likely causes.

What are the signs of low Testosterone?

Low testosterone can affect both the mind and the body. In terms of cognitive function, low testosterone is associated with depression, reduced self-confidence, difficulty concentrating, and undisturbed sleep. Physically they can contribute to a decline in muscle and bone mass, increased body, fat, fatigue, swollen or tender breasts in women, and hot flushes. Low testosterone is also a contributory factor in a lower sex drive and difficulty in men sustaining erections.

What are the Benefits and Risks of Testosterone Therapy for men and women?

In both the US and the UK, using prescription testosterone as an injection or gel is claimed by pharmaceutical companies to have widespread benefits.

1 – Healthy heart and blood

Testosterone is claimed to help the production of red blood cells in our bone marrow, with low testosterone being linked to various cardiovascular risks. Study results to prove this benefit to the heart are mixed, with some smaller studies showing only slight improvements, one with an increase in cardiovascular fitness, and another showing a widening of the arteries. However, a more recent study of 83,000 men in 2015 showed that men who were able to increase their low testosterone levels to normal using supplementation were 24% less likely to suffer heart attacks and had a 34% reduction in the likelihood of suffering a stroke.

2 – Increase in muscle mass and reduction in fat

Testosterone is responsible for increased muscle mass, which in turn has a beneficial effect on metabolic rate, an increase in energy, and improved coordination and connective tissue strength. Supplementation treatment has been shown in studies to increase lean muscle mass however the greatest benefits were seen in those that combined testosterone treatments with strength training.

3 – Stronger bones

Testosterone plays a vital role in bone density, which naturally decreases with age alongside a drop in testosterone. Although research shows that bone density increases with testosterone treatment, it only does so with those on high doses. Some clinical trials found increases in hip and spinal bone density.

4 – Improved cognitive function and a reduction in the chances of Alzheimer’s

Men with higher levels of testosterone have a lower chance of developing Alzheimer’s disease, while other evidence shows a strong link between higher levels of testosterone and the ability to solve complex problems and improved memory.

5 – Higher libido

Testosterone levels rise in response to sexual activity with a link between higher testosterone levels and greater sexual activity. In older men, testosterone can help with libido and erectile function, although it’s worth noting that this latter issue can be the result of many other conditions.

6 – Improved mood, lower irritability

Lower levels of testosterone come with symptoms of depression, fatigue, and irritability. In particular men with hypogonadism (reduced hormone production) reported better mood, fewer depressions, and more energy.

The benefits for women

For females, the same benefits are reported as for men in terms of mood, libido, muscle mass gains, and fat loss, but it is deemed particularly helpful in alleviating symptoms of menopause. As they enter menopause, women see a natural decline in hormones like estrogen, progesterone, and testosterone. Testosterone therapy has been clinically shown to improve these symptoms. However, one of the main issues with testosterone supplementation in the UK is that there are currently no available licensed preparations for women in the UK who have to use gels designed for men – thus care should be taken with dosage. It is also important that women have sufficient estrogen before adding testosterone supplements.

What are the risks of testosterone when taken for normal aging symptoms?

The main risks of testosterone therapy are:

Skin problems like acne and eczema

Growth of the prostate (benign prostatic hyperplasia) but also growth and acceleration of existing prostate cancer.

Breast enlargement in women

Limiting sperm production in men and shrinking testicles

Increaser production of red blood cells which can contribute to the risk of blood clots and clots that can become loose, travel through the bloodstream, and lodge the lungs causing a pulmonary embolism

Some research shows that testosterone therapy can increase the chances of heart disease, although more studies are needed to conclusively show this link.

The takeaway – should I take testosterone therapy?

Although on paper the benefits look to outweigh the possible risks, the long-term effects of taking testosterone are still unknown, with it being a relatively new treatment. It is also worth noting that low testosterone alone does not usually warrant additional supplements. So really, only people with proper symptoms of low testosterone, and a proven link that low levels are the cause of the symptoms should consider the treatment. As always, a doctor should always be the first step in determining if testosterone therapy is right for a given individual. As ever, many of the symptoms of low testosterone can be alleviated or even stopped with properly structured exercise. strength training for the over 50s is particularly beneficial – see our 50+ fitness page.