Today we welcome a guest writer, David DeLuca, to share his perspective on hormone replacement therapy for men:
From countless sources we hear a dangerous and seductive message: “youthfulness is good, and aging is bad.” We see advertisements for all sorts of drugs, ointments, and even surgical treatments that aim to hide the outward effects of aging. Some celebrities exfoliate their skin by bathing in wine.
Yes, bathing in wine.
A less outrageous technique, hormone replacement therapy (HRT), is marketed as a treatment for hypogonadism, a decrease in hormones that results in reproductive dysfunction. HRT promises boundless energy and a happier life to men and women alike. But the very idea of hormone replacement therapy runs counter to a simple fact of life: as we age, our hormone levels naturally change.
The natural decline in testosterone in men is well-documented. After age 20, the level of testosterone in our blood slides slowly downward (Harman et al 2001; Feldman et al 2002). Whether the natural fall in testosterone levels is a problem depends on what you expect from yourself at any given age. Do you at age 50 expect yourself to have the sexual energy of a 20-year-old? Do you expect yourself to be more aggressive? Hairier? Whatever you wish, hypogonadism as a medical condition depends on your belief that something is wrong with your hormone levels. This might not be true, but corporations have a strong interest in making you a believer.
How many men actually need testosterone replacement therapy (TRT)? In 2010, a study published in the New England Journal of Medicine reported that only two percent of men older than 40 actually need TRT. Even authors who supported the notion of TRT claimed that only one percent of men between the ages of 20 and 40 have testosterone levels that need adjustment (Pines 2011). Compared to the recent explosion of marketing for “andropause” treatments, these numbers seem strangely small.
On principle, I would caution against seeing TRT as the fountain of youth. There is not a large body of research on the risks of testosterone replacement therapy, the research that does exist shows it has no robust negative side effects (Grech, Breck & Heidelbaugh, 2014). However, there are much cheaper ways to increase your testosterone levels. Research indicates that high intensity interval training (HIIT) leaves testosterone levels soaring until the next day (Di Blasio et al., 2014). The $30/month you would have spent on T injections might make a more lasting difference if you put it toward a gym membership or a stack of weights.
For more information on testosterone treatments, try the following links.
- Testosterone Treatments and Prostate Cancer
- Turning Back Your Clock: Our Male Anti-aging Strategy
- Practical Advice on Improving Male Sexual Health
Healthy aging is a paradox. On the one hand, we all strive for longer, healthier lives. On the other hand, we accept that age brings along physical, hormonal, and cognitive changes that are not bad in themselves. Instead of jumping on the bandwagons of the most recently invented medical conditions and their treatments, we at XY Wellness advocate healthy living through simple daily practices: diet, exercise, and natural supplementation. We endeavor both to delay and to celebrate the markers of age-related change as we live healthy lives from now until the end.
Di Blasio, A., Izzicupo, P., Tacconi, L., Di Santo, S., Leogrande, M., Bucci, I., . . . Napolitano, G. (2014). Acute and delayed effects of high-intensity interval resistance training organization on cortisol and testosterone production. J Sports Med Phys Fitness.
Feldman HA, Longcope C, Derby CA, et al. 2002. Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts male aging study. J Clin Endocrinol Metab, 87:589–98.
Grech, A., Breck, J., & Heidelbaugh, J. (2014). Adverse effects of testosterone replacement therapy: an update on the evidence and controversy. Ther Adv Drug Saf, 5(5), 190-200. doi: 10.1177/2042098614548680
Harman SM, Metter EJ, Tobin JD, et al. 2001. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab, 86:724–31.
Pines, A. (2011). Male menopause: is it a real clinical syndrome? Climacteric, 14(1), 15-17. doi: 10.3109/13697137.2010.507442