Testosterone replacement therapy (TRT) remains controversial, despite its increasing popularity among men. Several issues are involved in this controversy about the hormone. For one, many physicians feel that the decline of testosterone levels in men that starts at about age 40 is a common manifestation of aging. As such, they feel that as the saying goes, "It's best not to fool with Mother Nature." What this means in a practical sense is that these physicians think that testosterone drops with age for a reason. Some even speculate that the decline in testosterone with age is a protective mechanism of the body. They use the same logic for growth hormone declines with aging. The protection comes in the form of defense against cancer. The risk of cancer increases with age in that the majority of cases of various types of cancer exist in older people. This occurs because with age cells become less efficient at self-repair and mistakes are made at the molecular level of cells that result in cellular mutations that lead to cancer. The hormones, such as testosterone and growth hormone, as well as estrogen, come into play because they stimulate the growth and turnover of cells. With cancer, the growth and turnover of cells become unregulated, and the fear is that since these hormones promote growth they will accelerate the deadly progress of cancer. According to some scientists, the body evolved to lower the release of these various growth hormones with age to protect against cancer. This, however, is specious logic since in recent years the genesis of cancer has been investigated and it's now known that hormones, with the exception of estrogen, have little to do with the progression or cause of cancer.
Looking at it from another perspective is what happens if you let nature take its course, as these doctors suggest, and do nothing to replace waning hormone levels. What happens here is a steady march towards decrepitude and a lower quality of life. In the case of testosterone, having a deficiency of the hormone means losing muscle mass; gaining body fat; increasing the risk of cardiovascular disease, the #1 killer; loss of bone mass; loss of sexual function and interest; increase in the risk of degenerative brain disease, such as Alzheimer's disease and more. For men engaged in exercise as a means of maintaining muscle mass with age, the decline of testosterone is particularly vexing. Without sufficient testosterone, it becomes more difficult to both build and maintain muscle mass. Many doctors don't seem to understand that many men do not want to look old and feeble and the notion that using hormonal therapy with testosterone can ameliorate such an appearance is attractive and alluring to these men. Indeed, in recent years the marketing of testosterone replacement therapy has reached unprecedented highs, despite the reluctance of many physicians to prescribe such therapy. The usual reason for such reluctance is fears of promoting prostate cancer . . .