Testosterone Therapy and Estrogen: Side effect or benefit? by Jerry Brainum

 

 

 

To say that the prescribing and administration of testosterone is mired in controversy would hardly be an exaggeration. The prescribing of testosterone to men with alleged "Low T syndrome," has skyrocketed in recent years, and the greater numbers of men using this hormone raise a number of questions related to the safety of being on a long-term testosterone therapy program. One of the primary controversies related to testosterone replacement therapy (TRT) is whether a man should be on it or not. Many physicians note that testosterone levels drop with age, about 1.6 to 2 percent per year starting at about age 40 although it can also proceed earlier in some men. These conservative physicians say that this drop is entirely normal, and may even serve a protective function by helping to prevent prostate cancer. What they overlook, however, is the symptoms that may occur with low testosterone levels (low T). These include loss of muscle mass; an increase of body fat, especially in the midsection area; loss of sex drive or libido; erectile dysfunction; depression; acceleration of insulin insensitivity and diabetes; lack of energy, and other symptoms. In short, the quality of life declines when testosterone (T) levels drop too low. Even that is a point of controversy, since the precise level at which a man is considered hypogonadal or low T varies with lab tests and physicians' opinions. Some researchers suggest that low T is a case of putting the proverbial cart before the horse in the sense that many men show Low T levels because of other health problems that cause the low T, rather than the other way around--that having low T is the cause of the primary symptoms. This is possible in many cases. Indeed, many men who are obese and start an exercise and diet program, and who are also showing low T levels, often show normal levels shortly after they lose a significant amount of body fat and improve their overall health measures. Still, there's no getting away from the fact that all men show drops in testosterone production with age, and about half of them show drops significant enough to cause the symptoms linked to having low T.

In those cases, it would seem a no-brainer that a man who is clearly showing a reduced quality of life should be on a TRT regime. But many doctors stubbornly resist this notion. Their recalcitrant attitude stems from things they were taught in medical school, along with some recent questionable studies related to the safety of TRT. One thing they were taught was that testosterone causes prostate cancer. Yet, few physicians ever bother to check the source of this statement. If they did, they would find that it was based on a case study of a single patient reported back in 1941. There were several attenuating circumstances associated with that particular patient that doesn't apply to most . . .