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November 14, 2011

Male Hormone Replacement Therapy and Its Benefits and Risks

male hormone replacement therapy
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Male Replacement Therapy for the Male Menopause

Men are not exempt from the toll of aging. They too have their own version of menopause, called andropause, which occurs usually between the ages of 40 to 55. Men do not receive any explicit warning that they have crossed the threshold of andropause, unlike women who are alerted by the stoppage of their monthly periods that they just entered the menopausal stage.

In both andropause and menopause, the man or woman experiences a decline in levels of testosterone and estrogen, respectively. Men gradually experience physical changes that could occur with mood swings, fatigue, decrease in muscle mass and strength, a loss of energy, libido and physical agility, increased upper and central body fat, and increased cardiovascular and metabolic risks. To help the old man cope with these symptoms, male hormone replacement therapy may be prescribed. Let us take a look at some of the pros and cons of the treatment to find out.

Male Hormone Replacement Therapy: The Good

Helps Old Blokes To Muscle Up. Male replacement therapy has been shown in 12 placebo-controlled trials to help shed off some fat and make a man leaner.

Revs Up Sexual Drive. Since testosterone performs an important part in libido, it is not surprising for male hormone replacement therapy to show efficacy in making old men get randy again, as shown in some studies.   Male HRT can be effective in treating erectile dysfunction in some men.  One downside – some men do develop testicular shrinkage and lower sperm counts on testosterone, but these can be managed by use of another hormone called human chorionic gonadotropin.

Reduces Risk for Metabolic Syndrome. Research, done by Bayer Schering Pharma, a pharmaceutical company that manufactures testosterone products, show that male HRT can decrease the risk factors for metabolic syndrome, such as stroke, heart disease, and type 2 diabetes.

Male Hormone Replacement Therapy: The Bad (really myths)

Heart Attacks and Other Cardiovascular Problems. Although this has been one of the major concerns, research has allayed this worry especially since it has been shown that what may contribute to cardiovascular risks like diabetes is low, not high, testosterone. On the contrary, some clinical studies have shown testosterone to dilate coronary arteries and could potentially help angina. While there is an increase the risk for blood clot and liver problems with oral testosterone this is not the case with injectable or transdermal preparations.  Oral testosterone is rarely if ever used in male hormone replacement therapy.

Prostate Cancer. This is potential side effect has unfortunately dampened the interest of men to take male hormone therapy. However, it is now accepted that testosterone does not cause prostate cancer.  On the contrary, it is believed that in men with naturally high levels, testosterone could impede prostate cancer. However, in men with prostate cancer, the hormone may just feed the cancerous cells to help them develop. Roughly 5 in 10 men more than 50 years of age have cancer cells in their prostate that do not show any manifestations or not do any harm. The fear is that, at least in theory, testosterone supplementation may stir these cells and make them cancerous. Hence. it is essential that any man receiving testosterone replacement be closely managed by a knowledgeable physician to monitor for this type of risk.

Overall, male hormone replacement therapy is safe and efficacious.  The challenge is finding a physician trained in male hormone replacement therapy.

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Dr. Joe Jacko


Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio at Grandview Primary Care. Read more about Dr. Joe Jacko

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