In recent years, the effects of testosterone replacement therapy (TRT) have been widely debated. Since the early 2000’s, TRT has been used to treat men, generally over 40 years of age, who produce low levels of testosterone. It has become extremely popular as an all-encompassing antidote for symptoms including low energy and low libido. While TRT seems to be a cure-all that promotes bone-health and aids in diabetes prevention, skeptics are challenging its safety. A recent study reveals that TRT use may pose an increased risk for cardiovascular disease in men over 65 and younger men with a history of heart issues. In 2014, the Food and Drug Administration announced plans to reassess the risk factors and safety of testosterone treatments, including stroke and heart attack potential. If you or a loved one has been affected by testosterone replacement therapy, understanding the
potential risks is vital for health and legal purposes.
What is Testosterone Replacement Therapy?
Called hypogonadism, low testosterone occurs when the natural decrease of the hormone dips lower than normal. Symptoms of an abnormally low level of testosterone are commonly mistaken for those of natural aging. These include fatigue, loss of muscle mass, low libido with difficulty achieving an erection, hair loss, an increase in body fat, decreased bone mass, and mood changes. Testosterone is administered as an injection, patch, lozenge, or gel.
Increased Use and Questionable Prescribing of TRT
The use of testosterone replacement therapy has increased extensively since it was first marketed. The number of men age 40 and over prescribed some form of the hormone quadrupled between 2001 and 2011. In the U.S. approximately one in 25 men over 60 participate in the treatment. Despite indicated use for men with low testosterone levels, physicians have become increasingly comfortable prescribing it to men with borderline or normal levels of testosterone. However, because the long term effects have not been established, some medical professionals are concerned.
TRT Risks and Re-evaluation
In 2010, the New England Journal of Medicine reported that a clinical trial involving TRT in men over 65 was interrupted after a dangerous increase in heart attacks and other health issues among participants. The same researchers subsequently examined approximately 48,000 medical records of men under 65 and an additional 8,000 over 65 taking TRT. They found that risk for heart attack or other issues doubled during the first 90 days for both age groups. The belief is that the presence of extra testosterone in the blood promotes clotting, a dangerous event for older men with thinly-walled blood vessels. The report triggered renewed interest by the Food and Drug Administration, who is now focusing on re-evaluating the safety of TRT.