Table of ContentsView AllTable of ContentsWhat Is HRT for Men?Low Hormone LevelsBenefits of HRT for MenRisks and Side EffectsPrecautionsAlternative ApproachesWhat the Research Says
Table of ContentsView All
View All
Table of Contents
What Is HRT for Men?
Low Hormone Levels
Benefits of HRT for Men
Risks and Side Effects
Precautions
Alternative Approaches
What the Research Says
The use of HRT in males has tripled in the United States in recent years.Common reasons males undergo HRT include an age-related decline in testosterone, certain medical conditions, and symptoms that can be improved with HRT.
The following article covers HRT for men, its effects, benefits, and safety considerations.
A Note on Gender and Sex Terminology,Verywell Health acknowledges thatsex and genderare related concepts but differ. To accurately reflect our sources, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
A Note on Gender and Sex Terminology,
Verywell Health acknowledges thatsex and genderare related concepts but differ. To accurately reflect our sources, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
HRT for males is also known astestosterone replacement therapy (TRT).
The Food and Drug Administration (FDA) approves it for only one condition: males diagnosed with hypogonadism.Hypogonadism in males can be defined as total testosterone levels of less than 300 nanograms per deciliter (ng/dL) of blood plus at least one symptom associated withlow testosterone.
However, HRT is often marketed and prescribed for a broader range of off-label (not FDA-approved) uses. Research shows that much of the dramatic increase in testosterone prescriptions is due to these off-label uses.
Testosterone is available in various delivery methods, including these prescription products:
All of these formulations are effective in bringing testosterone levels to a standard range and treating symptoms associated with low testosterone.The choice of which one to use will likely come down to factors like cost, how well someone tolerates the treatment, insurance approval, and convenience.
Some testosterone products are specially formulated with a prescription at compounding pharmacies. These products are sometimes called “bioidentical” or “natural” hormones. It’s essential to remember that these compounded hormones are not FDA-approved, meaning they’ve not been studied for safety or effectiveness.
Testosterone therapy is sometimes used during gender transitioning to help a person develop male sex characteristics and suppress female ones. When used in this way, many of testosterone’s effects on the body are permanent.
A male taking his medicine at home.andreswd / Getty Images
andreswd / Getty Images
What Happens When Men Have Low Hormone Levels?
As the primary male sex hormone, testosterone is involved in the development of male sex characteristics (think muscle strength and deeper voices),spermproduction, and fertility.
Testosterone also plays a vital role in the following processes in the body:
Signs and symptoms of a hormonal balance in men are often nonspecific. This could also be due to other health conditions, lifestyle factors, or the aging process in general.
Some signs of low testosterone include:
Keep in mind that while some males with low testosterone will experience symptoms, others will have no symptoms at all.
HRT for males is sometimes promoted as a cure-all or a fountain of youth.
Potential benefits of HRT (testosterone) for males include:
HRT may reduce the risk of osteoporosis and heart disease in men, but more research is needed.
TRT is likely helpful in increasing bone strength for males with testosterone deficiency who already haveosteopenia(a precursor to osteoporosis) orosteoporosis. However, it does not seem to help prevent these conditions orfractures.
While testosterone deficiency is associated with cardiac complications likecongestive heart failure (CHF)andcoronary artery disease (CAD), more research is needed to determine whether TRT lowers these risks.In particular, the long-term effects of testosterone on the heart are not known at this time.
Potential risks associated with testosterone include:
A personalized risk assessment with a healthcare provider is essential to help you decide if HRT is right for you.
If you begin HRT, your testosterone levels will be checked shortly after you start treatment. The timeline depends on which formulation you use. For example, hormone levels may be checked eight hours after applying a testosterone gel to the skin or before your second injection if you use an intramuscular product.
Regardless of which testosterone product you use, expect to see your healthcare provider for monitoring within three to six months of starting treatment and then yearly afterward. Your healthcare provider will typically monitor testosterone levels,hematocrit(red blood cells in proportion to total blood volume), and any side effects you’re experiencing at these checks.
Depending on your age and family history, your risk of prostate cancer may also be assessed using arectal examand yourprostate-specific antigen (PSA) levels.
Due to the risks associated with HRT for men, testosterone treatment should be stopped if there are no noticeable improvements.
HRT is not for everyone. Males with the following conditions should not take testosterone due to the risks of side effects of treatment:
Testosterone can interact with some medications and supplements. A few examples are:
For optimal safety, discuss your medication list with your healthcare provider or pharmacist before starting HRT to rule out any significant drug or supplement interactions.
Before supplementing with testosterone, it’s best to manage underlying health conditions that can affect your hormone levels. Conditions like the following can decrease testosterone levels:
Alternative therapies and lifestyle modifications that may be used with or instead of HRT include:
Though it may be tempting to try to balance your hormones yourself, it’s best to involve a healthcare provider, particularly if you are considering medications or supplements. A healthcare provider can rule out other health conditions, screen for drug interactions, monitor how well treatments are working, and manage any side effects you may have.
Clinical trials of testosterone have had conflicting results.
HRT is most effective for improving libido and erectile function in males with diagnosed testosterone deficiency.But the effects may be minor. A review of 38 clinical trials concluded that testosterone treatment can modestly improve sexual function.
It has also not been shown to be effective for weight loss or boosting metabolism.
Since the risks of TRT are higher for older males than younger ones, some research suggests only using it in males over age 60 who have severely low levels of the hormone.The risks likely outweigh the benefits for older males with only slightly low testosterone levels.
Keep in mind that there’s very little data on the long-term effects of using testosterone (beyond a year).More research is needed to know if it is safe or not.
Summary
Males who plan to have children, those with a history of prostate cancer, and those with recent heart complications should typically not use HRT. If you decide to use it, be prepared for your healthcare provider to monitor your hormone levels and symptoms over time for optimal safety.
21 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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