Decisions about testosterone therapy can be tricky

Q. Will taking testosterone bring back the virility of my youth?

The subject of testosterone is fuzzy, so it’s difficult to give a simple answer to this question.

There is some controversy about whether testosterone therapy should be used in men who have naturally lower testosterone levels because of aging. It remains unclear whether restoring earlier testosterone levels benefits older men.

For example, studies found that healthy men who took testosterone medications got bigger muscles, but in most studies the men weren’t stronger. And, if you suffer from erectile dysfunction, taking testosterone may not relieve your condition.

Testosterone is a hormone produced by the testicles. It is responsible for male sexual characteristics and function. Testosterone is also important for maintaining muscle, red blood cells, bone, and a sense of well-being. In females, the ovaries produce testosterone, but at significantly lower levels than are found in men.

For most men, testosterone levels decline modestly as we age. The testosterone level in the male body peaks during adolescence and begins to decrease between the ages of 30 and 40. The significance of this decline is controversial and poorly understood.

There have been studies that show low testosterone levels can impair sexual function, diminish bone density, reduce muscle mass and strength, increase fat, contribute to memory loss and lead to depression.

However, some men who have adequate levels of testosterone have these symptoms. Others with low levels of testosterone may not experience the symptoms. Very fuzzy.

Your doctor can prescribe a synthetic version of testosterone. Testosterone replacement medications may be necessary for men with extremely low levels of testosterone. These medications are delivered with injections, patches and gels.

Implantable testosterone pellets are a relatively new form of treatment. Several pellets are placed under the skin of the buttocks, where they release testosterone over the course of about three to four months.

Not enough study has been done to determine the risks of testosterone therapy in men with normal testosterone levels.

The potential benefits of this therapy are: more muscle and strength, increased bone mineral density, thicker body hair and skin, elevated sexual desire, more energy, less irritability and depression, and improved mental capacity.

The potential risks are: growth of existing prostate cancer, benign growth of prostate that can worsen urinary problems, sleep apnea that makes you start and stop breathing as you sleep, reduced sperm production, fluid retention, baldness, skin reactions, enlarged breasts, testicle shrinkage, acne, and excess blood production that can increase your risk of heart disease.

The only accurate way to determine if you have a testosterone deficiency is to have a blood test. It  can take several measurements because testosterone levels fluctuate throughout the day. The highest levels of testosterone are generally in the morning. This is why doctors prefer, if possible, to obtain early morning levels of testosterone.

Normal testosterone levels for males are between 300 and 800 nanograms per deciliter (ng/dL). For females, the range is 15 to 70 ng/dL.