Testosterone is a sex hormone produced both by men and women that play important roles in the body. In men, it’s known to regulate sex drive, fat distribution, bone mass, muscle mass and strength, and the production of red blood cells and sperm. As men age, the levels of testosterone produced decreases, which causes many health complications.
The hormone is now widely prescribed to men whose bodies naturally produce low levels. But the levels at which testosterone deficiency become medically relevant still aren’t well understood. Normal testosterone production varies widely in men, so it’s difficult to know what levels have medical significance.1
Insufficient testosterone, called hypogonadism, causes the androgen receptors throughout the body and brain to stay silent, resulting in symptoms such as low energy, weak erections, low sex drive, poor orgasms, inability to build muscle mass, or a gloomy feeling. So, to increase their testosterone levels, people often turn to testosterone replacement therapy (TRT), which is given as an injection, a gel, a suction cup on your gums, or even as a deodorant.
But, since TRT has shown to have both positive and negative effects, let’s find out what it does to our body and how our body reacts to it.
1. It Improves Your Mood
For people who are feeling down or depressed, a testosterone boost can be, quite literally, a shot in the arm. It is known to improve your mood and make you feel more energetic. But, high levels of testosterone can also have effects that may include changes in mood, often overlapping with symptoms of mood disorders.2
But, many patients report feeling better and more optimistic. One study found that after a year of testosterone therapy, the percentages of men with moderately severe to severe depression symptoms decreased from 17 percent to just 2 percent.3
2. It May Cause Swelling Of Your Feet And Ankles
Some men who have a limited cardiovascular capacity may experience swelling in their feet and ankles, as testosterone may cause the body retain excess fluid. Though scientists are aware that TRT can lead to a risk of water retention and/or edema, they are still unclear about the etiology of this association.4
It is thought that testosterone is anabolic and hence causes some nitrogen, sodium and water retention. Edema or swelling may be worsened in patients with pre-existing cardiac, renal, or hepatic disease.5
3. It Boosts Your Libido
Research shows that men with marked hypogonadism have a significant reduction in the frequency, amplitude, and rigidity of erections.6 Complaints such as erectile dysfunction and decreased libido are common among the older male population. Some recent studies have shown that testosterone therapy can help treat these problems in men with low testosterone levels.
One such study suggests that testosterone therapy improves mild erectile dysfunction, though it may be less effective in men with more severe erectile dysfunction. It has also shown consistent benefit in increasing the sex drive (libido) in men with low testosterone levels.7
4. It May Increase Cardiovascular Risk
A major downside of taking testosterone is the adverse effect it can have on your heart and brain health. Clinical concern over the health risks of TRT was heightened when a meta-analysis reported increased cardiovascular (CV) risk in men receiving TRT. Another recent study reported an increased risk of stroke, myocardial infarction, and all-cause mortality in hypogonadal men receiving TRT after angiography.
It also results in a 3-fold increase in the risk for polycythemia (an abnormally increased concentration of hemoglobin in the blood) and reduced HDL cholesterol, which increases the risk for CV and cerebrovascular events.8
5. It May Cause Enlargement Of Your Breast
Gynecomastia, a condition defined as benign proliferation of male breast glandular tissue, is often caused due to increased estrogen activity and decreased testosterone activity. It sometimes also occurs because of using numerous medications. Even many herbal supplements, particularly those containing phytoestrogen, may also cause gynecomastia.9
In all men, some testosterone is converted into a hormone called estradiol (a form of estrogen), which stimulates the growth of the breast tissue in men who already have more breast tissue naturally. However, this happens extremely rarely and stopping the treatment temporarily or including drugs that block the conversion of testosterone to estradiol can solve this problem.
6. It Can Change Your Skin Type
Another effect that testosterone has on your body, specifically your skin, is that it increases the secretion of oil. This can be both good or bad depending on your skin type. People with dull, scaly skin can suddenly experience smoother skin with improved complexion. But, those who already have oily skin or those with a history of acne may experience a sudden surge in the occurrence of acne or pimple outbreak.
7. It May Shrink Your Testicles
Another very common effect of taking testosterone is a considerable reduction in the size of your testicles. Testosterone replacement therapy makes it unnecessary for the pituitary gland to send signals to your testicles for the production of sperm and testosterone. This causes the testicles to remain inactive and since the size of your testicle is mainly dedicated to sperm production, a low production of sperm causes the testicles to shrink.
This may adversely affect your fertility and almost perform the role of birth control. So, TRT is not something for those who plan on having kids. Sadly, as some studies have demonstrated, the production of sperm may not return to its original capacity even after you stop the TRT.10
8. It Increases Your Energy Levels
Low testosterone levels are frequently associated with low energy levels and fatigue. Most patients who undergo TRT report an increased level of energy and reduction in the frequency of brain fog, which occurs due to low testosterone levels. Experts believe that it may have an effect on your mitochondria, which produce energy within your cells. Studies have shown that TRT has variable effects on mood, energy, and sense of well being.11
9. It Helps Build Muscles
One of the most prominent effects of taking testosterone is the visible increase in muscle mass, as muscles actively respond to testosterone. The androgen receptors found in muscle tissue is activated by testosterone, causing them to stimulate growth. So, many people take up strength training during this time to boost muscle growth.
Studies have shown that in addition to increasing muscle mass, testosterone also reduces fat mass.12 Another study also found that increased testosterone in older men also improves muscle protein anabolism and muscle strength.13
|↑1||Wein, Harrison. Understanding How Testosterone Affects Men. National Institutes of Health. 2013.|
|↑2||Johnson, Justin M., Lisa B. Nachtigall, and Theodore A. Stern. “The effect of testosterone levels on mood in men: a review.” Psychosomatics 54, no. 6 (2013): 509-514.|
|↑3||Khera, Mohit, Rajib K. Bhattacharya, Gary Blick, Harvey Kushner, Dat Nguyen, and Martin M. Miner. “The effect of testosterone supplementation on depression symptoms in hypogonadal men from the Testim Registry in the US (TRiUS).” The Aging Male 15, no. 1 (2012): 14-21.|
|↑4||Osterberg, E. Charles, Aaron M. Bernie, and Ranjith Ramasamy. “Risks of testosterone replacement therapy in men.” Indian journal of urology: IJU: journal of the Urological Society of India 30, no. 1 (2014): 2.|
|↑5, ↑11||Bassil, Nazem, Saad Alkaade, and John E. Morley. “The benefits and risks of testosterone replacement therapy: a review.” Therapeutics and clinical risk management 5 (2009): 427.|
|↑6||Rajfer, Jacob. “Relationship between testosterone and erectile dysfunction.” Reviews in urology 2, no. 2 (2000): 122.|
|↑7||Rizk, Paul J., Taylor P. Kohn, Alexander W. Pastuszak, and Mohit Khera. “Testosterone therapy improves erectile function and libido in hypogonadal men.” Current opinion in urology 27, no. 6 (2017): 511-515.|
|↑8||Jia, Huanguang, Charles T. Sullivan, Sean C. McCoy, Joshua F. Yarrow, Matthew Morrow, and Stephen E. Borst. “Review of health risks of low testosterone and testosterone administration.” World Journal of Clinical Cases: WJCC 3, no. 4 (2015): 338.|
|↑9||Johnson, Ruth E., and M. Hassan Murad. “Gynecomastia: pathophysiology, evaluation, and management.” In Mayo Clinic Proceedings, vol. 84, no. 11, pp. 1010-1015. Elsevier, 2009.|
|↑10||Kohn, Taylor P., Matthew R. Louis, Stephen M. Pickett, Mark C. Lindgren, Jaden R. Kohn, Alexander W. Pastuszak, and Larry I. Lipshultz. “Age and duration of testosterone therapy predict time to return of sperm count after human chorionic gonadotropin therapy.” Fertility and sterility 107, no. 2 (2017): 351-357.|
|↑12||Hackett, Geoffrey. “An update on the role of testosterone replacement therapy in the management of hypogonadism.” Therapeutic advances in urology 8, no. 2 (2016): 147-160.|
|↑13||Ferrando, Arny A., Melinda Sheffield-Moore, Catherine W. Yeckel, Charles Gilkison, Jie Jiang, Alison Achacosa, Steven A. Lieberman, Kevin Tipton, Robert R. Wolfe, and Randall J. Urban. “Testosterone administration to older men improves muscle function: molecular and physiological mechanisms.” American Journal of Physiology-Endocrinology and Metabolism 282, no. 3 (2002): E601-E607.|