Most people have heard of menopause and know that women experience it as they age. But did you know that men also go through a process during which they lose hormones? Let’s take a look at testosterone replacement therapy.

Sometimes called andropause, the process in men isn’t as swift; these changes take place gradually. This hormone loss can cause some side effects, which is why many more men are asking about testosterone replacement therapy. But TRT is not for everyone.

The Effects of Testosterone Changes

Men begin to lose testosterone at a rate of about 1 percent a year starting at age 40. The changes in their reproductive system occur mainly in the testes. The mass of testicular tissue decreases; the levels of testosterone may remain the same or decrease gradually. The testes continue to produce sperm, but at a slower rate, and the tubes that that carry sperm may become more elastic. While some men experience problems with erectile function, men are often still able to father children even into old age.

These changes also affect urinary function. About 50 percent of men experience an enlarged prostate as some of that tissue is replaced with scar-like tissue. This can cause problems with slowed urination and ejaculation.

Reduced testosterone can also cause:

  • changes in sleep patterns
  • emotional changes, such as low self-confidence or lack of motivation
  • physical changes, like increased body fat, reduced muscle bulk and strength, and decreased bone density
  • reduced sexual desire, or low libido
  • fewer spontaneous erections
  • impotence (erectile dysfunction)
  • infertility

Testosterone Replacement Therapy

TRT is also known as Androgen replacement therapy (ART) and involves the prescription of testosterone either by injections, patches, or skin creams. (There is a pill form, but it poses hazards to the liver.) This therapy is often prescribed to those with hypogonadism, a condition in which the body doesn’t produce enough testosterone. Many men who try TRT report improvements in energy levels, sex drive, quality of erections, and have been shown to have higher bone density and muscle mass.

The Problems with TRT

Some men are asking for testosterone to counteract some of the unpleasant side effects of normal hormone loss. On their own, low testosterone levels caused by aging do not need treatment and TRT is not recommended for this use. TRT can have side effects, and the long-term risks aren’t fully known yet because there have not been any large extended studies on its use. Experts studying this approach have concerns that such therapy might stimulate the growth of prostate cancer cells. TRT can worsen sleep apnea, cause blood clots, and congestive heart failure. Some men experience increased breast size, decreased testicular size, mood swings, or acne. However, others argue more research is needed before dismissing TRT as an aid.

Cost is another factor when considering TRT. Testosterone injections are the least expensive option, but they still cost between $150 and $400 per month and must be administered by your doctor every few weeks. Patches, gels, creams, and similar methods often cost between $200 and $500 per month.


If you are experiencing the side effects of decreased testosterone, speak to your Generations Family Practice doctor. He or she can perform tests to confirm whether your testosterone changes are due to aging or another cause and determine the best approach, whether it’s TRT or other hormone therapies.

Contact us to learn more.