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Testosterone Therapy

By K.S. Mitchell
Posted On Dec 03, 2010

Words: J.P. Faber

For men—and increasingly for women—testosterone replacement therapy promises a host of benefits

I don’t believe you can live forever,” says Andre Berger, MD, a cosmetic surgeon and anti-aging physician in Beverly Hills. “That’s not what anti-aging is all about. What it’s about is living at an optimal level of health for the length of your years. And that means remaining vigorous and never becoming frail, which is the beginning of the end for most elderly people.”

Fortunately, how to avoid frailty and remain vigorous is fairly simple, says Dr. Berger. “I have found that most frailty is preventable and easy to treat with exercise, diet and hormone replacement, primarily testosterone.”

Testosterone. It immediately brings to mind the male libido, and with it connotations of aggression, sex drive and the male testes, or the “gonads.” Indeed, testosterone was first used to treat hypogonadism (decreased functionality in male testicles). After that it got a bad rap because body builders used it as a steroid to create gigantic biceps.

“We now know that testosterone is good for just about every cell in the body,” says Ron Rothenberg, MD, an anti-aging doctor who practices in San Diego, and who has been prescribing testosterone for hormone deficiencies since the late 1990s. “It isn’t just about sex and muscle.” It’s about restoring the levels of hormones that we enjoyed in our youth. After the age of 25 these hormones steadily decline. While this decline is “natural,” it’s also one of the main reasons we age.

Anti-aging doctors do not accept the fact that simply because it is normal or natural for our hormone levels to decline as we grow older that we should accept the situation. “This concept doesn’t make sense anymore,” says Dr. Rothenberg. “Just because something is normal for a 60-year-old doesn’t mean that is the way to go.” After all, should we accept heart disease as we age just because it is “normal” for the elderly to suffer more cardiovascular illness than the young?

When it comes to replacing the hormones we lose as we age, none may be more significant than testosterone. It plays a huge role in both male and female bodies. When our testosterone levels decline, we experience everything from low energy, memory loss, depression and reduced muscle mass, to brittle bones, low sex drive and obesity.

Michael Carter, MD, a cosmetic surgeon in Atlanta who practices bio-identical hormone replacement therapy, (a fancy way of saying that our hormones should be replaced with something identical to what the human body produces) prescribes testosterone because of its role in weight gain. While most of his patients see him for liposuction and fat transfer, he recommends hormone balancing and high-quality natural supplements that help the body produce more of the critical protein.

“For both women and men in their 40s, their hormonal milieu is being challenged, and that leads them to store more fat,” he says, which he counters with hormone replacements. Dr. Carter also sites research that indicates a decrease in cardiovascular risk as testosterone levels return to youthful levels.

Indeed, rather than merely restoring our libido as we grow older, maintaining basic levels of testosterone may be essential for many physiologic functions. Doctors now know that low testosterone is associated with a host of symptoms and illnesses.

One study completed in 2007 showed that men with low levels of testosterone had a much greater chance of dying at a younger age—from all causes—than men with higher levels of testosterone. The study was conducted by the University of California’s San Diego School of Medicine, and funded by the National Institute of Aging (NIA); it tracked 800 men aged 50 to 91.

“We used to think testosterone was bad for the heart, because men had more heart attacks than pre-menopausal women, and they had more testosterone,” says Rothenberg. “Then there was the myth that testosterone caused cancer.”

Now, says Dr. Rothenberg, we realize that testosterone is something that keeps you alive, and that “the higher the testosterone the lower the mortality from everything, including cancers.” Other benefits include better cognitive function, better blood flow, lower blood pressure, a more potent sex drive, greater muscle mass and stronger bones.

Not everyone agrees that testosterone is without risk. Opponents of the use of testosterone site a recent NIA study called the TOM trial (testosterone in older men), during which 106 older men (average age 74) with mobility problems were given testosterone gel. The trial was halted when 23 of the men experienced “cardiovascular events” when their ability to walk and climb stairs was tested.

Proponents of testosterone feel the TOM study was flawed, including its use of geriatric men who had lost their mobility. Most anti-aging doctors, in fact, cannot understand why mainstream gerontologists don’t advocate basic hormonal therapy. “They think that you can be old and decrepit and frail, but the fact that your testosterone level is in the toilet is irrelevant,” says Dr. Berger. “There are studies now being funded by the NIA that are going to prove this concept [of hormone replacement therapy].”

Dr. Berger is referring to a $47 million study at the University of Pennsylvania School of Medicine that is following 800 low-testosterone men aged 65 and older to see if they benefit from a testosterone gel supplement. Called the “T-Trial,” the study is intended to produce conclusive research on the subject—though results are not expected for another six years.

In the meantime, thousands of anti-aging doctors will continue to use testosterone to turn back the aging clock—in men and women.

“Women suffer from testosterone level deficiencies as they get older as well,” says Tina Miranda, MD, a South Florida cosmetic and anti-aging doctor. Testosterone, she says, is broken down by the female body into estrogen. “It does all the same things (as with a man). It gives you stamina, muscle growth, mental focus; strengthens hair growth; makes your skin get tighter; and increases your hemoglobin. All things physical and mental are better.”