Treatments purporting to offer "male rejuvenation" and combat the effects of aging have become popular in recent years, but such claims are not backed up by science, experts say.
Men seeking such treatments often receive testosterone, sometimes in combination with other hormones such as steroids and growth hormones. Advertisers claim the treatments increase strength and sex drive, and make patients feel younger.
However, studies examining the effects of these treatments are lacking, and there's little evidence to support their use in men who don't have hormone deficiencies, experts say.
"There's really no scientific evidence that they will help a man to function optimally, either in the sexual arena, or that they will have a effect on the general health and wellbeing of a man," said Dr. Eli Lizza, a urologist at Lenox Hill Hospital in New York.
Moreover, the treatments also have side effects that should be considered. For instance, testosterone treatments can temporarily decrease sperm count and impair fertility, experts said. Further, studies have suggested a possible link between the receiving the hormone and prostate cancer.
If you're looking for a way to lengthen lifespan and increase strength, some say you're better off sticking with the common sense advice to exercise more and eat better.
Exercise in the elderly has been shown to improve daily living and decrease muscle and bone loss, according to John Morley, a geriatrics specialist at Saint Louis University School of Medicine, who wrote a review article about the topic.
"Overall, exercise, adequate sunlight exposure [for Vitamin D], and adequate protein intake all appear more appropriate 'elixirs of youth' than hormone supplementation," Morley wrote in the May 10 issue of the journal Fertility and Sterility.
Levels of testosterone naturally decrease with age, but exactly what level constitutes "low T" or hypogonadism, is controversial, Lizza said. Testosterone levels vary wildly, and can even differ depending on the time of day they're measured (levels tend to be lower in the evenings.) Doctors typically to treat men for hypogonadism if they have symptoms of low testosterone and their levels are below 300 nanograms per deciliter.
In older men with true testosterone deficiencies, testosterone treatment has been shown to increase strength and sex drive, Morley said.
Sometimes, symptoms such as decreased energy and low sex drive are due to conditions such as depression. Treating these men with testosterone hormone won't improve symptoms, Lizza said.
And even in men with hypogonadism, Viagra is a better treatment than testosterone for help with difficulties maintaining erections, Lizza said.
Testosterone treatment is also known to lower sperm count — at one time, it was even considered as a male contraceptive, although it was not proven to be effective for this purpose. Studies suggest sperm count can sometimes be recovered, but not always, especially if men are also taking steroids, Lizza said.
Testosterone treatments should be avoided in men desiring future fertility, said Dr. Jared Moss, a urologist at the University of Tennessee Graduate School of Medicine. Concerningly, a recent survey of urologists found that about 25 percent said they had prescribed testosterone to men with low T who were infertile. "That is completely counterproductive," Moss said.
The drug clomiphene (Clomid) is the safest therapy doctors have to increase testosterone levels while preserving fertility, Moss said.
Other hormones and supplements
Levels of the hormone dehydroepiandrosterone (DHEA) also decline with age, but there's not enough evidence to say that taking DHEA supplements has any effect on aging. A 2003 study looking at the effect of DHEA supplementation in people ages 60 to 80 found no effect on muscle mass and strength over a year. Because the supplement may increase the risk of hormone-related cancers, such as prostate, breast and ovarian cancer, it is not recommended for regular use without supervision from a doctor, according to the Mayo Clinic.
There's also not enough evidence to show that growth hormone treatments are beneficial for older people, Morley said, and there's no proof that they help with sperm count.
Because many older people are deficient in vitamin D, it may be prudent for them to take a vitamin D supplement (up to 1000 international units a day), Morley said.
Pass it on: There's little evidence to support hormone therapies men who don't have hormone deficiencies, and testosterone treatments can impair fertility.
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