Men in search of improved energy and memory aren’t going to find it in testosterone treatment, which should be used in older men just for sexual dysfunction, according to researchers, as well as a new guideline published Monday. The only scientifically proven use for the hormone in older men with age-related low testosterone levels is for impotence, based on a brand new recommendation from the American College of Physicians published in the Annals of Internal Medicine.

The new recommendation was decided after researchers reviewed 38 randomized controlled testosterone treatment trials, which ranged from 10 to 798 male participants from the U.S., Europe, Asia, and Australia between 1997 and 2018. The studies tracked men from less than twelve months up to three years. Twenty-four of the studies reported a minimum of partial industry sponsorship. In the studies, men got testosterone via intramuscular shots or through the skin by using a hormone patch or gel. That analysis was published Monday, in addition to the new guideline.
Countless men seek a quick health fix with testosterone replacement, both from prescriptions and over-the-counter supplements. The brand new analysis showed that there isn’t any evidence that long-term testosterone supplementation improves — or damages — health, said Dr. Robert McLean, president of the APA as well as a rheumatologist at Yale-New Haven Health’s Northeast Medical Group. The only benefit is short-term treatment for men with sexuality.

Other issues, such as “general vitality and cognition might not be symptoms that improve with testosterone replacement,” McLean said. There’s nothing in the data. He added, “that suggests that testosterone is a fountain of youth.” And also that means, doctors shouldn’t even bother to check testosterone levels unless their older male patient “says my libido is in the tank,” McLean said. The brand new recommendation applies only to men in their 60s who ‘ve been clinically recognized as having a decline in testosterone. In this scenario, testosterone levels might be tested. Also, if they are low, “I can say, ‘If I give you a little extra testosterone, it will encourage your libido and sexual functioning,'” McLean said.
Younger men, those within their 30s, 40s, and 50s, don’t usually have low testosterone unless they have an uncommon medical condition — or if they have specific lifestyle issues, said Dr. Harry Fisch, a professor of urology and reproductive medicine at Weill Cornell Medical College.Based on Fisch, men can experience drops in testosterone levels if they:

• Overexercise.
• Don’t get enough sleep. Sleep is when the human body generates testosterone.
• Are overweight. Fat cells can cause testosterone to show into estrogen.
• Use marijuana frequently. Marijuana affects men’s estrogen levels, which happens to be linked to impotence and infertility.

The answer would be to make changes in lifestyle instead of to add testosterone because supplementation can ruin fertility, Fisch said.

“In young men, a side dish effect of testosterone replacement is low challenges with sperm,” he added. “And of course, the longer you’re on testosterone, the better problems you would likely have getting the sperm back.”

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