Hormone replacement thereapy is becoming more and more common with men in the last few years. It is also a controversial topic in the medical community.

What is HRT for men?

HRT on men is simply replacing a deficiency in Testosterone levels, in order to get them back into the “normal” range. There is legitimate reasons why a man would need to do it. Sometimes low levels can be caused by an injury. Men’s testosterone levels also decline with age. As men’s testosterone levels wane, it has a term called andropause. Unlike menopause, andropause is slow and steady decline over many years. Diet, excercise and lifestyle can help comabat against this decline in your natural testosterone levels. It is estimated 20% of men over 60 have below the low normal range of testosterone.

Benefits of HRT Therapy:

HRT therapy is very beneficial in many things. Increasing testosterone levels back to normal has the following effects: normalize his energy, better sense of well being, increase libido, improve sleep, treat erectile dysfunction, increased lean mass, reduced fat, improved cardiovascular health, reduced risk against osteoporosis, and help combat depression. The lowering of visceral fat from HRT therapy leads to lower risk of chronic ailments associated with visceral fat. HRT also seems to help many men with low testosterone shrink their prostate. I and many others believe that one cause of prostate growth might be low testosterone and high estrogen ratio, so taking HRT to maintain healthy testosterone levels

Controversy with HRT for men:

Many doctors are cautious about giving testosterone replacement therapy to patients for fear of the possible health side effects of the heart and prostate. There is a belief that testosterone therapy might increase the risk of BPH (benign prostate hypertrophy) and Prostate cancer. Although there are questions to the validity of those risks, bodybuilders also use HRT as a legal way to get steroids, and together this has led doctors being cautious about giving testosterone therapy.

In January 2004 New England Journal of Medicine (NEJM) suggested caution before administering HRT therapy for men. A significant percentage of middle aged men may have “dormant” prostate cancer in it’s early stages. Prostate cancer is often slow growing and asymptomatic. Most men will eventually develop prostate cancer, if they were to live into their 70’s and 80’s. NEJM wrote in the article, that supplementing with testosterone, may cause these “hidden” cases of prostate cancer to develop into a more aggressive (clinically significant) cancer. This is why doctors check your PSA (prostate specific antigen) before administering a person to a HRT program. It allows them to assess prostate cancer risk.

This theory between testosterone levels and BPH and Prostate Cancer is highly questionable. I recently wrote a very in depth article on this blog about steroid use(testosterone is a steroid too) and the issues of prostate cancer and benign prostate hyperplasia(BPH) here. It will help give a better understanding of hormonal interactions of steroids and HRT on prostate health.

Permanent infertility is one side effect of HRT therapy that will effect all men. You will permanently lose your ability to produce testosterone naturally, once you stay on HRT for an extended period. This is because your testicles stop producing their own testosterone.

Application of HRT therapy:

HRT can be administered in injection, transdermal, implant, and oral form. Some doctors allow patients to inject themselves at home. Testosterone injections are not the best method for trying to mimic natural test production. The injections give a high dose immediately after injection, which then declines steadily over the next 2 or 3 weeks.