Although low testosterone’s previous nickname of ‘the male menopause’ has largely been abandoned – perhaps for fear of drawing comparisons to the much-derided ‘man flu’ – it seems to be true that testosterone declines with age. Will our testosterone go gentle into that good night regardless of what we do? And when is testosterone replacement therapy (TRT) justified?

Don’t we all have lower testosterone as we get older?

Here at the Wellman Clinic, we’ve spoken before of the varied benefits and functions of testosterone, from making men more fertile to the part it plays in our personalities.

Despite being a central influence in men’s day to day lives, it has been widely observed that testosterone declines in a roughly linear trajectory from the age of 30 onwards.For many men, this decline will be gradual enough that it won’t be cause for alarm – the average rate of decline is only around 1% each year. In fact, some studies have suggested that around 80% of men aged 60 have testosterone levels that still fall within the normal range for men from younger age groups.

However, it is also possible for testosterone levels to decline past the point that would be considered normal or preferable for your age. When testosterone reaches these low levels, it can have a detrimental impact on men’s general health and wellbeing – loss of libido, erectile dysfunction, depression and fatigue have all been observed among its symptoms.

So while the majority of us will see our testosterone levels decrease as we age, not all of us will experience it declining to the point where we are considered to have problematically low testosterone.

Why does testosterone decline with age?

The exact causes of testosterone decline are disputed, although evidence points toward a number of factors that can exacerbate the process and lead to low testosterone.

A wide range of underlying medical conditions, including osteoporosis, obesity and diabeteshave all been suggested as contributing factors to the excessive decline that causes low testosterone – as has a traumatic injury to the testicles (although we’d say any injury down there is pretty traumatic).

As well as these medical factors, the NHS lists a number of contributing lifestyle issues, including poor diet, excessive alcohol consumption and a lack of exercise – all the usual suspects of a generally unhealthy lifestyle.

In fact, interestingly, a report by The Endocrine Society suggested that all testosterone decline was a symptom, rather than the cause, of an overall deterioration in health as we get older – with low testosterone the most drastic outcome.

Should you consider testosterone replacement therapy?

For men feeling the bite of low testosterone, TRT has often proven to be of significant benefit. Among the outcomes that have been observed are improved sexual desire and function, increased bone density and muscle mass and improvements in mood and energy levels.

However, before you go signing on the dotted line for quick-fix injections or buy suspect pills from the internet, it’s important to realise that TRT should really only be prescribed by a qualified medical professional – and only for those with testosterone levels lower than the normal range for their age.

The difficulty in determining between a normal level of testosterone decline and a medically ‘low’ level makes it necessary to seek the advice of a qualified expert and receive a diagnosis, before settling on TRT as an option. You may find that your testosterone isn’t low enough for TRT to be necessary, and that addressing various other factors is recommended first – a healthier diet, a better exercise regime, or even increasing your Vitamin D intake, for example.

As the UK’s first dedicated private men’s health clinic in London, the Wellman Clinic offers tailored, confidential TRT screening procedures.

One of our experienced male doctors will take you through a full consultation, from a physical examination to a discussion of appropriate treatments. If they think that testosterone replacement therapy could be the right answer for you, treatment begin within hours.

If you’re looking for testosterone replacement therapy in London, please get touch to arrange a consultation.


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