Treatment recommendations for older men with low testosterone

Recommendations on testosterone therapy for men with age-related low testosterone vary. In 2020, the American College of Physicians recommended that doctors consider starting testosterone treatment in men with sexual dysfunction who want to improve their sexual function, after explaining the risks and benefits. In 2018, the Endocrine Society recommended testosterone therapy for men with age-related low testosterone who have signs and symptoms associated with low testosterone.

Some experts also recommend offering testosterone treatment to men with age-related low testosterone without the presence of signs or symptoms.

If you choose to start testosterone therapy, your doctor will explain the different ways testosterone can be administered, target levels and follow-up testing.

For some men, testosterone therapy relieves bothersome signs and symptoms of testosterone deficiency. For others, the benefits aren't clear and there are possible risks.

Though further research is needed, testosterone therapy might stimulate growth of metastatic prostate and breast cancer. Testosterone therapy may also increase the risk of heart attack and stroke and contribute to the formation of blood clots in the veins.

Your doctor will likely recommend against starting testosterone therapy if your fertility is important in the near future or if you have conditions such as breast or prostate cancer, untreated severe obstructive sleep apnea, uncontrolled heart failure or thrombophilia, or if you've recently had a heart attack or stroke.

If you think you might have low testosterone, talk to your doctor about your signs and symptoms, testing, and possible treatment options. Your doctor can help you weigh the pros and cons of treatment.