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 healthcare professionals think about starting testosterone treatment in men with sexual dysfunction who wanted 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 symptoms related to low testosterone.

Some experts also recommend offering testosterone treatment to men with age-related low testosterone who have no symptoms.

If you choose to start testosterone therapy, your healthcare professional talks with you about the different ways you can take it. You may also talk about target levels and the need for follow-up testing.

For some men, testosterone therapy eases bothersome symptoms of low testosterone. For others, the benefits aren't clear. There are possible risks, too.

Though more research is needed, testosterone therapy might raise the risk of prostate and breast cancer. Testosterone therapy also has been linked to blood clots in the veins. It also may raise the risk of heart attack and stroke, but more research is needed.

Your healthcare professional may tell you not to start testosterone therapy if your fertility is likely to be important in the near future. Other reasons your healthcare professional may recommend against testosterone therapy include:

• History of breast or prostate cancer.
• Untreated severe obstructive sleep apnea.
• Uncontrolled heart failure, which lowers the heart's ability to pump blood.
• History of blood clots in the legs or lungs.
• Recent heart attack or stroke.

If you think you might have low testosterone, talk with your healthcare professional about your symptoms, testing and possible treatments. Your healthcare professional can help you weigh the pros and cons of treatment.