Effects of low testosterone in males over 50

Considering testosterone therapy to help you feel younger and more vigorous as you age? Know the risks before you decide.

By Mayo Clinic Staff

As you age, testosterone therapy might sound promising. But there are a lot of misconceptions about what the treatment can and can't do for you.

Testosterone therapy might seem like the ultimate anti-aging formula. Yet the health benefits of testosterone therapy for age-related decline in testosterone aren't clear.

Find out what's known — and not known — about testosterone therapy for normal aging.

What is testosterone?

The influence of testosterone in men

Testosterone is a hormone produced primarily in the testicles. Testosterone helps maintain men's:

  • Bone density
  • Fat distribution
  • Muscle strength and mass
  • Facial and body hair
  • Red blood cell production
  • Sex drive
  • Sperm production

What happens to testosterone levels with age?

Testosterone levels generally peak during adolescence and early adulthood. As you age, your testosterone level gradually declines — typically about 1% a year after age 30 or 40. For older men, it's important to determine if a low testosterone level is due to normal aging or if it is due to a disease (hypogonadism).

Hypogonadism hampers the ability to produce normal amounts of testosterone due to a problem with the testicles or with the pituitary gland that controls the testicles. Testosterone replacement therapy, in the form of injections, pellets, patches or gels, can improve the signs and symptoms of low testosterone in these men.

Does a naturally declining testosterone level cause the signs and symptoms of aging?

Not necessarily. Men can have many signs and symptoms as they age. Some that might occur as a result of lower testosterone levels can include:

  • Changes in sexual function. This might include reduced sexual desire, fewer spontaneous erections — such as during sleep — and infertility.
  • Physical changes. Various physical changes are possible, including increased body fat, reduced muscle bulk and strength, and decreased bone density. Swollen or tender breasts (gynecomastia) and body hair loss are possible. You might have less energy than you used to.
  • Emotional changes. Low testosterone can contribute to a decrease in motivation or self-confidence. You might feel sad or depressed, or have trouble concentrating or remembering things.

Some of these signs and symptoms can be caused by other factors, including medication side effects, obstructive sleep apnea, thyroid problems, diabetes and depression. It's also possible that these conditions cause low testosterone levels, so treatment might result in increase of testosterone levels.

A blood test is used to diagnose a low testosterone level.

Can testosterone therapy promote youth and vitality?

Testosterone therapy can help reverse the effects of hypogonadism, but it's unclear whether testosterone therapy would benefit older men who are otherwise healthy.

Although some men believe they feel younger and more vigorous if they take testosterone medications, there's little evidence to support the use of testosterone in otherwise healthy men. Guidelines from the American College of Physicians indicate that testosterone therapy might improve sexual function somewhat in some men, but there's little evidence that it improves other functions, such as vitality and energy.

What are the risks of testosterone therapy for normal aging?

Testosterone therapy has various risks, including:

  • Worsening sleep apnea — a potentially serious sleep disorder in which breathing repeatedly stops and starts.
  • Causing acne or other skin reactions.
  • Stimulating noncancerous growth of the prostate (benign prostatic hyperplasia) and growth of existing prostate cancer.
  • Enlarging breasts.
  • Limiting sperm production or causing testicles to shrink.
  • Stimulating too much red blood cell production, which contributes to the increased risk of forming a blood clot. A clot could break loose, travel through your bloodstream and lodge in your lungs, blocking blood flow (pulmonary embolism).

Also, some research shows that testosterone therapy can increase your risk of heart disease. More research is needed.

Should you talk to your doctor about testosterone therapy?

If you wonder whether testosterone therapy might be right for you, talk with your doctor about the risks and benefits. Your doctor will likely measure your testosterone levels at least twice before recommending testosterone therapy.

Treating normal aging with testosterone therapy is not advisable. If you don't have a medical condition that's contributing to your decline in testosterone levels, your doctor might suggest natural ways to boost testosterone, such as losing weight and increasing muscle mass through resistance exercise.

From Mayo Clinic to your inbox

Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

April 20, 2022

  1. Qaseem A, et al. Testosterone treatment in adult men with age-related low testosterone: A clinical guideline from the American College of Physicians. Annals of Internal Medicine. 2020; doi:10.7326/M19-0882.
  2. AskMayoExpert. Male hypogonadism (adult). Mayo Clinic; 2020.
  3. Gilbert K, et al. Gaps in patient knowledge about risks and benefits of testosterone replacement therapy. Urology. 2017; doi:10.1016/j.urology.2016.12.066.
  4. Synder PJ. Approach to older men with low testosterone. https://www.uptodate.com/contents/search. Accessed Feb. 18, 2020.
  5. What is low testosterone? Urology Care Foundation. https://www.urologyhealth.org/urologic-conditions/low-testosterone. Accessed Feb. 20, 2020.
  6. Snyder PJ, et al. Lessons from the testosterone trials. Endocrine Reviews. 2018; doi:10.1210/er.2017-00234.

See more In-depth

See also

  1. Pre-ejaculation fluid and pregnancy
  2. Birth control options
  3. Discolored semen: What does it mean?
  4. Erectile dysfunction and diabetes
  5. Frequent sex: Does it protect against prostate cancer?
  6. Health issues for gay men
  7. Healthy sperm: Improving your fertility
  8. Loss of sex drive in men: Natural with aging?
  9. Male masturbation: Does frequency affect male fertility?
  10. Penis fracture
  11. Penis health
  12. Penis enlargement
  13. Prostatitis and sex
  14. Psoriasis and intimacy
  15. Yeast infection in men: How can I tell if I have one?

.

What happens to a man when his testosterone is low?

Reduced erectile function. Loss of body hair. Less beard growth. Loss of lean muscle mass.

What are the symptoms of low testosterone in men over 50?

What are the symptoms of low testosterone?.
Reduced sex drive..
Erectile dysfunction..
Loss of armpit and pubic hair..
Shrinking testicles..
Hot flashes..
Low or zero sperm count (azoospermia), which causes male infertility..

What happens if low testosterone goes untreated?

Living with a testosterone deficiency long-term will increase your likelihood of developing age-related diseases, including osteoporosis and heart disease, among others.

Do men need testosterone after 50?

Most older men don't need testosterone replacement, new guidelines say. (Reuters Health) - Older men whose testosterone levels have dropped over the years should only be given testosterone replacement to treat sexual dysfunction, according to new guidelines from the American College of Physicians released on Monday.