Testosterone therapy can be safe for men over 55 when it is properly prescribed and carefully monitored. Recent large clinical trials have shown that testosterone replacement therapy (TRT) does not increase the risk of major cardiovascular events in men with documented low testosterone levels and cardiovascular risk factors. This means that for men who truly have testosterone deficiency confirmed by symptoms and lab tests, TRT can be used without added heart risks compared to placebo. However, safety depends heavily on selecting the right candidates and ongoing medical supervision.
As men age, testosterone levels naturally decline, starting around their 30s and continuing gradually thereafter. By the time men reach their 50s and beyond, many experience symptoms related to low testosterone such as fatigue, reduced libido, mood changes, decreased muscle mass, and poor sleep. These symptoms can significantly affect quality of life. Testosterone therapy aims to restore hormone levels to a normal physiological range, which can improve energy, mood, sexual function, muscle strength, and overall well-being.
Before starting testosterone therapy, doctors require evidence of both consistent symptoms and low testosterone levels, typically below 300 ng/dL measured on two separate mornings. Men with active prostate or breast cancer, elevated prostate-specific antigen (PSA) levels, or uncontrolled heart failure are generally not candidates for TRT. Recent research has also shown no increased risk of prostate cancer with testosterone therapy when used appropriately, supporting the idea that restoring normal testosterone levels does not fuel prostate cancer growth.
Different methods of testosterone delivery exist, including topical gels, injections, and subcutaneous pellets. Each has its own risk and convenience profile. Topical gels tend to provide more stable hormone levels and may carry a lower risk of blood pressure increases compared to injections. Blood pressure monitoring is important during therapy because testosterone can cause mild increases in blood pressure in some men.
The benefits of testosterone therapy often become noticeable within weeks to months. Men may experience improved mood, increased stamina, better sleep, and enhanced sexual function. Muscle mass and strength can improve over time, and some men also notice changes such as increased facial hair growth. The therapy is usually ongoing, with treatment intervals depending on the delivery method—pellets may last several months, while gels require daily application and injections are given weekly or biweekly.
Despite the potential benefits, testosterone therapy is not suitable for everyone and should never be started without medical evaluation. Many men with symptoms of low testosterone remain undiagnosed because routine screening is uncommon. It is important for men over 55 experiencing symptoms like fatigue, low libido, or mood changes to discuss hormone testing with their healthcare provider.
In summary, testosterone therapy for men over 55 is generally safe when used in men with confirmed testosterone deficiency and under careful medical supervision. It can improve many symptoms related to aging and hormone decline without increasing cardiovascular or prostate cancer risks when properly managed. Regular monitoring of hormone levels, prostate health, and cardiovascular parameters is essential to ensure ongoing safety and effectiveness.
