Is hormone replacement therapy (HRT / TRT) the key to anti-aging? Or is it the cause of increased risk of heart disease, cancer and stroke? In this article I answer that question objectively as I present the pros and cons of HRT in men and women. And I will share my personal experience using TRT, the good and the bad.
First of all, I’m not a doctor, this is not medical advice. I’m speaking as a patient, as a fitness trainer, as a brother in Christ, and as a friend. As always I encourage you to do your own research.
Hormone replacement therapy is the replacement of sex hormones in men and women, to control symptoms caused by low levels of these hormones. For women we’re talking about estrogen and possibly progesterone and testosterone in small amounts. For men we’re talking about testosterone, which some of it converts into estrogen in the body, so there’s no point in taking it exogenously. Low hormone levels are caused by aging and menopause, as well as certain health conditions – such as turner syndrome, kidney disease, and low functioning pituitary gland due to injury or defect. The most common cause in both men and women is, of course, aging.
Low hormone levels are diagnosed by taking a blood test, as well as assessing symptoms. In cases where pituitary gland issues are suspected, a brain scan is also needed. Symptoms for low hormone levels include: depression, fatigue, mood swings, trouble concentrating, and low libido and other sexual issues. More serious late onset symptoms can include osteoporosis (weakening of the bones) and cardiovascular events. Women may also experience hot flashes and irregular or absent periods. And men may also experience a loss of muscle mass and increased body fat. These symptoms are an overview not an exhaustive list.
One reason testosterone replacement therapy is so controversial is that testosterone IS an anabolic steroid, and when misused along with other anabolic steroids it can cause health problems. So legitimate doctor-prescribed TRT gets confused with anabolic steroid abuse.
Another reason TRT is controversial is that the “normal” range is so broad – from 300 nanograms per deciliter to over 1000. A man in his 20s may be closer to the higher end of the spectrum, and a man in his 50s or 60s may be substantially lower. But it’s important to look at symptoms as well as blood testosterone levels. Here’s the issue: Most doctors will not prescribe TRT for men that fall in that range REGARDLESS of symptoms, saying this is just part of aging, and TRT causes health problems like steroids.
HRT for women is controversial for different reasons. As far back as the 1960s HRT was commonly prescribed to mitigate symptoms of menopause. In the late 1990s two of the largest studies of HRT users were undertaken, one in the United States and one in the UK. Both studies released results in the early 2000s raising safety concerns of increased risk of breast cancer and heart disease. The media ran with it and caused a panic among doctors and users, and HRT prescriptions dropped 66% overnight.
Since that time the methods and results of these studies have come under much scrutiny. One thing that came out later was women used in the American study were in their mid-sixties, and many of them were overweight. This does not accurately represent the majority of HRT candidates, namely menopausal women 45-55 years old. And a subsequent publication of the full results showed the apparent risk of breast cancer was ONLY found in those who had taken HRT before entering the study.
More recent results published in 2020 showed a significant reduction in breast cancer diagnosis and mortality in women using estrogen only. Women using estrogen and progesterone did have an increase in breast cancer diagnosis but not in mortality. Other studies report that obesity was a factor in cancer diagnosis, and that micronized progesterone is associated with a lower risk of breast cancer than other forms of progesterone.
And regarding cardiovascular risk, recent data from Denmark has demonstrated that healthy women taking HRT for 10 years immediately after menopause had a reduced risk of heart disease. This study AND follow up data from the original American study both found that women who start HRT 10 years or more after menopause do not have an increased risk of cardiovascular events or mortality.
So today there remains widespread confusion and controversy regarding HRT and TRT, and many doctors will not prescribe it. Thankfully there are doctors and clinics that specialize in hormone replacement therapy. Unfortunately most insurance will not cover HRT and TRT.
I’ve touched on some of the pros and cons but I think it would be helpful to summarize them for you:
HRT and TRT can help fight depression, fatigue, mood swings, and improve concentration. It can improve sexual function, increase lean body mass and bone density, and relieve hot flashes in women. Again this is not meant to be an exhaustive list, but HRT and TRT can restore your hormone levels to where they were when you were much younger.
TRT in men can increase hematocrit, or red blood cell count. The fear is that the blood becomes thick and increases stroke risk. However to date there have not been any cases of stroke or severe clotting related to TRT. And this side effect has an easy fix- donate blood a few times a year.
There is also a fear of developing prostate cancer from TRT. The reason is: prostate cancer that has metastasized improves when treated by lowering testosterone. The thinking is: if lowering testosterone improves prostate cancer then raising it must make prostate cancer grow. However if you look at the rate of prostate cancer in men on TRT compared to men not on TRT, the rate is the same for both. So even though this is a widely held belief, there is NO evidence to support it.
A small number of men may experience other TRT side effects such as increased acne, water retention, disturbed breathing at night and gynecomastia or breast enlargement.
And the Cons for HRT for women: There may be an increased risk in breast cancer. Other side effects include: water retention, breast tenderness, leg cramps, and headaches. These side effects don’t happen to everybody, and often pass after a few weeks.
As for my personal experience, in January of 2019 I was diagnosed with low testosterone after filling out an online questionnaire and having a blood tested. My testosterone level was a little over 300, I don’t remember the exact number, so I was in the (quote) “normal” range. But my doctor was willing to prescribe TRT based on my symptoms as well as the blood test. It’s not that things were so terrible, but I just wanted to feel better.
So I started taking it and immediately started feeling better and younger! Unfortunately my gynecomastia that I had as a teenager started flaring up. Gynecomastia is when a male starts growing female breast tissue due to too much estrogen. Extra testosterone in the body is converted to estrogen. And apparently I am extremely sensitive to estrogen. So the doctor prescribed me an estrogen blocker and that seemed to take care of the symptoms, but unfortunately the damage was done and to make a long story short, last November I got the gynecomastia removal surgery.
Anyway that clinic cost $200 a month and the doctor wasn’t all that attentive, I had heard of another Hormone Replacement Clinic called Defy Medical. They had great reviews and were less expensive so I switched over to them. They are awesome, I can’t say enough good things about them. My Physicians Assistant Janelle is the best! It was only after switching that I realized how cookie-cutter the other clinic was. Janelle has worked closely with me to fine tune my regimen. The other clinic was over prescribing my testosterone and estrogen blockers. Apparently my testosterone was through the roof, and my estrogen was crashed, giving me sore joints and some other symptoms. I didn’t realize this till she started asking me questions. So after we adjusted my dosage, I’ve been doing great!
So that’s about it, let me know if you have any questions. I’ll leave a link below to Defy Medical in case you want to learn more about Hormone Replacement Therapy, they serve men and women. And if you decide to become a patient I have a special coupon code good for 10% off your initial labs.
That’s all for now, God bless you, and I’ll see you next time!
Defy Medical: https://www.defymedical.com/
(use code Jerold2021 for 10% off initial labs)
Free Calorie Calculator: https://www.spiritandmuscle.com/calories