Men's testosterone levels naturally drop about 1% every year after 30, leaving many to weigh their options in the debate of TRT vs natural testosterone. A 75-year-old man's testosterone will be roughly 30% lower than what he had at 25. This isn't just about numbers—lower testosterone substantially affects quality of life. Men often experience muscle loss, mood swings, depression, and decreased sex drive.
British men over 60 need to think over several factors when choosing between testosterone replacement therapy and natural options. Research shows that all but one of these men over 45 might already have below-normal testosterone levels . These numbers climb even higher with age, and half of all men over 80 show reduced levels . Modern testosterone replacement therapy options in the UK keep evolving. Yet many older patients worry about possible side effects. The choice between natural and synthetic testosterone raises questions about what it all means for long-term health. Research proves that lifestyle changes can substantially change hormone levels. To cite an instance, adding 4 inches to your waist might increase your chances of low testosterone by 75% . This suggests that men over 60 might benefit from targeted weight management among other conventional hormone replacement approaches alternatives.
What is Testosterone Replacement Therapy (TRT)?
Image Source: Nature
Testosterone Replacement Therapy (TRT) helps restore testosterone to normal levels in men who have consistently low levels and show related symptoms. Unlike natural remedies for [male andropause](https://goldmanlaboratories.com/blogs/blog/natural-remedies-male-for-male-andropause-low-testosterone), TRT uses manufactured testosterone through different delivery methods to balance hormone levels in the body [1].
How TRT works in the body
Patients on TRT receive bioidentical testosterone that works just like the natural hormone in their body. The treatment wants to bring serum testosterone levels back to mid-normal range, which usually falls between 400-700 ng/dL [2]. The testosterone binds to plasma proteins like sex hormone-binding-globulin and albumin. Small amounts of free testosterone work directly on muscles, bones, and the prostate gland [3].
The body's testosterone works in two ways. About 2% moves freely through the body, while 98% attaches to sex hormone binding globulin or albumin [4]. This difference matters because bioavailable testosterone actively affects body functions. Testosterone plays multiple roles - it helps make red blood cells, builds proteins, and controls sexual function [3].
TRT's success depends on how you take it. Here are the common ways to get testosterone:
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Daily skin gels you put on clean, dry skin
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Muscle injections every one to two weeks
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Daily skin patches
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Pellets placed under the skin every three to six months
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Weekly shots under the skin [1]
Each method gets absorbed differently, and some keep hormone levels steadier than others.
Why men over 60 think about TRT
Men's testosterone levels drop steadily as they age, falling faster than what we discussed earlier. This natural drop becomes more obvious after 65. Many men notice their testicles getting smaller, less interest in sex, weaker bones, less muscle, more fat, and fewer red blood cells [3].
About 16-18% of men over 65 have hypogonadism, which means their morning testosterone levels fall below 280 ng/dL [4]. This explains why TRT prescriptions for men over 60 jumped from 1.32% in 2001 to 3.75% in 2011 [4].
Older men usually try TRT to fix specific problems affecting their daily life. TRT can boost sexual function, add lean muscle, strengthen bones, lift mood, raise energy levels, and make men feel better overall [1]. Results vary quite a bit - most benefits start showing up 3 to 6 weeks after starting, but some take up to a year to fully show [2].
NHS eligibility vs private TRT in the UK
Getting TRT through the NHS takes more work than through private clinics. NHS needs total testosterone levels to drop below 8.6 nmol/L [4], which private doctors would call very low [5]. After seeing your GP, you might wait 3-4 months to see an endocrinologist [5].
Private TRT in the UK moves faster and offers more options. These clinics often treat men with testosterone below 15 nmol/L [5], helping those with borderline levels who still have symptoms. Private clinics run more detailed hormone tests, checking both total and free testosterone to better understand your available hormone levels [4].
Money makes a big difference too. NHS treatment costs just the regular prescription fee (about £9.90 per item) [4]. Private TRT costs much more - your first year with injections and monitoring could reach £1,665 [6].
Treatment choices also look different. NHS mainly gives out gels and patches, which don't always absorb well [4]. Private clinics offer more testosterone types and extra medications like human chorionic gonadotropin (hCG) that help keep fertility while on TRT [4].
Older men who want to mix balanced nutrition for hormone health with medical treatment should understand these differences to choose between natural remedies for andropause and medical options.
Natural Ways to Boost Testosterone After 60: TRT vs Natural Testosterone
Many men over 60 look into natural ways to boost their testosterone levels before they try synthetic hormones. These methods can work as TRT alternatives for men 60 and older, often bringing fewer side effects than medical treatments.
Exercise and strength training
Physical activity proves to be one of the strongest natural testosterone boosters for ageing men. Studies show that older men who were inactive before they started High-Intensity Interval Training (HIIT) saw their total testosterone levels rise by about 17% [7]. They managed to keep these gains even after reducing their weekly training from 150 minutes to just 3-6 minutes.
Resistance training works exceptionally well for hormone production, especially with large muscle groups. Exercises targeting major muscle areas like squats and bench presses create the strongest hormonal response [7]. Free testosterone levels keep rising even after the body adapts to exercise, making regular workouts vital for long-term hormonal health [7].
Weight loss and body fat reduction
A man's body composition plays a decisive role in testosterone production after 60. Research shows that testosterone levels rise by about one point for every one-point decrease in BMI [7]. Men can prevent their testosterone from dropping as they age by keeping their weight in check.
Changes in body fat directly affect hormone levels. A 3.3% drop in body fat leads to better testosterone levels [7]. Building lean mass by 3.6% helps balance hormones even more [7]. This happens because extra body fat, especially around the belly, turns testosterone into oestrogen through aromatase activity.
Improving sleep quality
Sleep is the life-blood of natural testosterone production. The body releases most testosterone during deep sleep, especially during Rapid Eye Movement (REM) sleep [7]. Research reveals that testosterone keeps rising with more sleep up to 9.9 hours in older men, but benefits stop there [4].
Older men at normal weight who sleep more than 9.5 hours show higher testosterone levels [4]. Just five hours of sleep per night for a week can drop testosterone by 10-15%—like ageing ten years overnight [8]. Poor sleep hits older men harder because it reduces both how often and how much testosterone pulses through their system [4].
Managing stress and cortisol
Your body needs good stress management because cortisol fights against testosterone [5]. Long-term stress damages proteins needed for testosterone production [8] and triggers the hypothalamic-pituitary-adrenal axis, which cuts testosterone even more [8].
Regular aerobic exercise helps alleviate this issue. People under high stress who do aerobic training show much lower cortisol/DHEA ratios than those who don't exercise [8]. Exercise also improves hormone health by making hormone receptors more responsive [8]. Time spent outdoors, meditation, and mindfulness can help control stress hormones and support balanced nutrition for male hormones.
Reducing alcohol intake
Alcohol hits testosterone production hard, especially in older men. Heavy drinking (over 15 drinks weekly) damages the testosterone-producing Leydig cells in the testes [6].
Studies confirm that men who drink heavily have lower total testosterone than non-drinkers [6]. The research also shows that men who don't drink have more free testosterone than chronic drinkers [6].
Some men face higher risks than others. Heavy drinkers who get facial flushing showed more signs of testosterone deficiency after just 8 drinks per week [6]. The evidence makes cutting back on alcohol a vital strategy for treating natural remedies for male andropause symptoms.
Herbal and Nutritional Alternatives to TRT
Image Source: Allo Health
Men who worry about TRT side effects often look beyond exercise and lifestyle changes. Natural alternatives like herbal and nutritional supplements attract many elderly patients.
Ashwagandha and stress regulation
Ashwagandha (Withania somnifera) works as an adaptogen and helps your body deal with stress that lowers testosterone. This ancient Ayurvedic herb reduces cortisol levels in your body, which helps boost testosterone production.
Research shows promising results for men who want natural remedies for andropause. Men's testosterone levels went up by 17% after taking ashwagandha in one study [9]. A smaller study showed that 600mg of ashwagandha extract boosted testosterone levels by almost 15% over eight weeks [9].
You'll need between 300mg and 5g daily to see results [10]. The herb might not mix well with medicines for diabetes, high blood pressure, and thyroid issues [10]. Men who have autoimmune disorders, hormone-sensitive prostate cancer, or liver problems should be careful.
Fenugreek and libido support
Fenugreek (Trigonella foenum-graecum L) is common in Indian cooking. It contains furostanolic saponins that might boost testosterone production [7]. These compounds work by blocking enzymes that turn testosterone into oestrogen.
The research looks promising. Men who took 500mg of fenugreek daily saw their testosterone levels jump. Up to 46% of participants showed improvement in a 12-week study [7]. Another study of men aged 43-75 showed better libido and higher testosterone levels with 600mg daily doses [7].
A compound called protodioscin in fenugreek seems to work best at raising hormone levels [11]. The results aren't consistent across all studies, and some research showed no real change in testosterone [7].
Vitamin D, zinc, and magnesium
These three nutrients work together naturally to support testosterone production. They offer a safer option for men who worry about TRT risks.
Your body uses Vitamin D more like a hormone than a vitamin. Men's testosterone levels rose by 25% after taking 3,332 IU of Vitamin D daily for a year [12]. It helps Leydig cells make testosterone and reduces Sex Hormone-Binding Globulin (SHBG), which lets more testosterone work in your body [12].
Zinc plays a direct role in how Leydig cells work and make testosterone. Your testosterone can drop by 75% within six months if you don't get enough zinc [12]. It also stops testosterone from turning into oestrogen [12].
Taking 450mg of magnesium daily can boost testosterone by 24% in just four weeks [12]. It lowers SHBG, helps you sleep better, and gives your cells more energy - all vital for making testosterone.
ZMA (zinc magnesium aspartate) combines these three nutrients and helps both immunity and testosterone production [13].
D-aspartic acid and DHEA
D-aspartic acid shows mixed results in studies. Twenty out of 23 men saw higher testosterone levels, with an average rise of 42% in one study [14]. Men aged 27-43 saw increases of 30-60% after taking supplements for 90 days [14].
The results aren't as good for active men. People who weight train didn't see much change in their testosterone [14]. Inactive men or those with low testosterone seem to benefit most from 3 grammes daily [14].
Your adrenal glands make DHEA naturally, which helps produce both testosterone and oestrogen. Many clinical trials show that DHEA supplements raise blood testosterone in men [15]. The improvement in symptoms varies from person to person.
Risks of unregulated supplements
Men over 60 should know that supplements don't face the same strict rules as prescription medicines. The Food and Drug Administration doesn't regulate them closely [16].
This lack of oversight creates problems with dose accuracy, product quality, and possible contamination. Many natural testosterone boosters make big promises without scientific proof [16]. Even natural supplements can cause problems with medications or have side effects.
Zinc supplements might make you feel sick, cause vomiting, or give you stomach cramps. They can also hide copper deficiency [13]. Too much magnesium often leads to digestive problems [13].
Talk to your doctor before trying natural or synthetic testosterone options instead of experimenting on your own [16].
Medical Alternatives to TRT Without Hormone Replacement
Men looking for a middle ground between traditional hormone replacement therapy and natural approaches can benefit from several pharmaceutical options that provide clinical benefits without adding external testosterone.
Clomiphene citrate and fertility preservation
Scientists developed clomiphene citrate in the 1960s as a female fertility treatment. This selective oestrogen receptor modulator (SERM) blocks oestrogen receptors at the hypothalamus level [4]. The medication boosts GnRH pulse frequency and amplitude by stopping oestrogen's negative feedback. This stimulates the pituitary to release more FSH and LH [4].
The medication boosts total testosterone levels and helps improve hypogonadism symptoms [4]. Unlike standard hormone replacement for men, it helps preserve fertility. This makes it a great option for younger men and those who want to become fathers.
Research shows it works well for men of all ages. A study showed men taking 25-50mg of clomiphene every other day for about 19 months reached testosterone levels of around 550ng/dL [4]. Another study with older patients (average age 62) revealed testosterone increases from 309ng/dL to 642ng/dL after three months of taking 25mg daily [4].
The medication is well-tolerated, with mild side effects like hot flashes, headache, and occasional dizziness [4].
Human chorionic gonadotropin (hCG)
Human chorionic gonadotropin works like luteinizing hormone but lasts longer in the body [17]. Regular subcutaneous doses of hCG make Leydig cells produce and release intratesticular testosterone [17].
This treatment helps men who show testosterone deficiency symptoms even with levels above traditional treatment thresholds (>300 ng/dL) [17]. Research shows that hCG alone improved testosterone levels over six months. Half of the patients reported better symptoms with no adverse effects [17].
HCG keeps testicular size and function intact, which prevents the shrinkage often seen with traditional TRT [5]. This preservation of testicular function helps maintain fertility, giving it an edge over standard testosterone replacement therapy UK options.
Aromatase inhibitors and oestrogen control
Aromatase inhibitors block the enzyme that converts androgens to oestrogens [8]. These medications come in two types: steroidal (formestane, exemestane) and nonsteroidal (anastrozole, letrozole) [8].
Older men with low testosterone can benefit from aromatase inhibitors. Taking anastrozole at 1mg daily doubled bioavailable testosterone in a 12-week study [8]. Atamestane at 100mg daily boosted total testosterone by 40% after 36 weeks [8].
These benefits come with some limitations for elderly men. The testosterone boost might be too weak, especially for those with very low starting levels who need it most [8].
The medication works differently in men compared to women. Men's oestrogen/testosterone ratios typically drop by about 77% rather than being completely suppressed [8]. This partial reduction helps prevent excessive oestrogen decrease and its associated side effects.
Risks and Side Effects of TRT in Older Men
Image Source: Centre for Men's Health of Rhode Island
TRT brings many benefits to men with low testosterone, but you need to learn about what it all means to make smart choices about your treatment. Men over 60 should carefully weigh the relief from symptoms against possible complications.
TRT side effects in elderly men
Blood thickening (polycythemia) affects all but one of five men who use TRT, so they need regular checkups [6]. This condition makes blood thicker and might lead to blood clots. The treatment causes skin problems like acne and oily skin in about 60% of users [6]. Users also report headaches, weight gain, and faster hair loss if they're prone to it [18].
New research has found unexpected problems like atrial fibrillation and acute kidney injury in people taking testosterone [19]. Yes, it is crucial to think over balanced nutrition for male hormones among other medical treatments.
Cardiovascular and prostate health concerns
Large-scale studies show mixed results about heart safety. The TRAVERSE trial found no major increase in overall heart risks, but more cases of pulmonary embolism showed up in testosterone users [20]. Therefore, doctors now warn men who had blood clots before [20].
Testosterone therapy makes the prostate grow about 12% bigger on average [6]. The good news comes from 14,304 person-years of follow-up data - high-grade prostate cancer rates (0.19% in TRT group vs 0.12% in placebo group) stayed similar between groups [21]. A study even found that TRT users had 16% lower chances of getting prostate cancer [22].
Monitoring requirements for hormone replacement
These possible complications mean complete monitoring is vital. Prostate health checks usually need PSA tests at the start, after 3-6 months, then yearly, plus regular digital rectal exams [6]. Doctors should look deeper if PSA levels jump more than 1.0 ng/mL within 12 months [6].
Blood tests check hematocrit levels at the start, after 3-6 months, then yearly. Treatment stops if levels go above 54% [6]. Heart health monitoring needs blood pressure checks at each visit, lipid tests every 6-12 months, and doctors watch for fluid buildup through weight and ancle checks [6]. These steps work well with advice about natural remedies for andropause when you plan your treatment approach.
TRT vs Natural Remedies: Cost, Safety, and Effectiveness
Image Source: Centre for Men's Health of Rhode Island
Making smart decisions about testosterone management needs a clear understanding of how medical and natural approaches differ in practise.
Cost comparison: TRT vs natural remedies in the UK
UK men must make a substantial investment in TRT treatment. Private TRT prices start at £59.99 monthly for Sustanon and go up to £109.99 for Cypionate or testosterone gels [10]. Blood tests add to these costs - £33.95-£64.95 for the original tests and mandatory follow-ups every 3-6 months [10]. Natural supplements provide a more affordable option at £23.82-£80 monthly [9]. These supplements need no prescription or required testing.
Natural vs synthetic testosterone: key differences
The basic difference comes down to how each method works. Natural testosterone boosters use plant-based ingredients that help the body produce its own hormones instead of adding external ones [23]. Results appear gradually over 2-3 months [23]. Synthetic testosterone works faster by directly raising hormone levels, with results showing up in 2-4 weeks [9]. Both forms go through lab processing, despite the term "bioidentical" [24].
When to combine both approaches
Men with borderline low testosterone levels should start with natural remedies for andropause. TRT under medical supervision becomes necessary for those who still have severe symptoms after trying lifestyle changes. These patients can benefit from TRT combined with balanced nutrition for male hormones. The most effective treatment plans merge both approaches. They combine medical oversight with support for overall hormonal health through diet, exercise and targeted supplements [23].
Conclusion
Managing testosterone after 60 isn't a one-size-fits-all solution. You need to look at several factors carefully. This piece looks at both medical treatments and natural remedies for male andropause. Each option has its own benefits and drawbacks. Your symptoms, health background, and what works best for you will help decide between TRT and natural methods.
Men with mild symptoms should start with lifestyle changes. These include strength training, managing weight, getting quality sleep, and reducing stress. When combined with balanced nutrition for male hormones, these changes often help men with slightly low testosterone levels. On top of that, herbs like ashwagandha and fenugreek, plus vitamins D, zinc, and magnesium are worth trying as middle-ground options.
Men with very low testosterone levels might need medical help. TRT gives quick results that make a big difference, but doctors need to watch for side effects. Some alternatives like clomiphene citrate and hCG can boost testosterone while keeping fertility and natural production intact. This matters a lot to younger men.
Money plays a vital role in choosing treatment. NHS-provided TRT costs less but has strict requirements. Private options give you more choices but cost more. Remedies for andropause are usually budget-friendly but take longer to show results.
The best approach often mixes both worlds - medical hormone management and better lifestyle choices. You should team up with your healthcare provider to create a plan that fits your needs. Regular checkups help adjust the treatment as needed.
Your testosterone might naturally drop with age, but this doesn't have to affect your quality of life badly. We now know much more about hormone health. You have several ways to stay healthy and active in your later years, whether through medicine, natural methods, or a mix of both.
Key Takeaways
Understanding your options for managing testosterone decline after 60 empowers you to make informed decisions about your health and quality of life.
• Natural approaches work best for mild symptoms: Exercise, weight loss, quality sleep, and stress management can boost testosterone by 15-25% without medical intervention or side effects.
• TRT offers rapid results but requires ongoing monitoring: Medical testosterone replacement delivers significant improvements within 2-4 weeks but costs £720-£1,320 annually and needs regular blood tests.
• Middle-ground medical options preserve fertility: Clomiphene citrate and hCG stimulate natural testosterone production whilst maintaining testicular function, unlike traditional TRT.
• NHS eligibility is restrictive compared to private care: NHS requires testosterone below 8.6 nmol/L whilst private clinics treat levels below 15 nmol/L, offering faster access but higher costs.
• Combination approaches often prove most effective: Integrating lifestyle changes with medical supervision provides comprehensive hormone management tailored to individual needs and symptom severity.
The key is working with healthcare providers to develop a personalised strategy that balances effectiveness, safety, and cost whilst addressing your specific symptoms and health goals.
FAQs
Q1. Is testosterone replacement therapy recommended for men over 60? Testosterone replacement therapy (TRT) is not routinely recommended for normal ageing in men over 60. It's typically reserved for those with diagnosed hypogonadism and significant symptoms. Natural methods like weight loss and resistance exercise are often suggested first to boost testosterone levels.
Q2. What are the most effective natural ways to increase testosterone for men over 60? For men over 60, the most effective natural ways to boost testosterone include regular exercise (especially strength training), maintaining a healthy weight, getting quality sleep, managing stress, and following a balanced diet rich in zinc, vitamin D, and healthy fats.
Q3. How does TRT compare to natural remedies in terms of effectiveness and safety? TRT typically provides faster and more significant testosterone increases compared to natural remedies, but it comes with potential risks and side effects. Natural methods are generally safer but may produce more gradual results. The choice depends on individual health status, symptom severity, and personal preferences.
Q4. What are the potential risks of TRT for older men? Potential risks of TRT for older men include blood thickening (polycythemia), cardiovascular issues, prostate enlargement, skin problems like acne, and sleep apnea. Regular monitoring is essential to manage these risks effectively.
Q5. Are there alternatives to traditional TRT that can help boost testosterone? Yes, there are alternatives to traditional TRT. These include medications like clomiphene citrate and human chorionic gonadotropin (hCG), which can stimulate natural testosterone production. Additionally, certain herbs and supplements like ashwagandha, fenugreek, and zinc may help support testosterone levels naturally.
References
[1] - https://my.clevelandclinic.org/health/treatments/testosterone-replacement-therapy-trt
[2] - https://pmc.ncbi.nlm.nih.gov/articles/PMC5182226/
[3] - https://www.ncbi.nlm.nih.gov/books/NBK526128/
[4] - https://pmc.ncbi.nlm.nih.gov/articles/PMC9388170/
[5] - https://www.htxurology.com/understanding-mens-hormone-therapy-do-you-need-hcg-with-trt/
[6] - https://cmh-ri.com/trt-side-effects/
[7] - https://www.healthline.com/nutrition/fenugreek-for-testosterone
[8] - https://pmc.ncbi.nlm.nih.gov/articles/PMC3143915/
[9] - https://qnwellness.com/blogs/article/testosterone-booster-vs-trt-a-complete-guide-to-cost-risks-benefits
[10] - https://www.optimale.co.uk/trt-uk/cost-of-trt/
[11] - https://www.vinmec.com/eng/blog/can-fenugreek-boost-mens-testosterone-levels-en
[12] - https://thedoctorspractice.co.uk/the-science-behind-vitamin-d-magnesium-and-zinc-natural-strategies-to-optimise-testosterone-levels/
[13] - https://www.healthline.com/nutrition/zma-testosterone
[14] - https://www.healthline.com/nutrition/d-aspartic-acid-and-testosterone
[15] - https://www.webmd.com/healthy-ageing/the-best-testosterone-boosters-for-men-over-50
[16] - https://www.premiermedicalhv.com/news/beware-of-natural-testosterone-boosters/
[17] - https://pmc.ncbi.nlm.nih.gov/articles/PMC6844348/
[18] - https://www.baus.org.uk/patients/conditions/7/male_menopause_androgen_deficiency_in_the_ageing_male/
[19] - https://www.nejm.org/doi/full/10.1056/NEJMoa2215025
[20] - https://www.acc.org/Latest-in-Cardiology/Journal-Scans/2023/06/20/14/42/cardiovascular-safety-of-testosterone
[21] - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2813293
[22] - https://www.endocrinologyadvisor.com/news/testosterone-replacement-therapy-may-lower-prostate-cancer-risk-in-hypogonadism/
[23] - https://wellbeingnutrition.com/blogs/listing/natural-vs-synthetic-testosterone-supplements-what-you-need-to-know?srsltid=AfmBOorpvGDopAe2sg8fpVWWD16AnZ_yRn5vXLOuB9lj7Vq2ieH3oJaA
[24] - https://www.nebraskamed.com/for-providers/which-is-better-bioidentical-vs-traditional-testosterone-replacement-therapy
