Muscle Strength and Hormonal Balance: Connecting the Dots

Male muscle loss (also called sarcopenia) often occurs as a result of aging. When this happens, muscle loss manifests itself both as the loss of muscle strength and the loss of overall muscle mass.

Deterioration can start to take place in men as early as their mid-20’s but is most pronounced after 60 years of age. Studies have shown that between the ages of 25 and 60, a physically inactive male will lose muscle mass and strength at a rate of 5% each year. This may seem like a small amount, but it adds up over time. Additionally, this process accelerates as a man continues to grow older – muscle loss may increase to a rate of 1% each year in men over 60, and 2% each year in men over 70.

Fortunately, you don’t have to accept muscle loss as an inevitable part of aging. Hormone replacement therapy is a safe and effective way to rebuild and maintain lost muscle mass.

If low testosterone is causing your muscle atrophy, hormone replacement therapy may be the solution for you. Our physicians administer and monitor HRT treatments to help men regain lost muscle mass.

What causes muscle atrophy?

In men, there is a well-established relationship between hormonal imbalances and age-related muscle loss. Hormonal imbalances in men over 40 are usually related to andropause (also called “male menopause”), which is the time in a man’s life when gradually falling testosterone levels begin to affect his health.

Testosterone is vital to maintaining strong muscles. Testosterone binds to receptors in muscle cells and triggers both contraction and growth. Insufficient testosterone levels prevent good muscle health.

Other symptoms of andropause can also contribute to muscle loss. For example, weight gain is often a symptom of hormonal imbalances, which can lead to less willingness to exercise and train the muscles.

Depression and fatigue are also common symptoms of andropause and can result in a decreased motivation to exercise or even to move around on a daily basis, resulting in the acceleration of weight gain and muscle loss.

Sarcopenia Treatment with HRT

Our physicians are able to design programs that specifically address the hormonal imbalances associated with muscle loss. Combined with lifestyle, nutrition, and resistance-based exercise programs, we aim to promote improved muscle mass and strength through HRT. We help you build back lost muscle mass and maintain it!

Is HRT for men safe?

It’s important to remember that even though it’s called hormone replacement therapy, the goal of this treatment is not to replace someone’s hormone level with what they once had. Our process is to give a very small amount of hormones to supplement or to help your body naturally produce hormones that it no longer makes as a result of aging. By doing this, we alleviate symptoms associated with hormone imbalance and help you feel better.

HRT is completely safe when taken under the guidance of an expert practitioner. Among men, HRT has been proven to help prevent cardiovascular risks and type 2 diabetes. We don’t want anyone to suffer from lost muscle mass or muscle atrophy when there’s a much better option available.

A meta-analysis of testosterone supplementation in older men found broad variations in reported increases in muscle mass and decreases in body fat.

Testosterone Therapy Researches

Researchers began by searching for randomized placebo-controlled trials that studied the effect of testosterone replacement therapy on body composition in older men. They excluded studies that mixed men and women, along with studies that included men who were less than 60 years old or men who started off with total testosterone levels greater than 550 ng/dl.

An initial search of relevant terms yielded 2,681 articles, but only 26 merited a full-text analysis and only 11 were included in the current study.

All of them found that testosterone replacement was associated with a significantly greater increase in lean muscle mass than placebo, but effect sizes varied greatly. The smallest average increase was 1.65 kg (95 % confidence interval [CI], 1.61—1.69kg). The largest increase was 6.20 kg (95 % CI, 5.22–7.18 kg).

The overall effect estimate from the meta-analysis was 3.59 [2.38—4.81], although it was obviously heterogeneous (I 2 = 98%).

Testosterone replacement therapy was also associated with consistent reductions in body fat. The effect estimate was smaller −1.78 [−2.57, −0.99] but the analysis was slightly less heterogeneous (I2 = 81%).

The authors of the paper, which was published in the journal Age, explained the wide range in the initial study results and the heterogeneity of the resulting meta-analysis by noting just how much the underlying studies varied.

Patients in different studies received different amounts of testosterone, at different intervals, via different methods of administration for different lengths of time.

For example, 1 study of topical testosterone gel that appeared in the Journal of Clinical Endocrinology & Metabolism focused mainly on whether the gel in question could successfully raise testosterone levels (it could) so it ran for only 90 days.

That was still enough time for men who received the larger of the 2 doses (100 mg per day) to see an average gain of 1.7 kg of muscle and an average body fat reduction of 1.2%, but research consistently shows that testosterone therapy takes considerably more time to produce its full effects.

Another study of testosterone gel, this one published in the Journal of the American Geriatrics Society, ran for a full year, but men in the treatment group received just 5 mg of testosterone per day, and study adherence was just 54%. A yearlong study from the Journals of Gerontology, meanwhile, provided men in the treatment group 160 mg testosterone every day — orally.

Men in both groups saw significant increases in muscle and significant decreases in fat, but effect sizes, unsurprisingly, varied considerably.

Indeed, effect sizes and almost everything else about the underlying research varied so much that the authors of the meta-study, who hail from Sao Judas Tadeu University in Brazil, were forced to draw only the vaguest of conclusions.

“The results suggest that testosterone replacement therapy is able to increase muscle mass in elderly men,” they wrote, “and that [increase] is affected by the time that the treatment is carried out and the method of administration of the drug.”

If any questions are still left, contact us to meet a physician and get started with your free HRT consultation today.

15 January 2021 Hormones
About Dr. Nil Hoppins

Dr. Nil Hoppins is a consultant dermatologist and professor of medical dermatology specializing in the diagnosis and treatment of skin disorders, treatment of severe scarring, and photodermatology. He has a strong background in translational research, and expertise in genetic skin disorders.

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