Testosterone therapy — Explore the benefits, risks of creams and gels used to increase testosterone.
The possibilities of testosterone therapy are enticing — increase your muscle mass, sharpen your memory and mental focus, boost your libido, and improve your energy level. As you get older, testosterone therapy may sound like the ultimate anti-aging formula. But health benefits from testosterone therapy aren't quite so clear-cut.
Before you buy into the tempting claims, find out what's known — and not known — about testosterone therapy so that you can make the best decision for your long-term health.
What happens to your testosterone level as you age?
Your body's testosterone level peaks during adolescence and early adulthood. Starting around age 40, your body produces less testosterone. For most men, testosterone levels decline modestly.
What could testosterone therapy do for men with normal testosterone levels?
Some men believe that taking testosterone medications may help them feel younger and more vigorous as they age. But while studies show that testosterone therapy can restore your testosterone level to that of your youth, it isn't clear that there's any benefit to this. And it isn't clear if a higher testosterone level can help you live longer.
Few rigorous studies have examined testosterone therapy in men with healthy testosterone levels. Some small studies have revealed unclear results. For instance, studies found that healthy men who take testosterone medications saw their muscle mass increase, but in most studies the men weren't any stronger after testosterone therapy.
Should you talk to your doctor about testosterone therapy?
If you're concerned that you might have a hormone deficiency, talk to your doctor. A decline in testosterone that falls below normal values may be a reason to take supplemental testosterone. There is some controversy about whether testosterone therapy should be used in men who have naturally lower testosterone levels as a result of aging. It remains unclear whether restoring the testosterone levels to those of youth benefits older men.
Causes of cancer fatigue
Cancer fatigue may be caused by many factors, and the factors that contribute to your cancer fatigue may be completely different from those of someone you know. However, possible contributing factors include:
- Your cancer. Your cancer itself can cause changes to your body that can lead to fatigue. For instance, some cancers release proteins called cytokines, which are thought to cause fatigue. Other cancers can increase your body's need for energy, weaken your muscles or alter your body's hormones, all of which may contribute to fatigue.
- Cancer treatment. Chemotherapy, radiation therapy, surgery, bone marrow transplantation and biological therapy may all cause fatigue. You may experience fatigue when chemotherapy or radiation therapy destroys healthy cells in addition to the targeted cancer cells. Fatigue may occur as your body tries to repair the damage to healthy cells and tissue. Some treatment side effects — such as anemia, nausea, vomiting, pain, insomnia and changes in mood — also may cause fatigue.
- Anemia. You might develop anemia if your treatment destroys too many healthy red blood cells. You can also develop anemia as a result of the cancer itself if the cancer has spread to your bone marrow and interferes with blood cell production or causes you to lose blood. Anemia may also result from unrelated medical conditions, such as thyroid problems.
- Pain. If you experience chronic pain, you may be less active, eat less, sleep less and become depressed, all of which may add to your fatigue.
- Emotions. Anxiety, stress or depression associated with your cancer diagnosis also may lead to fatigue.
- Lack of sleep. If you're sleeping less at night or your sleep is frequently interrupted, you may experience fatigue.
- Poor nutrition. In order to work efficiently, your body needs the energy that a healthy diet provides. When you have cancer, changes can occur in your body's need for and ability to process nutrients. These changes can lead to poor nutrition, resulting in fatigue. For example, your body may need more nutrients than usual or it may not be able to process nutrients adequately. You may also take in fewer nutrients if your appetite wanes or treatment side effects, such as nausea and vomiting, make it difficult to eat.
- Medications. Certain medications, such as pain relievers, can cause fatigue.
- Lack of exercise. If you're used to being on the go, slowing down can make you feel fatigued. Though you will have good days and bad days, try to maintain your normal level of activity if you can.
- Hormonal changes. Many hormonal changes can occur during cancer treatment. Hormonal therapies may alter hormones as a way to treat cancer. Hormonal changes may occur as side effects of treatments, such as surgery, radiation therapy or chemotherapy. Changes to the thyroid gland, adrenal glands, testes or ovaries can all cause fatigue.
Not everyone who has cancer experiences fatigue. And if you do, the level of cancer fatigue you experience can vary — you may feel a mild lack of energy, or you may feel completely wiped out. Your cancer fatigue may occur episodically and last just a short while, or it may last for several months after you complete treatment.
What to tell your doctor
If you tell your doctor you're fatigued, he or she will examine you and ask you questions to assess the severity and nature of your symptoms. This gives your doctor clues about what's causing your cancer fatigue and how to treat it.
Your doctor might ask questions such as these:
- When did you begin experiencing fatigue?
- Has it progressed since your diagnosis?
- How severe is it?
- How long does it last?
- What eases it?
- What makes it worse?
- How does it affect your daily life?
- Do you experience shortness of breath or chest discomfort?
- How are well you sleeping?
- How and what are you eating?
- How are you feeling emotionally?
In addition to these questions, your doctor will likely conduct a physical exam and further evaluate your medical history, the type or types of treatment you are receiving or have received in the past, and any medications you're taking. He or she may recommend some tests, such as blood tests or X-rays, specific to your condition.
Speak up about your fatigue
Don't assume the fatigue you're experiencing is just part of the cancer experience. If it's frustrating you or affecting your ability to go about your day, it's time to talk with your doctor.
Though fatigue is a common symptom when you have cancer, there are steps you can take to reduce or cope with your condition. If you're feeling fatigued, talk with your doctor about what factors might be causing your fatigue and what you can do to improve them.
Who's at risk of nausea and vomiting during and after chemotherapy?
Whether you'll experience nausea and vomiting as a result of chemotherapy depends on what chemotherapy drugs you receive, whether you receive other cancer treatments, such as radiation, during your chemotherapy treatment, and whether you've experienced nausea and vomiting in the past.
Chemotherapy drugs that cause nausea and vomiting
Certain chemotherapy drugs are more likely to cause nausea and vomiting than are others. If you're receiving one of these chemotherapy drugs, preventive measures are available to help you avoid these side effects.
Whether a drug will cause nausea and vomiting also depends on the dosage you receive. Some drugs may be less likely to cause side effects at lower dosages. Ask your doctor whether your particular treatment is likely to cause nausea and vomiting.
Personal factors that may increase your risk
Not everyone reacts to treatment in the same way. Certain factors may make you more vulnerable to treatment-related nausea and vomiting. You may be more vulnerable if one or more of the following apply to you:
- You're a woman.
- You're younger than 50.
- You've experienced nausea and vomiting with previous treatments, or you have a history of motion sickness.
- You have a high level of anxiety.
- You experienced morning sickness during pregnancy.
In addition, if you expect that your treatment will cause nausea and vomiting, there's a chance that it will. You can become so convinced that nausea and vomiting will occur that it does occur. This might happen if you think, like many people do, that all cancer treatments cause these side effects, which isn't true. Your doctor can tell you specifically whether the treatment you'll receive is likely to cause nausea and vomiting.
How do doctors prevent nausea and vomiting?
Most people undergoing chemotherapy receive anti-nausea (anti-emetic) drugs to prevent nausea and vomiting. These drugs, given alone or in combination, can be given orally or intravenously (IV). Your doctor decides which to use based on the treatment you're receiving.
Anti-nausea medications are typically given before treatment begins and on a scheduled basis for several hours or days after treatment. You may receive additional medications if you develop nausea and vomiting after chemotherapy.
Your doctor determines which anti-nausea medications to use based on your specific situation, for example, what type of chemotherapy drugs you're receiving. If your chemotherapy is likely to cause nausea and vomiting, commonly used anti-nausea medications include:
- Ondansetron (Zofran)
- Dolasetron (Anzemet)
- Granisetron (Kytril)
- Palonosetron (Aloxi)
- Dexamethasone (Decadron)
- Prochlorperazine
- Metoclopramide (Reglan)
- Haloperidol
- Lorazepam (Ativan)
Doctors take this proactive approach to prevent nausea and vomiting because these side effects can be difficult to control once they begin. Nausea and vomiting can make you feel miserable, add to the fatigue and distress you may already feel, and make you reluctant to stick to your treatment schedule. If you're unsure about taking anti-nausea medication when you aren't feeling nauseous, talk to your doctor about the risks and benefits of these drugs.
Last Updated: 04/12/2008
