Ultimately, patients with low testosterone have poorer scores of quality of life compared with healthy patients with normal testosterone levels for their age range. In fact, studies show that two quality of life scales, the Aging Males’ Symptoms (AMS) and the Age-Related Hormone Deficiency-Dependent Quality of Life (A-RHDQoL) scales, found that cognition, energy levels, physical capabilities, and sexual function were the factors most adversely affected by the age-related decline in testosterone levels. [567-568]
Guo et al. evaluated the safety and efficacy of testosterone replacement therapy in men with hypogonadism.  The researchers conducted a meta-analysis of several clinical trials focusing on the therapeutic benefits of testosterone. Their meta-analysis indicated that testosterone replacement therapy in hypogonadal men improved the quality of life, increased lean body mass and significantly decreased total cholesterol. Furthermore, testosterone treatment is well-tolerated without any adverse side effects.
Similarly, a study by Almehmadi et al. looked at the effects of long-acting intramuscular testosterone undecanoate (TU) for up to 5 years in men with late-onset hypogonadism (LOH).  In all, 261 patients (mean age 58 years) diagnosed with LOH received testosterone injections. As early as 3 months, health quality indicators such as the International Prostate Symptom Score (IPSS), the five-item version of the International Index of Erectile Function (IIEF-5), and the Aging Males’ Symptoms (AMS) scale significantly improved and these parameters continued to improve over the course of the trial.
Another study by Hajjar et al. found that testosterone replacement in elderly men in the form of injections at a dose of 200 mg every 2 weeks significantly increased circulating testosterone and improved quality of life of study participants without increasing their risk of prostate cancer.  In addition, over 84% of the subjects tolerated testosterone replacement therapy well.
A study by Kanaka et al. evaluated the effects of up to 12 intramuscular injections of testosterone enanthate 250 mg every 4 weeks in 169 men.  After 52 weeks, men who were given testosterone replacement therapy had significant improvement in muscle volume, voiding, physical role functioning, and sexual function, which are all indicative of improved quality of life.
In a study of men undergoing treatment with testosterone undecanoate, Yassin et al. reported that the treatment was able to improve various parameters related to quality of life including libido, vigour and vitality, sleep quality, and body composition.  The researchers therefore concluded that testosterone replacement therapy in hypogonadal men may be a valuable tool to restore various components of well-being.
To further assess the effects of testosterone on quality of life, Hackett et al. treated 199 men with type 2 diabetes and hypogonadism for 30 weeks with either 1,000 mg of testosterone undecanoate or matching placebo.  At 30 weeks and more significantly after 52 weeks, testosterone treatment improved all domains of the International Index of Erectile Function (IIEF) as well as quality of life. These positive effects were mostly observed in the testosterone-treated group compared to the placebo-treated group.
Restoring testosterone levels can make a huge difference for patients suffering from unpleasant symptoms of low testosterone. Not only does restoring testosterone level lead to a better quality of life, but better overall health too since low testosterone can lead to many other serious health conditions.
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