Does Hormone Replacement Therapy Shorten or Lengthen Lifespan? And What Are the Alternatives?
by Nils Osmar – Updated November 1, 2022 – Medical disclaimer
Hormone replacement has numerous possible benefits.
In males, studies suggest that restoring testosterone to youthful levels with medical intervention can result in both a longer and healthier lifespan. In women, there’s evidence HRT is associated with better health and a longer lifespan. And several studies have also shown that having higher testosterone levels improves brain health and cognitive function in both sexes.
Life shortening effects?
With that said, there’s also evidence that hormone replacement can be associated with health problems, including greater odds of cancer. Some studies suggest that taking anabolic steroids, as some bodybuilders do, may shorten the lifespan – at least in athletes under 50.
According to this article, pro bodybuilders are actually dying at a slightly lower rate than the average American man. However, they are still dying at a much faster rate than pro athletes in major sports. Performance-enhancing drugs, including steroids, appear to be a possible culprit.
Not true in older people
It’s interesting to note, though, that past the age of 50, there’s no evidence of a life shortening effect from taking anabolic steroids. It may be that the benefits of gaining muscle are great enough in people in this age group as to counterbalance the damage done by steroids. Anabolic steroids don’t make people over 50 years live longer, but they also don’t appear to shorten the lifespan in men older than 50.
What about supplements?
The discussion about maintaining healthy testosterone levels often assumes that we have two choices: watching passively while our hormone decline, or medical hormone replacement therapy. An alternative which is often overlooked is taking nutritional supplements which increase testosterone levels, not by injecting exogenous testosterone, but by increasing the body’s production of it.
To me this is preferable because it utilizes the body’s own mechanisms to increase testosterone. For males, doing TRT can shut down the body’s own production of testosterone; taking the right supplements increases that production.
Effects of exercise
Both endurance exercise and resistance training have been found to increase testosterone levels (and also increase levels of human growth hormone) in both males and females. However, this effect is more pronounced in young adults, and is not long lasting. (See article.)
What about women?
According to a study called “Mortality Associated with Hormone Replacement Therapy in Younger and Older Women“,
Hormone replacement therapy (in females) reduced total mortality in trials with mean age of participants under 60 years. No change in mortality was seen in trials with mean age over 60 years.
A study called Increased longevity in older users of postmenopausal estrogen therapy: the Leisure World Cohort Study, concluded that:
Long-term users of ET seem to have a lower death rate in the Leisure World population. The reduction in the risk of death from all causes was 15%. Considering only mortality as the index of therapeutic success or failure, these results suggest that long-term therapy may extend life.
Our results add to the complexity of issues surrounding the risk-benefit equation of hormone therapy. However, with the results of recent clinical trials and other observational studies, our findings suggest that after an initial period of increased risk, use of ET may be without excess adverse effect.
From a 2017 article called Hormone Therapy Doesn’t Increase Mortality in Postmenopausal Women:
Whatever the other controversies surrounding use of hormone therapy in postmenopausal women, an estrogen-progestin combination or estrogen alone do not appear to affect total mortality or deaths from cardiovascular disease, cancer, or other major illnesses.
That’s according to a study in JAMA based on the Women’s Health Initiative (WHI) hormone therapy trials. Brigham and Women’s Hospital researchers note that earlier reports did not focus specifically on all-cause mortality and cause-specific mortality.
The results of studies have varied a bit over the years. But the consensus in 2022 appears to be that women live at least as long, in better health, if they find ways to restore their sex hormones to youthful levels, than if they don’t.
The Cancer Question
When I posted this article in an online forum, some people mentioned in their comments that some studies show a relationship between cancer and hormone supplementation.
This is accurate. But it’s also accurate that people live longer, on the average, if they raise their hormone levels.
We don’t know yet whether the cancer increase is because hormones are being raised, or because of the way they’re being raised. l suspect that raising them using herbal supplements will not have the same side effects as doing so by injecting hormones. Time and more studies will clarify whether this is true. Either way, though, if it’s a choice between dying at 80 without raising hormone levels, or living to 90 then getting cancer, I’d choose the latter. But I don’t think those have to be our only two choices.
What I’m Doing
I’ve never taken testosterone injections, and I hope I never have to (though I won’t turn up my nose at hormone replacement therapy if my current approach ever stops working). I do take testosterone-boosting supplements such as tongkat ali, longjack, ashwagandha, boron, L. reuteri 6475, HMB, and one prohormone (DHEA), and have found that they work well as long as I also eat a high nutrient diet and do resistance training.
The relationship between diet and our hormones is complex, but it’s clear that we can at least postpone the decline in testosterone levels by eating specific nutrients, such as foods high in zinc, healthy fats, and cholesterol (which our body actually needs to make testosterone). (The notion that cholesterol is “bad” is greatly oversimplified.)
Should we stop eating meat? Or eat more of it?
Opinions will obviously vary on this question.
Speaking for myself (and speaking anecdotally for a moment) I can say that the worst approach I ever tried, in terms of my testosterone and general health, was going vegan.
I found that when I cut all animal-based foods out of my diet, my sex drive faded away after a few months, I lost muscle mass, developed mood and memory problems, felt depressed and low-energy, and my testosterone levels dropped precipitously. I thought these changes were age-based, but they were not; adding meat back into my diet reversed them.
I’m not alone in having this experience. According to a 2021 New York Times article, “A recent British review that pooled data from 206 volunteers, for example, found that men on high-fat diets had testosterone levels that were about 60 points higher, on average, than men on low-fat diets. Men who followed a vegetarian diet tended to have the lowest levels of testosterone, about 150 points lower, on average, than those following a high-fat, meat-based diet.”.
So these days, I eat a balanced omnivorous diet that includes foods from all three kingdoms (plant, animal and fungi). I work out in my home gym three times a week, and do two 36 hour fasts per week.
- I describe the supplements in more detail in this section.
- I discuss the workout I’m doing with the aim of building muscle in this article.
- If my protocol ever stops working, I’ll consider injections. For now, I’m getting good results with exercise and supplements..
- This video shows at a glance how my body has changed by following an approach I developed called the Rekindle Protocol. One element of the protocol has been restoring my testosterone to youthful levels. (Mine has gone from the low 300s to the mid 900s during the past two years – again while taking supplements, not testosterone injections.)
Not medical advice
This article is not intended as, and should not be taken as, medical advice. I’m not advising that people eat any particular diet or take any particular supplements, just reporting on what I’m doing. All supplements can have side effects; I would encourage people to research both possible benefits and side effects before starting on any supplementation regimen. See full Medical Disclaimer