Testosterone in men over 60 added lean mass, but strength gains matched lifting alone
In short
A systematic review of four randomized controlled trials published from 2013 to 2023 in men aged 60 or older found exogenous testosterone increased fat-free mass and reduced fat mass but produced no significant strength gains. Combined with resistance training, testosterone gave larger lean-mass and fat-loss changes than training alone, but similar improvements in strength and function. Only 4 of 6,149 screened articles qualified, so the evidence base is thin.
Giving testosterone to men over 60 built a body that looked more muscular, but they lifted about the same as men who only did resistance training. That is the conclusion of a systematic review of four randomized controlled trials.
Which studies did the review include?
The authors searched for randomized controlled trials published between January 2013 and October 2023 in biological males aged 60 or older who received testosterone alone, resistance training alone, or both. Of 6,149 articles identified, only 4 met the inclusion criteria. Delivery methods and doses varied between trials; the appraisal judged them valid but hard to apply in a local clinical setting.
What did testosterone change, and what didn't it?
- Fat-free mass — increased with testosterone, and by more than with resistance training alone.
- Fat mass — decreased, again by more than with training alone.
- Strength — testosterone by itself produced no significant gain.
- Combined with training — strength and function improved in some trials, but results were inconsistent and similar to training alone.
What does this mean for a masters lifter's numbers?
More lean mass on a scan does not automatically mean a heavier bar. In this review, what moved strength and function was resistance training. The Muscle Index is calculated from the squat, bench press, and deadlift you actually lift, not from body composition, so for a lifter in their 60s the training record is what counts. Lifters over 40 get an age adjustment, and the Muscle Index calculator shows your adjusted score. How muscle gain from the same training volume shrinks with age is covered in our study comparing lifters in their 20s and 50s.
Testosterone is a prescription drug whose cardiovascular and prostate risks need medical assessment, and it is banned in most tested powerlifting federations. This article does not recommend using it.
Frequently asked questions
Does testosterone therapy make older men stronger?
A systematic review of four randomized trials in men aged 60 and older found testosterone increased fat-free mass and reduced fat mass but did not significantly increase strength. Combined with resistance training, strength and function gains were similar to training alone.
Does adding testosterone to resistance training build more muscle?
Gains in fat-free mass and losses of fat mass were larger than with resistance training alone. The extra lean mass did not translate into more strength.
How reliable is this finding?
Only 4 of 6,149 screened articles met the criteria, and the trials used different testosterone delivery methods and doses. The direction is informative, but the evidence base is small.
Can men in their 60s still gain strength from lifting?
Yes. In this review, resistance training alone produced strength and function improvements similar to those seen when testosterone was added.
Source: PubMed