The U.S. Food and Drug Administration (FDA) recently discussed expanding access to testosterone therapy for people with various health issues. Some experts call it a key part of preventive healthcare, worth billions of dollars.
Currently, testosterone is available in the U.S. for those with low levels due to medical reasons, like testicular damage. However, growing evidence suggests more men and women might benefit from it, including through injections, patches, implants, or gels.
The debate over who should use testosterone therapy is heating up. Some doctors say most men with low testosterone, especially young ones without medical issues, don’t need treatment and could improve their levels through healthier lifestyles. Others believe men with symptoms like low libido, fatigue, and irritability could benefit from the hormone.
Some experts go further, suggesting all cisgender men should be tested for testosterone levels and treated if they’re low, even without symptoms. Abraham Morgentaler, a urologist at Harvard Medical School, argues that normal testosterone levels are crucial for overall health.
Despite these claims, testosterone is increasingly marketed as a lifestyle drug to boost muscle and energy, popularized by podcasters like Joe Rogan. However, high doses can lead to risks like infertility, heart problems, and even increased mortality.
Historically, testosterone therapy was popular but fell out of favor due to fears it could cause cancer. Those fears came from studies showing prostate cancer shrinkage when testosterone levels were lowered. These concerns have since been partially addressed, though debates continue.
Recent studies show that while testosterone can improve sexual function and energy in some, its benefits may be modest. For example, a large trial found no increased risk of heart attacks or strokes in men with low testosterone who used the hormone.
However, high doses of testosterone can cause serious side effects, including heart issues and infertility. Smaller trials suggest it may increase muscle mass and strength but doesn’t significantly improve mood or energy levels.
Testosterone therapy is also being discussed for women and transgender individuals, though they’re often excluded from major studies. More research is needed to fully understand its benefits and risks for all groups.