“Those symptoms are true of everybody as they age, to a greater or lesser extent,” says Glenn Braunstein, an endocrinologist and vice president of clinical innovation at Cedars-Sinai Medical Center in Los Angeles. Low T, he says, is the latest trend in direct-to-consumer advertising, promoting such products as AndroGel, Testim and Axiron that deliver the male sex hormone through the skin — a more convenient and less painful option than the injections that have been available for decades.
These drugs, which require a prescription, treat hypogonadism, or low testosterone production. While doctors agree that testosterone therapy is beneficial in hypogonadal men, they are concerned about rejuvenation clinics and Internet sites that push testosterone — or supplements dubiously claimed to boost it — as a cure-all for aging symptoms.
Radio and TV spots suggest that testosterone can cure depression, improve mood and sexual performance, boost energy and melt away pounds. While those symptoms can all be signs of too little testosterone, they are also caused by other conditions, many of which can be treated with changes in diet, exercise and lifestyle. Hormone experts say that using testosterone as a quick fix for aging may be misguided or, worse, unsafe.
More men than ever are asking their doctors about the newer testosterone products. A study published this month showed that between 2001 and 2011, testosterone prescriptions for men age 40 and older more than tripled, with the topical gels being the most popular form and men in their 40s the fastest-growing group of users. The report also found that more than a quarter of men prescribed testosterone had not had their levels of the hormone checked before they were given a prescription.
Replacement testosterone therapy in men 40 years and older who have low levels of natural hormone “is legitimate, when done legitimately,” says John Morley, an endocrinologist at St. Louis University School of Medicine. But, he contends, giving testosterone to men with normal levels of the hormone, especially over the long term, holds unknown risks.
He recently reviewed the scientific evidence behind testosterone and other rejuvenation hormones and found “little evidence” that human growth hormone, dehydroepiandrosterone (DHEA) and melatonin hold any benefit. While testosterone improves sex drive, erectile function, muscle strength and bone density in men with low T, there are very few studies examining benefits or risks in normal men.
But doctors disagree about the waning of testosterone that occurs as men grow older: Is it a disorder to be treated or a natural part of aging? Estimates of how many men in their 60s have low T range from 1 percent up to 70 percent, depending on how doctors assess the condition, whether by symptoms alone or in conjunction with a hormone blood test.