Do Guys With Low Testosterone Really Need Hormone Replacement Therapy?

According to a urologist, it might cause more problems than it solves.

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If you’ve spent any amount of time listening to AM radio, no doubt you’ve heard ads where some nondescript man bemoans his lack of a sex drive or manliness, and then is followed by a voiceover recommending some variation on a course of testosterone — the idea being, if you buy some testosterone from us, you’ll feel more like a man in more ways than one.

Of course, these sorts of ads are like catnip for many guys. And, for some of those guys, maybe they could use a little help in the testosterone arena. Unfortunately, like a commercial tuna fisherman pulling up a dolphin with the rest of his catch, sometimes men who are perfectly healthy with no testosterone issues at all are so “caught” by the ad that they think they need a little hormonal pick-me-up. But do they?

“There’s definitely been an increase in the number of patients asking about hormone replacement therapy, especially in younger men,” says urologist and men’s sexual health expert Joshua Gonzalez. “Guys sometimes have this idea that hormone therapy will give them those washboard abs they’ve always wanted, or make them more virile lovers. Testosterone certainly helps improve these things, but as my trainer says, ‘Abs don’t come for free.’”

So if hormone therapy isn’t a cure-all or for everyone, who is it an option for? “If you’re experiencing symptoms like fatigue, decreased sex drive, erectile dysfunction, decreased muscle mass and/or weight gain, depressed mood, anxiety, difficulty with sleep and even cognitive dysfunction or difficulty with memory, [get a blood test],” explains Gonzalez. “Those symptoms, plus measurably low hormone levels on a blood test would make someone a good candidate.”

“That said, hormone therapy isn’t ideal for someone who doesn’t fit the criteria above, or someone just ‘looking to build muscle,’” warns Gonzalez. “The truth is: I’ve seen many men experiment with hormone therapy for these purposes who end up causing sexual dysfunction or fertility issues that they previously didn’t have.”

Even if you do fit the criteria and are experiencing symptoms, though, that doesn’t mean you should rush out and buy the kind of testosterone you’ve heard about on the radio, or seen on late-night TV. Considering the side effects, Gonzalez says the best thing you can do is take whatever your doctor prescribes. “Generally, hormone therapy is very safe when monitored and administered by a knowledgeable physician.”

But if you really are having issues with sexual dysfunction, or you’re gaining weight, or you’ve been feeling depressed, maybe consider your lifestyle before opting for any type of hormone therapy. “It’s definitely worth looking at your life to see what you can improve. If you’re a smoker, stop!  If you’ve been avoiding the gym, start a regular exercise routine. Try to avoid a lot of alcohol and sugar, and start eating a balanced, heart-healthy diet.”

After all, it’s doctors — not radio ads — that know best, right?