Testosterone, a key hormone in both men and women, fluctuates naturally throughout life. In men, levels tend to peak in the morning and gradually decline with age, particularly after the age of 40, when production drops by approximately 1 to 2 percent annually. This decrease can result in symptoms like fatigue, decreased libido, muscle loss, erectile dysfunction, and difficulty concentrating. For some, testosterone supplementation—via injections, patches, gels, or pills—has become a solution.
Dr. Thomas Zaciewski, a urologist with Mercy Health, observes that many of his male patients seek testosterone therapy due to fatigue and low sex drive, alongside challenges like reduced muscle mass despite exercise and concentration difficulties. Men with diabetes or obesity may also experience low testosterone levels.
The use of testosterone supplements has surged among both genders in recent years. According to a study published in JAMA Internal Medicine, prescriptions for testosterone therapy among men aged 40 and older tripled between 2001 and 2011. This upward trend continued, with a 50 percent increase in prescriptions between 2013 and 2023, as reported by health data company IQVIA.
While low testosterone, or “low T,” has traditionally been a concern for aging men, the growing use of testosterone is also seen in women, particularly those in their 40s and 50s. Dr. Tim Schuster, a urologist with ProMedica, notes that both men and women have measurable levels of testosterone in their bodies, though women typically have lower levels.
Concerns regarding the safety of testosterone therapy, especially its potential links to cardiovascular events, have been raised in the past. However, recent studies have largely dispelled these fears. Dr. Shalender Bhasin, a co-principal investigator of the TRAVERSE Study, which involved over 5,000 men with low testosterone, confirms that while testosterone therapy can benefit those with hypogonadism, it is not recommended for individuals without this condition, nor for those misusing the hormone in high doses.
Despite the growing popularity of testosterone treatment, experts caution against self-medicating, particularly with so-called “natural” testosterone boosters. Dr. Steven Nissen of the Cleveland Clinic warns that these products, often marketed without clinical oversight, can be risky. Excessive testosterone intake can also lead to side effects like aggressive behavior, thickened blood, and prostate enlargement.
Testosterone therapy is particularly complex for men seeking to father children. Testosterone replacement can disrupt the balance of hormone production in the testicles, potentially leading to decreased fertility. Additionally, excessive testosterone can thicken the blood, posing further health risks.
For women, the effects of testosterone supplementation are even more nuanced. While it may help build bone density, unwanted side effects, such as the growth of facial hair, can occur. Although the FDA has not approved testosterone for use in women, it is increasingly prescribed off-label for menopausal and post-menopausal symptoms.
As the market for testosterone continues to expand, medical professionals urge caution and emphasize the importance of consulting a doctor before pursuing treatment.
