Should you be taking testosterone?

Testosterone, a hormone associated with masculinity, is present in both men and women. It is primarily produced in men by Leydig cells in the testicles, with a small amount also produced by the adrenal glands. Testosterone plays a role in various functions such as growth of hair, muscles and male genitalia, sperm production, and driving libido. It is also present in women but at much lower levels, contributing to bone health, fertility, sex drive and menstrual health.

Despite its popularity among the bodybuilding community and claims for health benefits like enhanced looks and energy, the scientific evidence supporting these claims is unclear. While testosterone replacement therapy (TRT) can effectively treat testosterone deficiency, it comes with potential risks including decline in fertility, acne, and increased risk of heart disease, depression, and bone fractures.

In adults, testosterone levels can be affected by several diseases such as testicular cancer, hypothalamic disease, and pituitary disease. Damage to the testicles, conditions like HIV/AIDS, mumps infection, and obesity can also influence testosterone levels. Adult men typically experience a decrease in blood testosterone levels over time, which may lead to symptoms like decreased energy, lower sexual interest, reduced muscle mass and bone density, and lower red blood cell production.

In the past, TRT was primarily approved by the FDA for men with low testosterone associated with a medical condition. However, studies like the TTrials and TRAVERSE trial have shown benefits such as increased sexual activity, mood improvement, and bone density increase, but also potential risks like increased arterial plaque, prostate cancer, and bone fractures. As a result, the FDA has been reviewing the use of testosterone for broader applications.