Testosterone: Fear-mongering by pharma and doctors

Here's the lede from a story in the Washington Post about prescribing testosterone to men:

In case you haven’t noticed, advertisements aimed at treating low levels of testosterone, or “low T,” have displaced those erectile dysfunction commercials with side-by-side bathtubs. The ads ask: Are you suffering from any of the following — depression, low energy, weight gain, fatigue, low sex drive?

If ever there were a case of medicalizing aging, this is it. Didn't we learn from the estrogen debacle? This is sheer predatory activity by pharma and doctors capitalizing on men's worst fear.

“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 . . . products . . . 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. 

I'll offer this unscientific prediction: Fifteen years from now we will wonder why the incidence of prostate cancer is mysteriously increasing.

“For a drug, testosterone’s relatively safe,” John Morley [an endocrinologist at St. Louis University School of Medicine] says. “But no studies go longer than three years. What happens if you take it for 20 years?” If large numbers of men begin taking testosterone in their 40s to combat normal aging, he says, “are we going to see similar problems in aging populations that we saw in the Women’s Health Initiative with estrogen [replacement therapy,]” which turned up small but significant increases in cardiovascular and cancer risks? “Probably so.”

I hope but do not expect that men among my generation of baby boomers will pay attention to this advice from Dr. Braunstein:

“If you don’t need it, don’t take it,” he advises. “There’s absolutely no evidence that these treatments decrease aging. Ponce de Leon never found the fountain of youth, and the baby boomers won’t, either.”