Is There Any Real Danger in Having Low Testosterone?

Man shaving in modern bathroomMen frequently tell me about the vagaries and humiliation of “having low T” (low testosterone). And I recently saw an advertisement that read “Does Your Fella Have Low T?” But here’s the thing: any guy you know over 40 is practically guaranteed to qualify for a diagnosis of low testosterone.

No matter what age you are, wouldn’t you answer yes to online self assessment test questions like “Do you have less energy than you did five years ago?” or “Do you ever get headaches?” A frightened person in one of my therapy sessions told me about these questions recently; both she and her husband “failed” the test, which targeted “symptoms” like fatigue and reduced libido. “The only difference is that his body hair is reducing,” she wailed, “and mine is increasing!”

In the late 1990s many, if not most, of my female friends (boomers all) began taking HRT (hormone replacement therapy) as we entered menopause, confident that this miracle drug would prevent wrinkles, dementia, and heart attacks. Those of us who declined the miracle drug were vindicated when the Women’s Health Initiative found that HRT increased the risk of heart attacks and dementia. (Who knows about the wrinkles?!) Sales of HRT plummeted.

Now Big Pharma is targeting men, women who worry about them, and docs who can prescribe testosterone. And they’re using people’s fear to make sales. The primary fear is, you guessed it, SEX—or lack of sex.

AbbVie (doesn’t that make you think about building six-pack abs?), which sells the popular “Androgel” testosterone gel for guys, sponsors a website called Drive for Five (driveforfive.com).

No, it’s not about golf. They declare that there are five major risks to male health: high cholesterol, high blood pressure, high blood sugar, high prostate-specific antigens (PSA) levels, and—you guessed it—low testosterone levels. I think it’s outrageous to imply that T level is as crucial, or life threatening, as possible hypertension or diabetes!

Their testosterone page lists “reduced sex drive” and “sexual dysfunction” as being so-called risks of low T. It encourages worried men to “talk to your doctor about your symptoms. Ask if you should be tested for Low T.” This advice presumes that a “normal” level of testosterone exists. It doesn’t. T levels peak for men in their 20s and then decline gradually.

After age 40 levels decline by between 1% and 2% per year. An experienced urologist once told me that football fans have higher testosterone levels on Super Bowl Sunday than on other days! None of the literature that I’ve looked at finds a consistent relationship between symptoms like low libido and testosterone levels.

I was willing, however, to support male clients trying T products in attempts to perk up their sex life, until I read an article by Charlea T. Massion, MD and Adriane Fugh-Berman, MD in the September/October newsletter “The Women’s Health Activist.” They cite a meta-analysis of 27 trials consisting of 2,994 men, which identifies cardiovascular-related events, including 180 heart attacks, among men using T.

“Testosterone therapy,” they wrote, “significantly increased the risk of cardiovascular events; the risk identified varied depending on whether or not testosterone manufacturers funded the study.” Ouch!

We live in a culture that idolizes youth and fears aging. So Big Pharma capitalizes and portrays Low-T as a disease for men the same way that menopause has been dubbed a female disease. So I’m passing on medical wisdom from Massion and Fugh-Berman that should resonate for all of us:

“Don’t believe industry-funded research, and don’t let the men in your life take a dangerous hormone on the basis of hype and hope.” Sadly, I fear, this hope is based on hype.

© Copyright 2014 GoodTherapy.org. All rights reserved. Permission to publish granted by Jill Denton, LMFT, CSAT, CCS, therapist in Los Osos, California

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • ronald p

    ronald p

    May 5th, 2014 at 4:24 PM

    I take testosterone shots and my doctors have not said one thing to me about these risks and as a matter of fact made it sound like life would be a whole lot worse if I DIDN’T take the monthly or weekly shots. So what’s up with that? Are they that uneducated or am I? And should I talk to them about stopping because this is something that they have prescribed for me for a long time now, and I guess for as long as I live.

  • Carla

    Carla

    May 6th, 2014 at 3:25 AM

    Are you saying that the levels of this hormone being “off” really isn’t that dangerous for men? I thought that it had to be that all hormones had to be in balance and a man’s testosterone levels being off would be the equivalent of a woman having estrogen issues. Not true? Then where did all of thishyp e come from if that isn’t the case, because if it is all about generating more profit for those who already have more than enough then that kind of information makes me a little bit sick.

  • saul

    saul

    May 6th, 2014 at 3:46 PM

    Looks like the only thing that will suffer from the truth finally being told about the relative non dangers of low T will be to the doctors’ bank accounts who have been treating this like it was the answer to any problem that a male patient might have. There are men out there who are convinced that this could be the answer for anything that ails them, all associated in their mind with low T that some doctor somewhere along the way has convinced them is worng with them. And so what happens? They continue to have to see this guy year after year for treatment that probably has no real upside for them at all unless they just enjoy spending money on medical things that do nothing for them. Glad that someone finally has the courage to stand up and finally say the truth, and here’s hoping that a lot mre men read about this and learn that someone has been pulling one over on them for a while now.

  • Garrett

    Garrett

    May 7th, 2014 at 3:26 AM

    I think that I will play a little of the devil’s advocate here. When I went to my doctor with all sorts of vague health issues, he tested my levels and found out I was low and started treating me for that. Within just a few days I was back to my old self so I have a lot of faith that this can actually work for some guys out there. maybe it isn’t the answer for all or maybe it is and the dosages and method of delivery haven’t been right on an individual basis but to say that it should be stopped or that it has no real benefit is absurd. I am speaking from experience, I can very much tell the difference in me before I started getting treated and now… there is a huge difference that is undeniable.

  • henry

    henry

    May 8th, 2014 at 1:33 PM

    This might be a good time to consult your medical doctor if you have any worries or doubts about what having a low level of testosterone can mean for you. There may be those men wwho do just fine with a lower than normal level while there could be others who really struggle with those deficiencies. I don’t think that this is something that I would skin over and if you do have some concerns then talk to a medical professional, maybe even two to help decide what looks like it would be the best treatment or not for you. There is a whole lot of conflicting information out there and sometimes it can be really hard to makes any kind of sense out of it without frist having this conversation with someone who is knowledgeable and whom you can trust to give you the truth as they know it.

  • tommy

    tommy

    May 9th, 2014 at 3:45 AM

    So I take it this is an argument with firm beliefs on both sides of the argument So how do I know what the best choice for me would be?
    Obviously some of the health issues that you mention would be a concern but I don’t want to lose my drive and passion just because of something that could be easily fixed.

  • Nona

    Nona

    May 10th, 2014 at 2:49 PM

    Now there are even tv comemrcials advertising some sort of gel for me with this problem. I have a really hard time knowing what to believe anymore when there is always just a ton of conflicting information being thrown out there

  • Gretchen

    Gretchen

    May 12th, 2014 at 3:56 AM

    I understand that we are saying this right now and that there are many who think that low t is no big deal, or at least not as big of a deal as it may have been made out to be recently.
    But then what happens when these men go untreated and then in a few years someone comes up and says that it IS a big deal and these men now have serious health problems as a result of letting this go untreated or unmanaged?
    I understand that medicine and science are ever evolving and changing but it seems to me that even doing something minimal like getting your hormone levels in check seems like more of a healthy and sound thing to do instead of just letting it go around unbalanced.

  • Jill Denton

    Jill Denton

    May 13th, 2014 at 1:55 PM

    Sounds like this blog is creating some controversy! Now that all of us are living longer and longer we’re grappling with issues that didn’t crop up when average life span was 48! I wanted to share this information primarily because the side effects that are beginning to become apparent are serious – and life threatening – in themselves. I’m not a medical doctor, simply a therapist who gets to talk to lots of people about what’s going on for them re.sex…caveat emptor!

  • Norm M.

    Norm M.

    August 15th, 2014 at 12:47 PM

    I’m in the uneviable position of having a GP who is a cold fish, and doesn’t take any of my symptoms all that seriously. The only time he knows how to response is when something turns blue or falls off. Going to him for ED or low-T doesn’t seem to involve any true testing. The tendency is to either find some other reason for my problems that he can’t prove (like saying my heart attack was genetic… complete baloney) or he fluffs it off as if most of it is in my head.

    Even the old “call your doctor” phrase is so out of touch with the realities of medical practise today. It typically takes me well over a month to see my G.P., and by the time I see him, my symptoms have either gotten worse or better and I’ve either seen a doc at a clinic or have had five other problems since then. It’s easy to just say “find another doctor”, but it’s not that easy here in Canada. There is also no clear reporting system to identify doctors who are useless at their jobs. They don’t get paid for results, nor to they pay for their failures. They are padded from the “real world”. Men suffer in silence, while women’s issues get all the attention. I know I’m getting sick of it. Men are demonized for wanting sex, for not wanting sex enough, and for not behaving as women and society want them to. A lot of sex problems are being dumped on men when often it’s the wife or girlfriend that set men up for failure. Women tend to get their information from popular trash rags like Cosmo and Redbook. They perpetuate the myths and lies about relationships and sex much to the detrimental of themselves and their male counterparts.

    So few articles are written to women by men, so the information is skewed in their favour. Cosmopolitan has NEVER written an article that honestly tells them what men want. Having to boost my t-levels wouldn’t have been needed if my wife hadn’t continuously tried to stall my engine. Having fantasies of any kind that didn’t fit her mold helped poison what little hope I had of sex and intimacy with her. Thanks dear. So throw another damaged man on the crap heap. Medical science has no means of fixin’ this problem with a pill or a shot.

  • Greg

    Greg

    March 23rd, 2016 at 11:11 AM

    So I have a question. My testosterone level is 55 ng/dL. I have tried shots and hate the ups and down, as well as the cost. I also tried the gel and feel nothing. SO should I just take testosterone because i am told i should or not. Give a little background is I am 24 years old with XXY Syndrome.

    Thank you

  • Joe

    Joe

    April 22nd, 2016 at 8:04 PM

    Greg,
    What are your T levels on the gel? Have you tried testosterone patches? They might absorb better through the skin than the gel. I also have low T from a genetic condition and had the same problems you mentioned with shots and gels. The patches work better for me than the gel did.

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