Should the Modern Man Be Taking Testosterone?

By now you've likely seen the commercials. Fit-looking middle-age men telling you how they put on weight, had less energy, and were no longer the sexual tigers they were in their twenties—until, that is, they started rubbing testosterone gel on their shoulder, upper arm, or abdomen.

Now they feel more like the men they used to be.

The commercials don't mention a 2009 study in the New England Journal of Medicine wherein a group of men on testosterone replacement therapy had more than four times the number of cardiovascular problems—so many that the study had to be halted.

They also don't make clear how risky exposure to testosterone gel is for others—female partners, children, even pets. The gel is actually notorious for transferring to others. It can cause excess hair to grow on women's faces and arms, deepen their voices, interrupt menstruation, and make them anxious and irritable. In children, exposure to testosterone gels and creams can cause premature puberty and aggression. And in pets, it can cause aggressive behavior and enlargement of the genitalia.

Commercials do mention other potential side-effects for the male user, calling them "rare," including swollen and painful breasts, blood clots in the legs, increased risk for prostate cancer, problems breathing during sleep (sleep apnea), change in the size and shape of the testicles, and a low sperm count. But you're not supposed to focus on the details. Instead, just think of the energy you'll have. The great sex you'll have. And the muscles. It will be a veritable second adolescence as your aging body bursts into new bloom.

Don't get me wrong. The medical experts interviewed for this article emphasized that low testosterone—also known as hypogonadism or hypotestosteronemia—is real for a slim percentage of men. They hastened to add, however, that a normal "T" level for one man may be low for another.