Do you really have low testosterone? Probably not, doctor says

Low libido doesn't always equate to low testosterone. Credit: ColourBox
Low libido doesn’t always equate to low testosterone.
Credit: ColourBox

There’s good news for men who are worried about having low testosterone, or “Low T.” According to Dr. Michael O’Leary, an associate professor at Harvard Medical School, who specializes in urologic surgery and male infertility, much of the hoopla is product marketing and not an indication of a major epidemic.

“The direct-to-consumer marketing makes men ask themselves if they have it and they probably don’t,” says Dr. O’Leary. “Those ads are nauseating. It’s a real condition for some men, but it is rare, especially for younger men.”

Testosterone is a hormone necessary for normal male development that’s produced in the testicles, and, Dr. O’Leary says, “even men with only one testicle produce enough to be healthy.”

At around age 40, testosterone production decreases as part of the natural aging process and most men have nothing to worry about. The medical community at large now calls the drop Testosterone Deficiency Syndrome (TDS). It’s associated with decreased sex drive, fatigue, mood changes, insomnia, erectile dysfunction, decreased muscle mass and loss of hair, but in some cases, may present no noticeable symptoms. However, Dr. O’Leary is skeptical.

“Those symptoms could be anything and if there are no symptoms then it’s likely there isn’t a problem,” says Dr. O’Leary. “In men who really do have low testosterone, it is a serious cause for concern.”

Low testosterone treatment is via skin gels and injections that introduce more of the hormone into the body. According to the New York Times, such prescription skin gels made more than $2 billion in sales in the U.S. last year, and they’re expected to earn over $4 billion by 2017. However, there are dangers.

“Supplementing testosterone in young men can cause infertility,” Dr. O’Leary says. “I am extremely hesitant to treat young men with testosterone and risk decreasing their fertility. Generally, I treat it with a fertility drug that’s largely used for women. It stimulates the leydig cells, which produce testosterone.”

“Testosterone is an important hormone for health,” Dr. O’Leary adds. “But it’s not a panacea and should be used very cautiously.”

The makers of two testosterone gels, Axiron and AndroGel, remained confident in their mission when they spoke with the New York Times earlier this month.

Don’t just assume

“Men shouldn’t jump to the conclusion that because they feel tired or have a low libido that they have low testosterone,” says Dr. O’Leary. “People are working long hours and have stressful lives. Certainly, obesity doesn’t help — that much we do know. Men who eat a fatty diet have more estrogen, which lowers testosterone. We don’t know if a healthy diet prevents low testosterone, but a healthy lifestyle will make it less likely to occur.”



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