June 10-16 is National Men’s Health Week
To some men, testosterone is an athletic performance booster, while
others see it as a “miracle drug” that can improve your sex drive and
make you feel younger. According to experts at the Men’s Health Center at The Miriam Hospital, there are conflicting messages
about testosterone and testosterone treatment, making it tough for men
to separate fact from fiction.
Martin Miner, M.D., co-director of the Men’s Health Center at The Miriam
Hospital, says testosterone is a hormone naturally produced by men that
helps regulate bone density, fat distribution, muscle strength, red
blood cell production, sex drive and sperm production. Testosterone
levels gradually decrease as men age, which can cause symptoms such as
erectile dysfunction, depression, lack of energy and low libido –
symptoms that also mimic the signs of aging.
A 2010 study in the New England Journal of Medicine warned that
only about 2 percent of men older than 40 have clinically defined low
testosterone levels. However, recent research suggests testosterone
replacement therapy prescriptions have tripled among middle-aged men.
Yet how many of them really need it? Miner examines some of the most
common myths about this male hormone.
Myth No.1: Testosterone is only used to improve sexual function or build
When it comes to building muscle, men with normal testosterone levels
who use synthetic testosterone – which has been banned in professional
sports – in hopes of getting a performance boost are putting themselves
at risk for heart disease, stroke, impotence and other dangerous side
effects, Miner says, which is why is it not prescribed for men simply
looking to bulk up.
While it is true that testosterone does improve sexual function, it can
also improve a man’s overall metabolic health. “Testosterone levels are
connected to a man’s waist circumference, so basically the lower the
testosterone level, the larger his waist circumference and belly fat –
and the higher his blood sugar and blood pressure become. This can all
lead to metabolic syndrome, or pre-diabetes,” says Miner. Left
untreated, metabolic syndrome not only increases the risk for heart
attacks and strokes, but it can also lead to type 2 diabetes.
However, several studies have shown that treating low testosterone with
hormone replacement therapy – combined with diet and exercise changes –
reduces overall fat mass and improves both lean body mass and bone
strength, potentially reduces the risk of heart attack and stroke and
thwarts the development of type 2 diabetes.
“These are some of the non-sexual reasons that we are giving
testosterone therapy, although we do not simply prescribe testosterone
for these reasons alone,” says Miner. “We prescribe it to men with
documented low testosterone and signs and symptoms of testosterone
deficiency. However, we do incorporate these novel findings into our
Myth No. 2: Testosterone causes prostate cancer.
Miner says this is false … mostly. While prostate cancer is still listed
in the product insert for testosterone replacement treatment as a
possible risk, it is based on single study in the 1940s with only three
men. This long-standing fear about testosterone and prostate cancer held
up for decades, but Miner stresses that it is without any scientific
support and there is no evidence to date that testosterone therapy
causes or stimulates the growth of new or pre-existing cancers in the
The caveat, however, is men with metastatic prostate cancer, or cancer
that has spread outside the prostate gland. Miner says in these cases,
testosterone therapy should not be given, as it might increase the risk
that residual cancer will again start to grow.
Myth No. 3: You don’t really need a doctor’s prescription; it’s safe to
purchase testosterone replacement products on the Internet, at specialty
clinics or over-the-counter at health and nutrition stores.
Turn on late night television, and you’ll be bombarded with ads for
testosterone-like products that claim to enhance sexual potency, desire
and penile size. However, Miner says none of these have been found to
work. In addition, “vitality centers” and testosterone therapy clinics
have been springing up around the country, catering to men who are
looking to feel younger, get buff or boost their sexual desire.
Miner says these sources of testosterone can be potentially dangerous
for several reasons. Some of the physicians dispensing treatment are not
trained in hormone therapy and may miss underlying problems. Also, extra
testosterone can cause blood clots and harmful thickening of the blood
that could lead to a condition known as thrombocytosis, which is a
potential cause of heart attacks, stroke and peripheral vascular
disease. Testosterone abuse can also increase the risk of prolonged
testosterone deficiency, breast enlargement in men and infertility.
“Most importantly, the only men who should be treated with testosterone
replacement therapy are those who have had a full exam by their doctor,
discussed any symptoms they may be experiencing that could indicate low
testosterone and have had that diagnosis confirmed with a blood test,”